Washington D.C. Medicare Supplement Plans: What You Need to Know
Washington D.C. may be small in size, but it offers Medicare beneficiaries access to some of the finest healthcare facilities in the nation. With approximately 90,000 Medicare beneficiaries in the District, choosing the right Medicare Supplement (Medigap) plan is essential to maximize your access to these world-class medical resources.
Unlike Medicare Advantage plans that vary by location, Medigap plans in Washington D.C. are standardized by letter (A, B, C, D, F, G, K, L, M, N). This means a Plan G from one company covers exactly the same benefits as a Plan G from another company. The only differences are the premium you pay and the company's customer service.
D.C.'s Medigap Open Enrollment Period
In Washington D.C., your Medigap Open Enrollment Period begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. This 6-month window is critical because:
- Insurance companies cannot deny you coverage for any reason
- They cannot charge you more due to health conditions
- You have guaranteed issue rights to any Medigap plan sold in D.C.
D.C.-Specific Protection
Washington D.C. provides important consumer protections for Medigap policyholders. If you're replacing an existing Medigap policy with another, you have a 30-day "free look" period during which you can cancel the new policy for a full refund. D.C. follows standard federal Medigap regulations.
Most Popular Medigap Plans in Washington D.C.
While 10 standardized Medigap plans are available in D.C., the most popular choices are:
| Plan | Coverage Level | Best For | D.C. Monthly Premium* |
|---|---|---|---|
| Plan G | Comprehensive | Most new enrollees (best value) | $150 - $280 |
| Plan N | High with copays | Those wanting lower premiums | $120 - $220 |
| Plan F | Most comprehensive | Those eligible before 2020 | $180 - $320 |
*Premium ranges are estimates and vary by age, gender, and tobacco use. Contact us for personalized quotes.
Plan G vs Plan N in Washington D.C.
For most D.C. residents new to Medicare, the choice comes down to Plan G or Plan N:
- Plan G covers everything except the Part B deductible ($240 in 2024). No copays, no surprises. Ideal if you want predictable costs and visit doctors frequently.
- Plan N has lower premiums but requires up to $20 copays for office visits and up to $50 for ER visits (waived if admitted). Good choice if you're healthy and want to save on monthly costs.
Washington D.C. Medicare Supplement vs Medicare Advantage
D.C. has a competitive Medicare Advantage market, but these are very different products. Here's how they compare:
| Feature | Medigap (Supplement) | Medicare Advantage |
|---|---|---|
| Monthly Premium | $120 - $320+ | $0 - $50 (some higher) |
| Out-of-Pocket Maximum | Very low (predictable) | Up to $8,850/year |
| Doctor Network | Any doctor accepting Medicare | Network restrictions |
| Referrals Needed | No | Often yes (HMO plans) |
| Prescription Drug Coverage | Separate Part D plan needed | Usually included |
| Extra Benefits | None | May include dental, vision, gym |
Read our complete Medigap vs Medicare Advantage guide to understand which option might be better for your situation.
Washington D.C.-Specific Medicare Considerations
World-Class Healthcare Access
Washington D.C. is home to some of the nation's most prestigious medical institutions. With Medigap, you have access to any doctor or hospital that accepts Medicare, including these renowned facilities without network restrictions.
Major Healthcare Facilities in D.C.
D.C.'s major healthcare facilities include:
- MedStar Georgetown University Hospital - Academic medical center with specialized care
- MedStar Washington Hospital Center - One of the largest hospitals in the region
- George Washington University Hospital - Teaching hospital in Foggy Bottom
- Howard University Hospital - Historic academic medical center
- Sibley Memorial Hospital - Part of Johns Hopkins Medicine
- Children's National Medical Center - Top pediatric hospital (for grandchildren visits)
Federal Employee Considerations
Many D.C. residents are current or former federal employees with FEHB (Federal Employees Health Benefits) coverage. If you're transitioning from FEHB to Medicare, understanding how Medigap works alongside or instead of FEHB is crucial. A fee-only Medicare advisor can help you evaluate your specific situation.
Cross-Border Healthcare
D.C. residents frequently access healthcare in Maryland and Virginia. Medigap provides seamless nationwide coverage, so you can see specialists at Johns Hopkins in Baltimore, Virginia Hospital Center in Arlington, or any other facility without worrying about network restrictions.
Urban Living Advantages
Living in D.C. means healthcare is generally nearby and accessible. However, Medigap still offers advantages: no referrals needed for specialists, no prior authorization hassles, and predictable costs regardless of which D.C.-area provider you choose.
D.C. SHIP Program
Washington D.C. offers a free counseling program called SHIP (State Health Insurance Assistance Program) through the D.C. Office on Aging. While SHIP counselors can provide general Medicare information, they cannot recommend specific plans or companies. That's where a fee-only Medicare advisor adds value: we can make specific recommendations based on your individual situation.
Frequently Asked Questions: Washington D.C. Medicare
The best time is during your 6-month Medigap Open Enrollment Period, which starts the month you turn 65 and are enrolled in Part B. During this time, you have guaranteed issue rights and cannot be denied coverage or charged more due to health conditions.
Yes, but you'll need to go through medical underwriting, which means the insurance company can deny you coverage or charge higher premiums based on your health. Some situations trigger "guaranteed issue" rights outside of open enrollment, such as losing employer coverage or your Medicare Advantage plan leaving your area.
Medigap premiums in D.C. typically range from $120-$320+ per month depending on the plan letter, your age, gender, and tobacco use. Plan G generally offers the best value for comprehensive coverage, with premiums typically between $150-$280 per month. D.C. premiums may be slightly higher than national averages due to the urban location.
Plan F is only available to those who became eligible for Medicare before January 1, 2020. If you turned 65 before that date, you can still enroll in Plan F. However, Plan G offers nearly identical coverage (minus the Part B deductible) and often has lower premiums.
Yes. Medigap plans do not include prescription drug coverage. You'll need to enroll in a standalone Medicare Part D plan separately. We can help you compare Part D options based on your specific medications.