What Are the Different Parts of Medicare (A, B, C, D) in Washington?

Kevin Husted, Washington Medicare Broker — Advisor Health Benefits Group

Turning 65 in Washington or newly eligible for Medicare? You’ve probably heard about Medicare’s “alphabet soup” — Parts A, B, C, and D. Each part covers different aspects of healthcare, and understanding how they work together can save you money and help you choose the right coverage.

In this guide, I’ll explain what each part does, how they apply to Washington residents, and what choices you have when combining them. As a local broker, I help Washingtonians navigate Medicare every day — and my goal here is to make it easy and practical for you.


The Four Parts of Washington Medicare - Advisor Health Benefits Group

Understanding the Four Parts of Medicare

Medicare is divided into four main components:

  • Part A – Hospital insurance
  • Part B – Medical insurance
  • Part C – Medicare Advantage (private plans)
  • Part D – Prescription drug coverage

Each part plays a role in protecting your health and finances. Let’s look at each in detail.


Medicare Part A – Hospital Insurance

What Part A Covers

Medicare Part A helps pay for:

  • Inpatient hospital care
  • Skilled nursing facility care (after a qualifying hospital stay)
  • Hospice services
  • Limited home health care

You can think of it as coverage for care when you’re admitted to a facility — hospitals, rehab centers, or hospice programs.

Costs and Eligibility in Washington

If you or your spouse paid Medicare taxes for at least 10 years, you’ll likely get Part A with no monthly premium.
However, you’ll still have:

  • A deductible each time you’re admitted to the hospital
  • Coinsurance if your stay extends beyond 60 days

These amounts are federally set but apply equally in Washington.

Why Part A Matters

Part A is the foundation of your Medicare coverage. You need it to access inpatient hospital care and to qualify for other coverage types, like Medicare Advantage (Part C).

For most Washington residents, enrollment in Part A happens automatically when they sign up for Medicare — but it’s always worth verifying with the Social Security Administration.


Medicare Part B – Medical Insurance

What Part B Covers

Part B pays for:

  • Doctor visits and outpatient care
  • Preventive screenings and vaccines
  • Lab tests, X-rays, and imaging
  • Durable medical equipment
  • Some home health services

Basically, if Part A covers you inside the hospital, Part B covers you outside it.

Part B Costs and Enrollment

Unlike Part A, Part B always has a monthly premium.
For most people in 2025, that premium is about $174.70 per month, although higher-income individuals may pay more.

You’ll also have:

  • A small annual deductible
  • 20% coinsurance for most covered services after meeting the deductible

If you delay enrolling in Part B without other creditable coverage, you could face a permanent late-enrollment penalty.

Why Washington Residents Should Pay Attention

If you’re still working and have employer coverage, you may be able to delay Part B without penalty — but this depends on your employer size and plan type. Advisor Health Benefits Group can help you review your options.


Medicare Part C – Medicare Advantage Plans

What Part C Is

Medicare Advantage, also known as Part C, is a private insurance option that replaces Original Medicare (Parts A and B) with a single, all-in-one plan. These plans must cover everything Original Medicare does — and often much more.

When you enroll in a Medicare Advantage plan, you still have Medicare, but your benefits come through the private plan instead of directly from the federal government.

What’s Included

Most Medicare Advantage plans in Washington include:

  • All Part A and Part B benefits
  • Prescription drug coverage (Part D)
  • Additional perks like dental, vision, hearing, fitness programs, telehealth, and transportation

Costs and Coverage in Washington

Many Washington counties offer $0-premium Medicare Advantage plans (you still pay your Part B premium).
Plans set their own:

  • Copays and coinsurance
  • Provider networks
  • Out-of-pocket maximums (protecting you from unlimited costs)

That out-of-pocket cap is one of the biggest advantages of Part C — once you reach the yearly limit, your plan pays 100% of covered costs.

Why Washington Residents Choose Part C

Medicare Advantage plans can simplify your coverage. Instead of juggling multiple policies, you have:

  • One card
  • One network
  • One monthly premium (sometimes $0)

If your preferred doctors and hospitals are in-network, it’s often an affordable, convenient way to manage healthcare.

Important Washington Tip

Plan availability and networks depend on your ZIP code. Some rural counties have fewer plan options than metro areas like Seattle or Spokane. Check our resource:
👉 Washington Medicare Plan Options 2026


Medicare Part D – Prescription Drug Coverage

What Part D Covers

Medicare Part D provides coverage for prescription medications. Plans are offered by private insurance companies approved by Medicare.

Each plan has a formulary — a list of covered drugs grouped into tiers that determine what you pay.

Costs and Enrollment

Part D premiums vary widely in Washington, from about $0 to $60+ per month depending on the carrier and coverage. You’ll also pay:

  • A deductible (some plans waive this)
  • Copays or coinsurance at the pharmacy

If you go without drug coverage for 63 days or more, you may owe a late-enrollment penalty when you finally sign up.

How It Works in Washington

If you’re enrolled in Original Medicare (Parts A and B), you’ll need a standalone Part D plan.
If you have Medicare Advantage (Part C), most plans already include Part D coverage — called an MAPD plan.

Washington residents can also qualify for Extra Help (a federal subsidy) that reduces Part D premiums and copays for lower-income beneficiaries.


