There are currently 26 different Medicare Part D prescription drug plans on offer in the state of West Virginia. These plans are administered by 14 different health insurance providers under the direction of the federal government’s Medicare program. In order to qualify for one of the Part D plans, you’ll first need to make sure that you’re enrolled in Original Medicare Part A and Part B. Once you’ve done that, you may apply to the Part D plan of your choice. Usually this will require a personal visit to the company providing the plan, but in some instances you might be able to apply online via the company’s website.
You should apply as soon as you’re eligible. Delaying your application could result in higher monthly premium fees, late penalties, and even health audits.
Medicare Part D vs. Medicare Advantage
If you have a Medicare Advantage plan (also referred to as Medicare Part C), there are a few extra steps to take during your Part D research. The Part D prescription drug plan and Medicare Advantage are similar in some ways, namely that both plans are administered by third-party health insurance providers and both plans act as supplements to Original Medicare. Medicare Advantage typically provides the same or better care as Original Medicare, however, whereas Part D only covers prescription drugs.
Some Advantage plans may in fact cover prescription drugs, but these Advantage plans will likely differ substantially from Part D plans in terms of price, availability in your region, and the type and amount of drugs covered. Due to all these variations, you should consider your options carefully when deciding on a Part D prescription drug plan versus a Medicare Advantage plan that also features drug coverage. In many cases, enrolling in a Part D plan will automatically cancel your Medicare Advantage plan. If this happens, you will revert back to Original Medicare Part A and Part B coverage, meaning that your choice of drug plans could impact the entirety of your Medicare coverage.
You should contact your prospective Part D plan administrator as well as the administrator of your Medicare Advantage plan prior to making any changes.
When to sign up
Timely application to Medicare is essential, since both the federal government and private healthcare firms can and do penalize late enrollment with fees and increased monthly premium charges. In some cases, missing an enrollment period can even lead to an audit of your current medical condition, which can lead to rejected coverage applications or increased premium costs. The Initial Enrollment Period for Part D prescription drug coverage is a seven-month window based on your Original Medicare eligibility date. This date is based on your birth month and your 65th birthday. Your Initial Enrollment Period begins three months prior to your Original Medicare Eligibility date and concludes four months after it.
If you fail to enroll during the initial seven-month period, you can also enroll during the Annual Election Period. This period occurs once per calendar year, starting on October 15th and ending on December 7th. If you miss both the Initial Enrollment Period and the Annual Election Period, you may still qualify for enrollment during a Special Election period that Medicare provides to assist those who have lost prior insurance coverage or who are undergoing other extenuating circumstances that prevented prior enrollment. Contact Medicare at 1-800-633-4227 to see if you qualify.
What are my choices?
The Medicare Part D services listed in the preceding table are provided in all West Virginia counties. Your county of residence may provide additional plans and services. Contact your local Medicare office for additional details.
Plans are subject to change as contracts are finalized.
Includes contracts/plans as of April 22, 2016. The data does not reflect information for employer-sponsored plans, Part B-only plans, or plans not offering a Part D drug benefit.