Michael Gurr — Licensed Medicare Specialist with Bankers Life
Michael Gurr Medicare Specialist · Bankers Life
📞 (253) 880-6527
Serving Washington State · Licensed Medicare Advisor · Michael Gurr
Local pages: Tacoma Puyallup Olympia Cost Estimator

How Medicare Works in Washington State

Medicare has four parts: A and B (Original Medicare), C (Medicare Advantage), and D (prescription drugs). Most Washington residents combine these in one of two ways — and the right combination depends on your situation.

What are Medicare Parts A, B, C, and D?

Part A covers hospital stays, skilled nursing, hospice, and some home health. Part B covers doctor visits, outpatient care, and preventive services. Part C, also called Medicare Advantage, is an all-in-one private plan that bundles A and B (and usually D). Part D covers prescription drugs.

What does Original Medicare cover?

Original Medicare (Parts A and B) covers most hospital and doctor care across the country. It pays roughly 80% of approved charges. You pay the rest — deductibles, copays, and coinsurance — unless you have a supplement plan filling that gap.

What does Original Medicare NOT cover?

Original Medicare does not cover routine dental, vision exams, hearing aids, or long-term custodial care. It also doesn't cover prescription drugs — that's Part D. Most people add a Medicare Supplement (with a Part D plan) or choose a Medicare Advantage plan to fill these gaps.

How is Medicare different in Washington State?

The federal rules are the same nationwide, but Washington has its own mix of carriers, networks, and Medicare Advantage plans. What's available in Pierce County may differ from King or Thurston County. Provider networks for Advantage plans are local — your doctor in Tacoma may not be in the same network as a clinic in Olympia.

How much does Medicare cost?

In 2026, the standard Part B premium is $202.90/month. Most people pay $0 for Part A because they paid Medicare taxes through work for 10+ years. A Medicare Supplement plan in Washington typically runs $230–$350/month depending on age, plan letter, and carrier. Part D drug plans run about $20–$60/month. Some Medicare Advantage plans in Washington have $0 monthly premiums but may have copays and network rules.

The four parts at a glance

PartWhat it coversWho needs it
Part AHospital stays, skilled nursing, hospiceAlmost everyone — usually $0/month
Part BDoctor visits, outpatient care, preventive servicesMost people enrolling in Medicare
Part CMedicare Advantage — all-in-one plan from a private carrierPeople who want a bundled, network-based plan
Part DPrescription drug coverageAnyone who takes prescriptions or wants to avoid the late penalty

Frequently asked questions

Do I need both Part A and Part B?
Most people enroll in both. Part A is usually free, so almost everyone takes it. Part B has a premium, but it's required for most plan options including Medicare Supplement and Medicare Advantage.
Can I keep my doctor on Medicare in Washington?
Most Washington doctors take Original Medicare. With a Medicare Advantage plan, you'll need to check that your doctor is in the plan's network. We can verify that before you enroll.
What's the difference between Medicare Supplement and Medicare Advantage?
Medicare Supplement (Medigap) pairs with Original Medicare and pays the gaps — broad doctor choice, usually higher monthly premium. Medicare Advantage replaces Original Medicare with one private plan — networks, copays, often $0 premium.
Does Medicare cover prescriptions?
Original Medicare doesn't, but Part D does. You can buy a standalone Part D plan or get drug coverage built into a Medicare Advantage plan. Skipping Part D when eligible can mean a permanent late enrollment penalty.

Want help making sense of it?

As a licensed Medicare advisor serving Washington State, I'll walk you through the four parts and how they fit your life — in plain English.

Book a Free 10–15 Minute Call

No cost. No pressure. Just clarity.