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.

How Medicare Advantage Plans Work in West Virginia

If you would rather have a private health insurance plan manage your Medicare health benefits instead of the government, you can choose to purchase Medicare Advantage instead. Some beneficiaries like it because it reminds them of how their old employer 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.

Depending on where you live, you can choose between 25 and 30 plans. 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.

Medicare Advantage Plans Offers in West Virginia

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 in West Virginia

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 will have to pay thousands of dollars out-of-pocket for co-pays, deductibles, and more. Humana caps this expense limit at $4,500, saving you money on medical care.

The next most affordable plan would be UnitedHealthcare. Their out-of-pocket maximum is $900 more expensive than Humana. 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 worth your while.

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
UnitedHealthcare $0 $5,400 LOCAL PPO 4
Aetna $0 $6,900 HMO 4

Medicare Advantage Plans with a Zero Dollar Drug Deductible in West Virginia

Your deductible is an 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 will have to 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 in West Virginia

Are you sick of paying a monthly premium for Medicare Part B? Then find a Medicare Advantage plan which helps reduce the cost for you. If you live in the right zip code, you could choose one of the plans below to get cheaper Medicare premiums.

UnitedHealthcare 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
UnitedHealthcare $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.

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 at the same time 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 simply complete our easy online rate form to receive the best rates in your area of West Virginia.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.