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Compare options, including Medicare Advantage, Medicare Supplement, and prescription plans.
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Noah Wilson
Toni Aldridge
Kevin Hatfield
Shannon Davis
Tyler Eby
Kayla Torry
Brandon Kauffman
Calvin Fritz
Sara Morrissey
Matt Willenborg
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A Snapshot of Medicare in West Virginia
Medicare Advantage is the most popular coverage option for West Virginia Medicare enrollees. It covers 54% of all Medicare users in the state. The remaining 46% receive care under Original Medicare.
West Virginia residents become eligible for Medicare when they turn 65, but some may qualify earlier if they have certain disabilities. For those becoming eligible at 65, the Initial Enrollment Period begins three months before the month they turn 65, includes the month they turn 65, and ends three months afterward. Those already receiving Social Security when they become Medicare eligible may be automatically enrolled in Medicare Part A and Part B, which make up Original Medicare.
Reviewing coverage options both when you first enroll and annually is a good idea because costs, benefits, and provider networks for specific plans can change. West Virginia Medicare enrollees can review and change their Medicare coverage during the annual Medicare Open Enrollment Period, which occurs between October 15 and December 7. During this period, they can switch or join Medicare Advantage and Part D prescription drug plans, or switch between Medicare Advantage and Original Medicare.
How to apply for Medicare in West Virginia?
Medicare eligibility in West Virginia follows the same nationwide rules as everywhere else in the country. You qualify for Medicare as a US citizen if you meet one of these criteria:
- You're 65 or older
- You have a qualifying disability, such as End-Stage Renal Disease or ALS
- You've received SSDI for 24 months or more
Enrolling in West Virginia takes three key steps:
- Sign up for Original Medicare (Part A and Part B)
- Decide on your supplemental coverage:
- Medicare Supplement (Medigap)
- Medicare Advantage (Part C)
- Part D (prescription drug coverage)
- Confirm your doctors are in network, update your pharmacy with your new plan, and activate any additional benefits included with your coverage
Explore West Virginia Medicare Resources
FAQs
How can I get personalized help comparing Medicare coverage in West Virginia?
West Virginia residents looking for help with their Medicare options can contact Chapter's West Virginia Medicare Advisors. Our licensed Medicare agents can provide free advice and support as you weigh your options. Call Chapter at (855) 900-2427 or schedule a free consultation, and they'll answer your questions.
How can living in rural West Virginia affect Medicare Advantage provider access?
Insurers offer different plan options in different counties across West Virginia. Similar plans in different counties may have completely different provider networks. Rural beneficiaries often have fewer Medicare Advantage plans to choose from, and fewer providers may participate in those plans' provider networks. Overall, Original Medicare generally offers broader provider access in rural counties because you can see any doctor nationwide who accepts Medicare.
What help is available to West Virginia residents with Medicare premiums and other out-of-pocket costs?
There are four Medicare Savings Programs available to help West Virginia residents with their Medicare Part A and/or Part B costs. They are the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualified Individual (QI), and Qualified Disabled Working Individual (QDWI) programs. Low-income residents may also qualify for a program called Extra Help, which covers some or all of their Medicare Part D costs.
What should West Virginia residents know about Medicare Supplement plans?
Medicare Supplement plans, sometimes called Medigap plans, are privately offered insurance plans that complement Original Medicare. They reduce your out-of-pocket costs—copayments, coinsurance, and deductibles—that you're responsible for with Original Medicare. Coverage varies by plan letter. Medigap policies are standardized and labeled with letters A-D, F, G, and K-N. The only difference between policies labeled with the same letter offered by different insurers is their price. You can sign up during a six-month Medigap Open Enrollment Period that begins the first month you are both 65 or older and signed up for Original Medicare Part B. You may enroll in a Medigap plan later, but without a guaranteed issue right, insurers may deny your application or charge you more based on your health history.
