West Virginia Medicare Supplement Plans (Medigap)
Senior citizens are eligible for additional insurance benefits that compliment Original Medicare by providing added insurance coverage.
The different Medicare Supplement Plans or Medigap Plans as they are often called, pick up coverage for the out of pocket (OOP) expenses associated with deductibles, copayments and coinsurance, which would otherwise not be covered by straight Medicare.
Here, we will further discuss the different Medicare parts and Medicare Supplement Plans available to those seniors residing in West Virginia.
West Virginia Medicare Benefits Broken Down
Medicare Part A is your hospital benefits and provides coverage for any expenses incurred during a hospitalization.
The second part of Medicare is Part B. This includes your outpatient services associated with doctor’s visits, diagnostic imaging or testing and any outpatient medical procedures.
The next two parts are stand alone plans that can be purchased for coverage on benefits not offered by your Original Medicare benefits. Medicare Part C or also called Medicare Advantage, takes over the complete coverage of Medicare Parts A and B.
Due to the benefits offered you can oftentimes hear it referred to as a Medicare Replacement Plan. And finally, with Medicare Part D, or the Medicare Prescription Drug Plan (PDP), you get prescription medication coverage.
To subsidize the additional OOP costs not covered by any of the 4 part Medicare Plans, the ten letter plans offered as a Medicare Supplement Plan provide additional benefits.
What Does Medicare Cover in West Virginia
Insurance benefits on Medicare Part A and Medicare Part B both provide 80% coverage. So regardless of inpatient or outpatient coverage, no matter the benefits, it’s still 80%.
Leaving the 20% left for seniors responsible to pay, this can easily add up each month. You can obtain extra coverage for that pesky 20% by obtaining a Medicare Supplement Plan.
How to Qualify for West Virginia Medicare Supplement Plans
Medicare beneficiaries are eligible for a Medicare Supplement Plan if they meet certain criteria. The individual has to be at least 65 years of age and also currently carrying Medicare Part B.
Your Open Enrollment Period (OEP) starts a few months prior to your 65th birthday, continues through your birthday month and then the following three months after. This leaves you with a total of 7 months for your OEP.
After your 7 month OEP, you may still enroll but you leave yourself liable for the Part B penalty. This penalty increases your premium each month which as of this year was already $134.00. You can find out more about the Part B late penalty here.
Those persons who currently have End Stage Renal Disease (ESRD), carry SSDI benefits or certain Railroad Retirement Benefits are eligible for Medicare Parts A and B after 24 months.
Federals laws do not require each state to offer Medicare Supplement policies however, certain individual state laws do. If you’re under the age of 65 and disabled or have ESRD call us today to see which plans are available to West Virginians.
Our licensed insurance agents are readily available to answer any questions regarding qualifications for individuals with disabilities.
When to Sign Up for a Medicare Supplement Plans in West Virginia
On the 1st day of the month after your 65th birthday and having already been enrolled in Medicare Part B is the time to get supplement insurance.
For example, if your birthday was November 17th and your Medicare Part B effective date was December 9th, then your OEP begins on January 1st. To reiterate, the best time to enroll is during your OEP.
When you enroll for a Medicare Supplement Plan during your OEP you are automatically accepted for the insurance plan of your choice due to something called the Guaranteed Issue (GI) right.
With the GI, the private insurance companies cannot deny you coverage, enforce any insurance underwriting or charge more based on any of your pre-existing health conditions.
To avoid denial or higher insurance premium rates its imperative to enroll during OEP to, “guarantee”, your GI rights.
Medicare Supplement Plan Prices in West Virginia
Each state’s individual insurance companies will determine what they will decide to charge for insurance premium rates. There are a variety of factors considered when choosing these rates such as age, sex and location.
For example, a younger female living in Bridgeport, WV will have different rates than an older male living in Charleston, WV.
There are also pricing methods used when determining premium cost and the different pricing methods are:
- Community rated pricing which, despite your age at the time of purchase, everyone pays the same premium amounts. Additionally, your rates won’t increase as you age.
