Many West Virginia residents obtain health insurance by signing up for Medicare insurance coverage. Medicare is a national health insurance program for people who are age 65 and over, as well as people with certain disabilities and health conditions. The West Virginia state government also offers various assistance programs to assist Medicare beneficiaries.
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West Virginia Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2024 Medicare trends in West Virginia:
- Currently, 445,835 residents of West Virginia are enrolled in Medicare.
- The average Medicare Advantage monthly premium increased from $20.36 in 2023 to $20.90 in 2024.
- There are 58 Medicare Advantage plans available in West Virginia, an increase from 2023.
- All West Virginia residents with Medicare have access to Medicare Advantage, including plans with $0 premiums.
- There are 21 different Medicare Prescription Drug Plans offered in West Virginia for 2024.
- The lowest monthly premium for a Medicare prescription drug plan is $0.50.
Medicare Offered in West Virginia
Medicare is a government-sponsored health care program that offers financial assistance to American citizens ages 65 and over or those with disabilities.
Original Medicare
The primary coverage comes from Original Medicare, Part A, and Part B. Medicare Part A covers inpatient care in hospitals, critical access hospitals, and skilled nursing facilities. Additionally, hospice care and some types of home health care are included.
Medicare Part B covers doctor services and outpatient hospital care, and some health care services that are not covered in Medicare Part A. These include physical therapists and the use of durable medical supplies.
Medicare Part A does not typically require premiums, although in some cases, it may be required. Medicare Part B does require premiums based on the beneficiary’s income.
Both Medicare Part A and Part B may also require the beneficiary to pay for out-of-pocket expenses. These include deductibles, copays, and coinsurance costs.
Medicare Advantage
Also referred to as Medicare Part C, these Medicare Advantage Plans can take the place of Original Medicare. These are also available from private carriers with approval from Medicare. These plans provide the primary benefits included in Original Medicare, with additional benefits such as coverage for health care services that are not covered by Medicare Part A and Part B.
In 2024, companies offering Medicare Advantage plans in the state, with ratings, include:
- AARP – 4/5 stars
- Aetna – 4/5 stars
- Freedom Blue – 4.5/5 stars
- Lasso Healthcare – 2/5 stars
- The Health Plan – 4.5/5 stars
These Medicare Advantage plans are based on medicare.gov and their overall rating of plan quality and performance, found here.
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Medicare Supplement Plans
Medicare authorizes some private health insurance companies in West Virginia to provide supplemental plans for Original Medicare. These plans, also called Medigap, are able to cover extra health care services that Original Medicare does not include. Costs vary depending on which plan you choose and you cannot purchase a Medigap plan if you have Medicare Advantage.
Some of the companies offering Medigap plans throughout West Virginia include:
- AARP – UnitedHealthcare
- Bankers Fidelity
- Garden State
- Great Southern
- Highmark Blue Cross Blue Shield West Virginia
- Lumico
- Medico Corp
- State Farm
- USAA
West Virginia Medicare Enrollment
Citizens of West Virginia are eligible for Medicare if they are a U.S. citizen and above 65 years old, or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool to see if you qualify.
Requirements
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
West Virginia Enrollment Tips & Advice
Finding the right plan for you with Medicare coverage can be overwhelming. When signing up, always keep in mind the cost of each plan, whether the plan’s network includes your preferred doctors and hospitals, and the plan’s ratings/reviews.
Additional resources:
- West Virginia Bureau of Senior Services
- State Health Insurance Assistance Program (SHIP)
- WV Department of Health & Human Services
- PATH Program
How Do I Enroll in a Medicare Plan?
If you’re not sure about your Medicare coverage, talk to one of our licensed agents. We’ll help you find a plan that suits your needs and your budget.
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