How Medicare Parts Work Together in Washington

Two Main Coverage Paths

  1. Original Medicare Path
    • Includes Parts A + B
    • You can add a standalone Part D plan for prescriptions
    • Optionally add a Medigap (Supplement) plan for cost protection
    • Freedom to see any U.S. provider who accepts Medicare
  2. This path offers the most flexibility but may involve higher premiums and more policies to manage.
  3. Medicare Advantage Path
    • Includes Part C, which bundles A, B, and usually D
    • Provides extra benefits (dental, vision, etc.)
    • Typically uses a local provider network (HMO or PPO)
    • Has an annual out-of-pocket maximum
  4. This path offers convenience and predictable costs, but less flexibility for traveling or out-of-state care.

Comparing the Four Parts at a Glance

Medicare PartCoverage TypeWho Provides ItTypical CostKey Feature
Part AHospital insuranceFederal MedicareUsually $0Covers inpatient care
Part BMedical insuranceFederal MedicareMonthly premium (~$174.70)Covers outpatient & doctor services
Part CMedicare AdvantagePrivate insurersVaries; often $0Combines A, B, D & extras
Part DPrescription drugsPrivate insurers$0–$60+Covers medication costs

Enrollment Windows to Know

  • Initial Enrollment Period (IEP):
    Your 7-month window around your 65th birthday.
  • Annual Enrollment Period (AEP):
    October 15 – December 7 each year. Switch between Original Medicare, Advantage, or change drug plans.
  • Medicare Advantage Open Enrollment (MA OEP):
    January 1 – March 31. Switch to another Advantage plan or return to Original Medicare.
  • Special Enrollment Periods (SEPs):
    Triggered by moving, losing employer coverage, or other qualifying events.

Missing these windows could mean penalties or waiting until the next period to make changes.


Common Questions About Medicare Parts A, B, C, and D in Washington

Do I need all four parts?

Not necessarily. You need Parts A and B for full Medicare coverage. From there, you decide whether to add Part D and/or switch to a Part C plan depending on your needs.

Can I have Medicare Advantage and Medigap together?

No. You can have one or the other — Medigap only works with Original Medicare, not with Medicare Advantage.

What happens if I move within Washington?

If you move counties, your Advantage or Part D options might change. You’ll usually get a Special Enrollment Period to switch plans.

Are prescription costs the same statewide?

No. Washington plans vary by ZIP code and pharmacy network. Always check your specific medications before enrolling.

How do I get help choosing?

You don’t have to figure out Medicare alone. You can contact Advisor Health Benefits Group for personalized, one-on-one guidance from a licensed Washington Medicare broker. We’ll help you compare plan options in your ZIP code, review costs and benefits, and make sure your doctors and prescriptions are covered.

➡️ Contact Advisor Health Benefits Group today to schedule a free consultation and get expert help choosing the right Medicare plan for your needs.


Example: Choosing Coverage in Washington

Meet Mary, age 65, in Spokane.

  • She takes two daily medications and wants dental and vision coverage.
  • Her doctors are local and she doesn’t travel often.

Option 1: Original Medicare + Medigap + Part D

  • High flexibility, higher monthly cost
  • Excellent nationwide access

Option 2: Medicare Advantage (Part C)

  • Includes her drugs, dental, and vision
  • $0 plan premium + Part B premium
  • Local provider network

Mary chooses Medicare Advantage, saving money and gaining extra benefits. But if she ever moves or travels more, she can switch back during a future enrollment period.


How to Choose the Right Medicare Path in Washington

Step 1: Evaluate Your Health and Budget

List your doctors, specialists, medications, and travel habits.
Then compare total annual costs (premiums + expected copays).

Step 2: Check Available Plans

Each Washington county has unique options. Use Washington Medicare Plans to see what’s available where you live.

Step 3: Verify Networks and Drug Coverage

Always confirm your doctors and prescriptions are covered before enrolling.

Step 4: Get Professional Help

A local broker can compare multiple carriers and handle the paperwork — at no cost to you. You can also explore our Medicare Checklist Before 65 to prepare early.


Washington Resources for Medicare


Final Thoughts: Understanding Medicare Parts A, B, C, and D in Washington

Medicare doesn’t have to be confusing. Once you understand what each part does, the pieces fall into place:

  • Part A covers hospital care.
  • Part B covers doctor and outpatient services.
  • Part C combines A + B (+ D) and adds extra perks.
  • Part D covers your prescriptions.

Your best choice depends on your health, income, provider preferences, and location in Washington.

If you want personalized help comparing plans or understanding which Medicare parts fit your situation, I’d love to guide you through it.

👉 Visit Advisor Health Benefits Group to schedule a consultation and make confident, informed decisions about your Washington Medicare coverage.


About Kevin Husted
Kevin Husted is a licensed Washington health insurance and Medicare broker with Advisor Health Benefits Group. He helps individuals and families navigate Medicare Parts A, B, C, and D, compare plan options, and find cost-effective coverage tailored to their needs.


Medicare References for Washington Residents

If you want to understand how the four parts of Medicare work in Washington, these trusted sources provide neutral, government-verified information — not plan sales.

These references help you build knowledge — but they don’t replace personalized advice. For individualized help reviewing options.
👉 Contact Advisor Health Benefits Group to speak directly with a licensed Washington Medicare broker.

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