What Washington law requires
Federal law doesn't require Medigap (Medicare Supplement) companies to sell policies to people under 65, and states decide whether to add that requirement. Washington's open enrollment law, RCW 48.66.025, protects applicants during the six months that begin with the first month a person is both 65 or older and enrolled in Part B. It doesn't create a similar window for people who get Medicare earlier because of a disability, ALS or end-stage renal disease.
That leaves the decision to each company. Washington's Medigap rules, chapter 284-66 WAC, let a company file a separate policy form for people eligible for Medicare because of a disability, so some companies sell to people under 65 and others don't. Ask each company, or a licensed insurance agent, which ones currently do.
The protections you do have
- Community rating. Under RCW 48.66.045, Medigap rates in Washington can't vary by age or health within a company's standardized plan. A company may keep two rating pools, one for people eligible by age and one for people eligible because of a disability or end-stage renal disease, so the under-65 price can differ from the 65-and-over price.
- Switching once you have a policy. The same law lets anyone who already has Medigap, including people eligible because of a disability or ESRD, replace it with Plan B, D, G, high-deductible G, K, L, M or N without health questions (and C or F if first eligible before 2020). See can I switch Medigap plans in Washington?
- Guaranteed-issue rights. RCW 48.66.055 gives guaranteed issue, regardless of age, when certain coverage ends: for example, your Medicare Advantage plan leaves your area or stops, or an employer or union plan that supplements Medicare ends. You must apply within 63 days, and the plans you can get are limited.
- A fresh start at 65. When you turn 65 and have Part B, the six-month open enrollment period under RCW 48.66.025 applies, and every policy a company sells must be available to you without regard to your health.
- Suspension while you work. If you have Medigap because of a disability and later get coverage through an employer group health plan, you can ask to suspend the policy and restart it within 90 days of losing that coverage.
Other options under 65
If you can't find a Medigap policy you can afford, Medicare Advantage plans accept people under 65 with Medicare, including people with end-stage renal disease, during the usual enrollment periods. If your income is limited, a Medicare Savings Program through Apple Health can pay your Part B premium and, with QMB, your Medicare cost sharing; Washington has no asset test for these programs. Working people with disabilities may also look at Apple Health for Workers with Disabilities. See Medicare under 65 with a disability and the savings programs screener.
Get help
A licensed insurance agent with Benefits Life can check which companies they work with sell Medigap to people under 65 in your county and compare other options, at no cost to you: (206) SENIORS (206-736-4677), TTY 711. For a complaint about an insurance company, contact the Office of the Insurance Commissioner at insurance.wa.gov.
Related questions
Can I switch Medigap plans in Washington?
Washington's year-round replacement right.
Does Apple Health pay Medicare premiums?
Medicare Savings Programs in Washington.
When does Medicare start?
Start dates at 65 and after disability benefits.
Sources
- RCW 48.66.025 — Restrictions on issuers; age of applicants (Medigap open enrollment at 65)
- RCW 48.66.045 — Replacement policies; community rating and rating pools
- RCW 48.66.055 — Guaranteed issue periods
- Chapter 284-66 WAC — Medicare supplement insurance (policy forms for people eligible by disability; suspension notice)
- Medicare.gov — When can I buy Medigap?
- Washington State Health Care Authority — Medicare Savings Program
Frequently asked questions
Do Medigap companies have to sell to me if I'm under 65 in Washington?
Not in general. Washington's Medigap open enrollment law, RCW 48.66.025, applies to people who are 65 or older and enrolled in Part B. Companies may choose to offer policies to people under 65, and Washington rules let them file separate policy forms for people eligible because of a disability.
Will I pay more because I'm under 65?
Possibly. Washington requires community rating, so a company can't vary your premium by age or health, but it may use a separate rating pool for people who are eligible for Medicare because of a disability or end-stage renal disease. Compare the rates of the companies that sell to people under 65.
Do I get another chance at 65?
Yes. When you turn 65 and have Part B, you get a six-month Medigap open enrollment period. During it, a company can't deny you or charge more because of your health, even if you already had a policy or were turned down before.
Are there times a company must sell to me under 65?
Yes, in the guaranteed-issue situations in RCW 48.66.055, such as when a Medicare Advantage plan leaves your area or retiree coverage that supplements Medicare ends. Those rights don't depend on age, but they cover only certain plans and you must apply within 63 days of losing the coverage.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
