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Medicare in West Virginia

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Medicare coverage in West Virginia

If you’re a Medicare beneficiary in West Virginia, you may be wondering about your Medicare coverage options. You can choose to enroll in Original Medicare (Part A and Part B), which is the federally administered program for  people who are 65 or older and certain younger disabled individuals. Many people qualify for Medicare when they turn 65, but if you qualify by age or having certain conditions (such as Lou Gehrig’s disease or end-stage renal disease), you can get Medicare at any age. You must be an American citizen or have legally and permanently resided in the U.S. for at least five continuous years to be eligible for coverage. If you have Original Medicare, you can also enroll in a Medicare Prescription Drug Plan to get stand-alone prescription drug benefits.

Another option is to enroll in a Medicare Advantage plan, which is available through private insurance companies that contract with Medicare. Also known as Medicare Part C, these plans provide at least the same level of coverage as Original Medicare, but may also cover extra benefits like prescription drugs or routine vision and dental.

Below is some information on Medicare enrollment in West Virginia as of 2018*:

  • West Virginia beneficiaries enrolled in Medicare: 435,258
  • West Virginia beneficiaries enrolled in Original Medicare, Part A and/or Part B (not in Medicare Advantage plans): 299,787
  • West Virginia beneficiaries enrolled in Medicare Advantage plans (or other Medicare health plans): 135,471

As mentioned, Medicare Advantage plans and Medicare Prescription Drug Plans are available through private insurance companies that are approved by Medicare to offer Medicare plans (such as a Medicare HMO). Not every Medicare plan is available statewide or in all service areas. Because of this, it’s important to research Medicare plan options for your specific zip code and service area in West Virginia, since availability may vary throughout the state. You can enter your zip code right on this page to get started.

Medicare resources in West Virginia

West Virginia Medicare Savings Programs: Medicare Savings Programs help low-income beneficiaries with Medicare costs like premiums, copayments, and deductibles. To be eligible, you must meet certain income and asset thresholds, which are set by the government each year. To find out if you qualify and to get more information, contact the West Virginia Medicaid department.

West Virginia State Health Insurance Counseling and Assistance Program (SHIP): SHIP is funded by the Centers for Medicare & Medicaid Services (CMS) to provide free health-care counseling in each state. In West Virginia, SHIP counselors are available to help answer your Medicare and health coverage questions.

*Statistical data from the Centers for Medicare & Medicaid Services (CMS) “Medicare Enrollment Dashboard,” from the CMS Office of Enterprise Data & Analytics, February 2019.

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