Did you know that there are over 141,000 West Virginians who have decided to give Medicare Advantage a try? That’s almost a 30% participation rate, which is pretty impressive. We’ll cover West Virginia Medicare Advantage options available.
Medicare Advantage plans in West Virginia
If you would rather have a private health insurance plan manage your Medicare health benefits instead of the government, you can purchase Medicare Advantage. Some beneficiaries like it because it reminds them of how their old employer’s health plan worked.
You also get to manage all of your coverage — including your ancillary coverage — in one single policy. The government will pay your monthly premium, which can help make some plans as little as $0 per month. End the vast majority of them pay for prescription drugs, too.
You can choose between 25 and 30 plans depending on where you live. You can also choose to add things like dental, hearing, and more if you want truly comprehensive healthcare. But comparing that many plans simultaneously can be difficult, especially if you’re shopping around and comparing rates from company to company.
Medigap plans are small, standardized plans that the federal government closely regulates. Medicare Advantage, however, is the opposite. In addition to different pricing from one plan to the next, your explanation of benefits could be wildly different. Different plans offer different features to attract more customers. Some Advantage plans promise a $0 premium no matter what. Others eliminate your prescription drug deductible to make your medicine affordable. Some go further still and offer Medicare Part B reductions.
Medicare Advantage plans with a zero-dollar premium
Plans with a $0 monthly premium are attractive but can also be deceiving. Insurance companies often have sneaky ways of recouping the money they lose from charging you no monthly premium, usually in the form of higher out-of-pocket costs. The plans below offer a $0 monthly premium from companies with stellar customer service ratings. But you must pay thousands of dollars out-of-pocket for co-pays, deductibles, and more. Humana caps this limit at $4,500, saving you money on medical care.
The next most affordable plan would be . Their out-of-pocket maximum is $900, more expensive than Humana’s. Interestingly, they only offer a local PPO medical network instead of Humana’s regional PPO network. Aetna offers another local PPO plan with higher out-of-pocket costs. They allow for some of the highest out-of-pocket costs in West Virginia. But you may find something in your explanation of benefits that makes the expense worthwhile.
PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
Aetna | $0 | $7,550 | LOCAL PPO | 4 |
The Health Plan | $0 | $6,700 | HMO | 4 |
Humana | $0 | $4,500 | REGIONAL PPO | 4 |
$0 | $5,400 | LOCAL PPO | 4 | |
Aetna | $0 | $6,900 | HMO | 4 |
Medicare Advantage plans with a zero-dollar drug deductible
Your deductible is the amount of money you pay out of pocket every year to get access to things like discounts on prescription drugs. But the drugs on Humana’s formulary are so expensive that they can’t offer you a $0 deductible without charging you a $46 premium per month for the whole plan.
You have a couple of different options from Aetna in West Virginia. Both plans start with at least $7,000 in out-of-pocket expenses. But their medical networks cast a wider net for more choices. If you have a lot of prescription medicine needs and need that $0 deductible, you could also consider Highmark Inc. But you must pay a $25 monthly premium for the privilege.
PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
Humana | $0 | $6,700 | HMO | 4 |
Aetna | $0 | $7,000 | HMOPOS | 4 |
Aetna | $0 | $7,550 | LOCAL PPO | 4 |
Highmark Inc. | $25.00 | $6,500 | LOCAL PPO | 4 |
Humana | $46.00 | $6,700 | LOCAL PPO | 4 |
Medicare Advantage plans with a Part B reduction
Are you sick of paying a monthly premium for Medicare Part B? Then find a Medicare Advantage plan that helps reduce the cost. If you live in the right zip code, you could choose one of the plans below to get cheaper Medicare premiums. is a nice compromise between lower out-of-pocket costs and a slightly higher Part B reduction. But it’s not the only plan that tries to make this compromise.
The Health Plan tied with Humana for offering the highest Part B reduction. But both plans also set their out-of-pocket limit at $6,700. Aetna is only willing to offer you a $30 reduction. They also ask that you pay at least $6,900 out of pocket before they take on more of your medical expenses.
PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATINGS |
Aetna | $0 | $7,550 | $49.00 | 4 |
The Health Plan | $0 | $6,700 | $60.00 | 4 |
Aetna | $0 | $6,900 | $30.00 | 4 |
Humana | $0 | $6,700 | $60.00 | 4 |
$0 | $5,400 | $40.00 | 4 |
Ancillary/DVH
Medicare Advantage is the only form of Medicare that allows you to purchase ancillary coverage. If you want vision, dental, hearing, or prescription drugs, you must buy separate coverage with Original Medicare. But Medicare Advantage plans will let you add them together under one plan.
West Virginia cities with estimates for Medicare Advantage costs
Take a look at the charts linked below to find out what estimated premiums you should expect to pay for each type of Medicare Advantage plan in the cities listed:
Charleston
Huntington
Morgantown
Parkersburg
Wheeling
FAQs
Can you have Medicare Advantage and Medicare Part D in West Virginia?
No, you cannot. You usually don’t need it because Medicare Advantage plans already have prescription drug coverage.
Can you have a Medicare Advantage and a Medicare Supplement simultaneously in West Virginia?
Again, no. This would be duplicate coverage. Medicare Advantage plans already cover most or all of the gaps in Original Medicare coverage, thus saving you money.
In West Virginia, what is the relationship between Medicare Advantage Plans and Medicare Parts A, B, and D?
Medicare Advantage (Medicare Part C) effectively replaces Medicare Parts A, B, and D with a private health insurance plan. But don’t worry, you will get at least the same benefits as Original Medicare, if not more.
How to get help enrolling in a West Virginia Medicare Advantage plan
Medicare Advantage plans are within reach for West Virginia residents, but sifting through all the options can be overwhelming. That’s why we’re here to assist you.
Our licensed insurance agents can show you the benefits and pair you with a plan that fits your personal needs like a glove. Their time is free of charge, so there’s no excuse not to lean on them for help!
Give us a call today. Or complete our easy online rate form to receive the best rates in your area of West Virginia.