Washington's Medigap birthday rule lets you switch Medicare Supplement plans annually without medical underwriting—unique protection. Maru helps you navigate plans and the birthday rule.
Important Medicare disclaimer: We do not offer every plan available in your area. Please contact Medicare.gov or 1‑800‑MEDICARE to get information on all of your options.
Not connected with or endorsed by the United States government or the federal Medicare program. Maru Insurance is a licensed independent insurance agency. Enrollment in a plan may be limited to certain times of the year.
Medicare Supplement insurance (also called Medigap) pays for costs that Original Medicare doesn't cover—copayments, coinsurance, and deductibles. Medicare Supplement works alongside Original Medicare (not Medicare Advantage). When you have Medigap, you see any provider who accepts Medicare, pay predictable costs, and Medicare handles the billing.
All Medicare Supplement plans are standardized by the federal government (with minor variations by state). Plan A and Plan N are the most popular; Plan G is valuable for those wanting comprehensive coverage. All plans cover the same benefits regardless of insurer—the only difference is price. This means shopping for the lowest-cost carrier is the smart way to buy.
Washington has a unique Medigap birthday rule: each year around your birthday, you have a 30- or 60-day window to switch to any equal or lesser Medicare Supplement plan with the same or lower premium, and the carrier cannot deny coverage or charge for pre-existing conditions. This annual window gives Washington enrollees flexibility that most other states lack. You can use your birthday to upgrade, downgrade, or shop for a cheaper carrier annually.
You can enroll in Medigap during guaranteed-issue windows—the 6 months after you turn 65 and enroll in Medicare Part B. If you miss this window, insurers may use medical underwriting and charge higher premiums based on your health history. However, Washington's birthday rule gives you an additional annual guaranteed-issue opportunity. This makes Washington especially favorable for those who want to switch plans later.
Medicare Advantage is an HMO or PPO alternative (not Medigap); you typically have a lower premium but pay higher copays, use in-network providers, and deal with prior authorization. Medicare Supplement lets you see any Medicare provider with predictable costs. Choose Medicare Supplement if you value provider choice and predictability; choose Medicare Advantage if you want a lower monthly premium and don't mind using a network.
Maru helps you understand the difference between Medicare Supplement and Medicare Advantage, choose the right Medigap plan (A, G, N, etc.) for your health and costs, and explain Washington's unique birthday rule. We shop rates across carriers to find your lowest premium. Because Washington's birthday rule makes switching easier, we guide you on when to use that opportunity to save.
Medigap policies are standardized by the federal government and labeled with letters, so a Plan G from one company covers the same benefits as a Plan G from another — the price and the company's service are what differ. That standardization makes an apples-to-apples comparison possible, which is exactly what an independent agency does for you.
Medicare is built from parts that each do a different job. Understanding what each one does — and what it leaves out — is the first step to choosing coverage that actually fits your life.
| Part | What it covers | Good to know |
|---|---|---|
| Part A — Hospital | Inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. | Most people pay no monthly premium for Part A because they or a spouse paid Medicare taxes long enough while working. |
| Part B — Medical | Doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. | Part B has a monthly premium and an annual deductible, and it typically pays 80% of approved costs, leaving you the other 20% with no cap. |
| Part C — Medicare Advantage | A private-plan alternative that bundles Part A and Part B, and usually Part D, into one plan. | Plans use networks and set an annual out-of-pocket maximum. Extras like dental, vision, or hearing are sometimes included. |
| Part D — Drugs | Prescription-drug coverage, offered as a standalone plan or built into a Medicare Advantage plan. | Each plan has its own list of covered drugs (a formulary). Going without creditable drug coverage can trigger a lifelong penalty. |
| Medigap — Supplement | Private coverage that pays much of what Original Medicare leaves you to pay, like deductibles and coinsurance. | Medigap works only with Original Medicare — not with Medicare Advantage — and does not include drug coverage. |
Timing is one of the most important parts of Medicare. Enrolling in the right window protects you from penalties and gaps — and some windows only come around once. Here are the periods that matter most:
| Window | When | What it's for |
|---|---|---|
| Initial Enrollment Period (IEP) | The 7 months around your 65th birthday — the 3 months before your birthday month, the month itself, and the 3 months after. | Your first chance to sign up for Parts A, B, and D and to buy a Medigap policy with the strongest protections. |
| Medigap Open Enrollment | A one-time 6-month window that starts the month you're 65 and enrolled in Part B. | You can buy any Medigap plan sold in your state with no health questions — a guaranteed right that usually doesn't return. |
| Annual Enrollment Period (AEP) | October 15 – December 7 every year. | Switch Medicare Advantage or Part D plans for the coming year; changes take effect January 1. |
| Medicare Advantage Open Enrollment | January 1 – March 31 every year. | If you're already in a Medicare Advantage plan, make a one-time change or return to Original Medicare. |
| General Enrollment Period | January 1 – March 31 every year. | A fallback to enroll in Part B if you missed your IEP (a late penalty may apply). |
| Special Enrollment Periods (SEPs) | Triggered by life events — losing employer coverage, moving, and more. | Let you make changes outside the standard windows when something qualifying happens. |
Original Medicare is strong, but it has real gaps. Knowing them up front helps you decide what extra coverage — if any — is worth it for you. Original Medicare generally does not cover:
A Medigap policy, a Medicare Advantage plan, or standalone add-ons can each fill different gaps. We help you weigh which gaps are worth covering for your health and budget — without pushing you toward anything you don't need.
Several programs can lower what you pay for Medicare, and many people who qualify never apply. If money is tight, it's worth checking — we can point you in the right direction at no cost:
Whether you work with us or shop on your own, these questions cut through the noise and keep the decision focused on what matters to you:
| Term | What it means |
|---|---|
| Premium | The amount you pay each month to keep a plan, whether or not you use care. |
| Deductible | What you pay out of pocket before your coverage starts paying. |
| Coinsurance / copay | Your share of a cost after the deductible — a percentage (coinsurance) or a flat amount (copay). |
| Formulary | The list of prescription drugs a Part D or Advantage plan covers, organized in tiers. |
| Network | The doctors, hospitals, and pharmacies a plan has contracted with. |
| Out-of-pocket maximum | The most you'll pay in a year under a Medicare Advantage plan before it covers 100%. |
| Guaranteed issue | Your right to buy certain coverage without answering health questions. |
Washington offers a consumer-friendly Medigap "birthday rule": each year around your birthday you get a window to switch to an equal or lesser Medicare Supplement plan without new medical underwriting — a valuable protection few states offer. For free, unbiased counseling, Washington runs the SHIBA program (Statewide Health Insurance Benefits Advisors) through the Office of the Insurance Commissioner. As an independent agency licensed in Washington, we compare the plans available where you live and help you use windows like the birthday rule to your advantage.
Talk to a licensed Maru advisor in Washington or Florida. No pressure, no call-center scripts — just clear options and honest pricing.