Find 2018 Medicare Plans in West Virginia - WV Medicare Insurance Overview

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West Virginia Medicare Insurance

Medicare in West Virginia

Medicare offers healthcare coverage to West Virginia residents age 65 or older, or to those West Virginia residents that suffer from certain medical disabilities. In 2016, 413,000 people are enrolled in Medicare in West Virginia, accounting for 22.9% of the population in West Virginia. In 2009 approximately $9,333 was spent per Medicare enrollee in West Virginia, about 9.96% lower than the national average of $10,365.From 2015 to 2030 the number of seniors in West Virginia is projected to rise by an estimated 29.31% according to calculations based off of the 2000 Census. Therefore the number of Medicare enrollees in the state is also expected to grow.

Local Medicare Resources

Medicare beneficiaries, their families, and their caregivers who reside in West Virginia can receive free, personal, and objective health insurance counseling from the State Health Insurance Assistance Program (SHIP). Residents of the state can also participate in a program called Senior Medicare Patrol (SMP) which aims to help individuals detect, protect themselves against, and report possible instances of healthcare waste, errors, fraud, and/or abuse.

Types of Medicare Coverage

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they are eligible for financial assistance. Many Medicare beneficiaries will elect to enroll in a Medicare Advantage plan that includes prescription drug coverage (MAPD) or purchase a stand alone prescription drug plan to go with their Original Medicare coverage. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Most Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.

West Virginia 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in West Virginia is $55.93, 10.48% less than the national average of $62.48. 24.72% of 2017 Medicare Part C insurance plans in West Virginia have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in West Virginia the average annual drug deductible for Medicare Part C insurance plans with drug components is $202.25. 15.42% of 2017 Medicare Part C insurance plans with a drug component in West Virginia have a $0 annual drug deductible.
  • The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in West Virginia is $8.61. 70.32% of 2017 Medicare Part C insurance plans without a drug component in West Virginia have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in West Virginia is $6,376.86. None of 2017 Medicare Advantage plans in West Virginia had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in West Virginia was 3.6 stars in 2017.
  • Among West Virginia's 2017 Medicare Advantage plans with CMS star ratings:
    • 28.82% earned a score of 4 or 4.5 stars
    • 62.68% earned a score of 3 or 3.5 stars
    • 8.5% of plans are “Not enough data available” or “Too new to be measured”.

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

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West Virginia Medicare Insurance Companies

There are 18 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in West Virginia. Of these, the companies that offer the largest variety of plans to choose from are Humana, The Health Plan, and UnitedHealthcare. In West Virginia,. The following are all medicare insurance providers in West Virginia:

2018 Featured Medicare Plans in West Virginia

There are 54 medicare plans in West Virginia. The following are the 10 highest rated medicare plans in West Virginia based on their CMS rating for the plan's overall quality.

Monthly CostPlan NameCMS Rating
from $0The Health Plan - The Health Plan SecureCare Capitol Plan, MA Only (HMO) - Boone County
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from $0The Health Plan - The Health Plan SecureCare - Option I, MA Only (HMO) - Barbour County
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from $0Humana - HumanaChoice H5216-123 (PPO) - Berkeley County
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from $20Coventry Health Care of West Virginia - AdvantraOne (PPO) - Boone County
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from $24Medco Medicare - Express Scripts Medicare - Saver (PDP)
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from $27SilverScript - SilverScript Choice (PDP)
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from $29Humana - Humana Value Plus H5216-125 (PPO) - Berkeley County
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from $35Medco Medicare - Express Scripts Medicare - Value (PDP)
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from $43Humana - HumanaChoice H5216-021 (PPO) - Boone County
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from $47Humana - HumanaChoice H5216-052 (PPO) - Calhoun County
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West Virginia Featured Medicare Plans for Managing High Blood Pressure

The following are the 5 highest rated medicare plans in West Virginia based on their CMS rating for the plan's ability for controlling high blood pressure.

Monthly CostPlan NameCMS Rating
from $29Humana - HumanaChoice R0923-002 (Regional PPO)
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from $0Humana - HumanaChoice R0923-001 (Regional PPO) - Barbour County
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from $163Highmark - Freedom Blue PPO Standard (PPO) - Barbour County
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from $92Humana - Humana Gold Choice H8145-021 (PFFS) - Barbour County
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from $75Humana - Humana Gold Choice H8145-051 (PFFS) - Barbour County
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West Virginia Featured Medicare Plans for Managing Diabetes

The following are the 5 highest rated medicare plans in West Virginia based on their CMS rating for the plan's ability for diabetes care including: eye exam, kidney disease monitoring, blood sugar controlled and cholesterol controlled.

Monthly CostPlan NameCMS Rating
from $123Humana - HumanaChoice H5216-124 (PPO) - Berkeley County
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from $57Humana - HumanaChoice H5216-022 (PPO) - Berkeley County
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from $47Humana - HumanaChoice H5216-052 (PPO) - Calhoun County
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from $43Humana - HumanaChoice H5216-021 (PPO) - Boone County
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from $29Humana - Humana Value Plus H5216-125 (PPO) - Berkeley County
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West Virginia Featured Medicare Plans for Managing Rheumatoid Arthritis

The following are the 5 highest rated medicare plans in West Virginia based on their CMS rating for the plan's ability for rheumatoid arthritis management.

Monthly CostPlan NameCMS Rating
from $36Coventry Health Care of West Virginia - Advantra Silver (HMO) - Boone County
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from $0Coventry Health Care of West Virginia - Advantra Choice (HMO) - Barbour County
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from $163Highmark - Freedom Blue PPO Standard (PPO) - Barbour County
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from $86Coventry Health Care of West Virginia - Advantra Gold (PPO) - Brooke County
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from $20Coventry Health Care of West Virginia - AdvantraOne (PPO) - Boone County
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West Virginia Featured Medicare Plans for Managing Osteoporosis

The following are the 5 highest rated medicare plans in West Virginia based on their CMS rating for the plan's ability for osteoporosis management.

Monthly CostPlan NameCMS Rating
from $36Coventry Health Care of West Virginia - Advantra Silver (HMO) - Boone County
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from $29Humana - HumanaChoice R0923-002 (Regional PPO)
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from $0Coventry Health Care of West Virginia - Advantra Choice (HMO) - Barbour County
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from $0Humana - HumanaChoice R0923-001 (Regional PPO) - Barbour County
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from $123Humana - HumanaChoice H5216-124 (PPO) - Berkeley County
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Most Popular Medicare Doctors in West Virginia

The following are the most popular medicare doctors in West Virginia based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
DermatologyROMNEY, WV
Orthopaedic SurgeryCHARLESTON, WV
SurgeryPARKERSBURG, WV
Neurological SurgeryHUNTINGTON, WV
SurgeryHURRICANE, WV
Internal MedicineHUNTINGTON, WV
SurgeryBECKLEY, WV
SurgeryCHARLESTON, WV
OphthalmologyMORGANTOWN, WV
OtolaryngologyPRINCETON, WV
See all doctors accepting Medicare in West Virginia

Browse Medicare Plans by Cities

  1. Charleston, WV
  2. Huntington, WV
  3. Parkersburg, WV
  4. Morgantown, WV
  5. Wheeling, WV
  6. Weirton, WV
See all cities in West Virginia

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