- Issue age rating which the premium prices are determined depending on what your age is at the time of purchase. The older your age the higher the premium however, your premium will always stay the same and will not increase as you age.
- Attained age rating premiums are also based on your age at the time of purchase however, with this method the insurance premiums will increase every year.
The Top Medicare Supplement Plans in West Virginia
Medicare Supplement Plans offer 10 different letter plans that pick up on other medical costs not covered by your Traditional Medicare benefits. Across the nation, the letter plan benefits will be the same regardless of which insurance carrier you decide to choose.
The only difference between the different providers will be your monthly premium costs as each individual carrier is at liberty to choose what they charge the individual insurance applicants.
Of all the Medicare Supplement Plans, the most popular of the ten letter plans are Plans F, G and N.
Is considered cost-sharing plan as it applies a discount that lowers the OOP costs associated with benefits not covered by straight Medicare.
Because it’s the most affordable of the plans it’s one of the most popular however, it does offers less benefits. Plan N provides coverage for your deductible for Medicare Part A but requires a small copayment for office and ER visits.
Plan F is the most popular of all the letter plans as it provides the most comprehensive benefits.
For Medicare beneficiaries in West Virginia, Plan F provides 100% coverage for Medicare Part A and Medicare Part B deductibles.
It also provides coverage of the remaining 20% costs that straight Medicare wouldn’t normally cover. Additional benefits include copayment and coinsurance coverage for Medicare Part B.
With it also providing foreign travel coverage, which not all plans include, this plan truly has all areas of medical costs covered.
Plan G is another popular plan as it offers the same great benefits as supplement Plan F, with the exception of covering Medicare Part B’s deductible.
This is one of the only downsides, so West Virginia beneficiaries will be required to pay the $183.00 deductible. On the plus side however, Plan G offers excess charge coverage which will benefit West Virginia seniors as physicians in your state are allowed to tack on these charges to the regular Medicare allowable.
Medicare Advantage Plans in West Virginia
Like the Medicare Supplement Plans, Medicare Advantage Plans are purchased through the private insurance companies. Oftentimes referred to as a Medicare Replacement Plan as it takes over the benefits offered by Traditional Medicare.
While Advantage Plans may have lower monthly premiums, the downside is it cannot be combined with any of the Medigap Plans and also comes with policy restrictions and limitations.
Overtime the OOP costs end up higher and most seniors that opted for an Advantage Plan at first end up switching back to Traditional Medicare and then purchasing a Medigap Plan instead.
West Virginia Prescription Drug Plans for Medicare
The downside to Traditional Medicare and any of the Supplement Plans is that they don’t offer any prescription medication coverage. By purchasing a Prescription Drug Plan (PDP) you can save thousands of dollars each year on the OOP costs associated with medications alone.
Another downside is that failing to purchase a PDP will result in yet another penalty. The Part D penalty begins once your IEP has ended and depending on how long you go without drug coverage will depend on how much extra will be calculated into your monthly premiums.
For the most coverage benefits with the least OOP cost, West Virginia seniors should consider Original Medicare, a Medigap Plan and a Prescription Drug Plan combined.
Compare West Virginia Medicare Plans Online
Comparing all of the Medicare Supplement Plans online is easy! Simply call and one of our licensed insurance agents can answer any questions you may have regarding what plans best suit your needs.
You can also fill out one of our online forms today to compare rates. As always, our services are 100% free and there’s no obligation to purchase.
Resources for Medicare Help in West Virginia
West Virginia seniors who are on a limited income may be eligible for assistance when it comes to medicare expenses.
There are nationwide assistance programs and each individual state has their own financial resource programs.
You can learn more about West Virginia’s health insurance insurance assistance program here WV SHIP.
West Virginia FAQs
- Does Humana offer Medicare plans in West Virginia? Humana and many other private insurance companies offer Medicare Supplement Plans for seniors residing in West Virginia. Call us today to compare rates.
- What doctors accept Medicare in West Virginia? Many primary care physicians as well as specialists take Medicare and Medicare Supplement Plans in West Virginia. For a complete list of treating physicians you can reference here.