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Kirkland, King County

Medicare Plan Dropped in Kirkland: Five Mistakes to Avoid

Kirkland has a general hospital and a psychiatric hospital on the state lists. Check both if they matter to you, and avoid these common missteps.

Updated 2026-10-26 · Vadim Marusin, licensed independent insurance agent (NPN 22261820)

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. For free, unbiased Medicare counseling in Washington, contact SHIBA (Statewide Health Insurance Benefits Advisors) through the Office of the Insurance Commissioner at 800-562-6900.

Kirkland is home to two hospitals on the state and federal lists: EvergreenHealth Medical Center on NE 128th Street, a general acute care hospital, and BHC Fairfax Hospital on NE 132nd Street, which CMS classifies as psychiatric. If your Medicare plan has been dropped for 2027, both are worth a look when you compare what comes next.

Five mistakes I'd steer Kirkland readers away from

1. Checking only your primary care doctor

Don't stop at confirming your regular doctor is in a new Medicare Advantage network. Check the hospital too, and check any specialist you see even once a year. If you or a spouse use mental health or psychiatric services, including inpatient care at a place like Fairfax, look up those providers by name in the 2027 directory as well. Original Medicare avoids the issue entirely: any provider that takes Medicare is covered.

2. Forgetting the drug plan

If you move to Original Medicare, prescription coverage doesn't come with it. You must join a stand-alone Part D plan, unless you get Extra Help, in which case CMS assigns you one. Skip it and go 63 days or more without drug coverage, and a late enrollment penalty gets tacked onto your Part D premium for as long as you have it.

3. Treating February 28 as the deadline

Technically, your special enrollment period runs from December 8, 2026 through February 28, 2027, on top of Open Enrollment, which closes December 7. But only choices made by December 31 start on January 1. Choose in January and you start February 1; choose in February and you start March 1. Those are months with gaps you didn't need.

4. Assuming the January–March window will rescue you

The Medicare Advantage Open Enrollment Period, January 1 to March 31, is real, but it's only for people enrolled in a Medicare Advantage plan. If you do nothing and land in Original Medicare, it doesn't let you hop into a new Medicare Advantage plan. If you do join a new Medicare Advantage plan for January 1, though, it gives you one more switch if that plan disappoints.

5. Letting the Medigap right lapse without deciding

Because your plan is leaving, Washington law gives you a one-time guaranteed right to buy certain Medigap policies with no health questions, if you go to Original Medicare. OIC recommends applying on or after November 1, and the right ends March 4, 2027. After that, an insurer can medically underwrite you. Choosing another Medicare Advantage plan is a legitimate choice, but know that you're letting this door close when you make it. Plan letters and eligibility details are in our Washington guide.

Kirkland and King County numbers

FigureValue
Kirkland population, April 2026 (OFM)98,860
Kirkland residents 65+ (ACS 2020–2024)13,184 ±736 (14.2%)
King County Medicare beneficiaries (CMS, July 2026)368,813
In Medicare Advantage and other health plans197,594 (53.6%)
In Original Medicare171,219 (46.4%)
Part D enrollees whose drug coverage is inside a health plan190,884

Sources: WA OFM; U.S. Census ACS table B09020; CMS Medicare Monthly Enrollment, July 2026. CMS does not report city-level Medicare counts.

That last row is the one I'd look at. Nearly 191,000 people in the county get drugs through a health plan, and that coverage ends when the plan ends. If you're one of them, replacing it is on you.

Where to get help

Nobody at the state level can reverse the plan's decision. OIC states it has no authority over Medicare Advantage plans; CMS oversees them. If you believe the plan mishandled the change, you can file a complaint with Medicare online.

For choosing what's next:

  • SHIBA, Washington's free, no-sales Medicare counseling program: 800-562-6900, Monday through Friday, 8:30 a.m. to 4:30 p.m. OIC's local King County listings showed "Currently not accepting appointments" on October 26, 2026.
  • 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), 24 hours a day, 7 days a week, except some federal holidays. They can search Plan Finder with you by phone.
  • Peter Kirk Community Center, 352 Kirkland Ave, 425-587-3360, open weekdays 8 a.m. to 5 p.m. The city lists nutritional lunches, Meals on Wheels for the homebound, and van and transportation services among its 50-plus offerings.
  • Community Living Connections, King County, 1-844-348-5464, for broader aging and disability services.

Plain fine print: federal Medicare rules and Washington law decide how this works, your plan's own notices set the dates that apply to you, and 1-800-MEDICARE, SHIBA or a licensed agent can confirm your specifics before you act.

Kirkland help questions

My Medicare plan was dropped in Kirkland. Who can help me for free?
SHIBA, the state's Medicare counseling program, at 800-562-6900 on weekdays, and 1-800-MEDICARE, 24/7 except some federal holidays. Local King County SHIBA listings said they were not accepting appointments on October 26, 2026.
Should I check BHC Fairfax Hospital in a new plan?
If you or a family member use psychiatric or behavioral health services, yes. Look up those providers by name in each 2027 network. Original Medicare covers any provider that accepts Medicare.
Does the Peter Kirk Community Center offer transportation?
The city lists van and transportation services among its 50-plus programs. Call 425-587-3360 for details.
Can Washington's insurance commissioner stop my plan from leaving?
No. OIC says it has no authority over Medicare Advantage plans; CMS oversees them. You can file a complaint with Medicare online.

Sources

  1. WA DOH hospital data
  2. CMS Hospital General Information
  3. City of Kirkland: Adult 50+ activities and services
  4. WA OFM April 1, 2026 population
  5. U.S. Census ACS 2020-2024 B09020
  6. CMS Medicare Monthly Enrollment, July 2026
  7. CMS CY2027 enrollment guidance
  8. WA OIC: Medicare Advantage plan changing or leaving
  9. RCW 48.66.055
  10. Medicare.gov: Part D costs and penalty
  11. WA OIC: local SHIBA offices
Vadim Marusin, licensed insurance agent at Maru Insurance
Vadim Marusin — Maru Insurance
Licensed independent insurance agent (NPN 22261820) · WA & FL
Written by Vadim Marusin, licensed independent insurance agent. Maru Insurance is an independent agency (WA License WAOIC #1365574, FL License #G363233). This page is general education about Medicare rules, not advice about any specific plan.

Want someone to double-check your choice?

Talk with a licensed Maru agent in Washington by phone. Or get unbiased help from SHIBA at 800-562-6900 or Medicare at 1-800-MEDICARE.