Medicare Advantage in West Virginia

Looking for West Virginia Medicare Advantage Plans? Enter your ZIP below to compare affordable or $0 premium plans in your area.

West Virginia state

Information about Medicare Advantage Plans in West Virginia

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32 percent of Medicare beneficiaries in West Virginia were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 995 different West Virginia Medicare Advantage plans in 2019.1 Not every plan is available in each county, so it's important to find out which ones are offered where you live.

A licensed insurance agent can help you compare Medicare Advantage plan availability, benefits and costs in your area of West Virginia. Read below to learn more about Medicare in your state.

You can also learn more about other types of Medicare plans:

Average costs of Medicare Advantage in WV

West Virginia Medicare Advantage beneficiaries paid an average of $25 per month for their Medicare Advantage plan premiums in 2019.

There were 339 Medicare Advantage plans in WV in 2019 that featured $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $25
  • Average in-network out-of-pocket spending limit: $6,249
  • Average deductible in 2019 (weighted): $18.671

Plan costs can vary from one location to the next.

Some average Medicare Advantage cost and enrollment information is listed below in this guide for every county in West Virginia in 2019.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare West Virginia Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

Enrolling in a Medicare Advantage plan in the state of West Virginia requires first belonging to Original Medicare (Part A and Part B).

In order to sign up for Original Medicare at age 65, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

If you meet the following requirements, you may be eligible for Medicare before age 65:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may be able to enroll in a West Virginia Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs. Beneficiaries with ESRD are typically not eligible for most other types of Medicare Advantage plans.

How to sign up for a Medicare Advantage Plan in West Virginia

You can typically enroll in a West Virginia Medicare Part C plan during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP starts three months before your 65th birthday, continues during the month of your 65th birthday and then continues for another three months after your birthday.

Additional times at which you may sign up for a Medicare Advantage plan include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

You may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare during this period.

If you return to Original Medicare during the Medicare Advantage Open Enrollment Period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan, disenroll from Medicare Advantage to switch back to Original Medicare or switch from one Medicare Advantage plan to another.

During AEP, you may also join, switch or drop a Medicare Part D plan.

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year, but only if you are in a specific circumstance.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a West Virginia Medicare Advantage plan

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in West Virginia 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) issues Star Ratings for all Medicare Advantage plans using a system of one to five stars.2

Plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

If a plan has four or more stars out of five stars, it may be considered a top-rated Medicare Advantage plan.

There are 239 top-rated 2019 Medicare Advantage plans in West Virginia that are rated four stars or higher.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in West Virginia in 2019

To view a list of plans offered in your area within West Virginia, use our plan comparison tool.

Find a West Virginia Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in West Virginia

A number of different insurance carriers may offer Medicare Advantage plans in West Virginia, though plan selection can vary from one location to another.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare Medicare Advantage plans that are sold by insurance companies in your area.

You can also use these sources of information as you shop for plans:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

West Virginia Medicare Advantage plans by county

The chart below provides some more information about 2019 West Virginia Medicare Advantage plans by county.1

  • Kanawha County had the highest number of Medicare Advantage beneficiaries West Virginia in 2019.
2019 WV Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Barbour 1171 28% 13 3 83.1%
Berkeley 5277 23% 20 6 58.6%
Boone 2809 45% 19 7 90.2%
Braxton 1322 35% 18 6 90.6%
Brooke 2383 38% 20 6 30.7%
Cabell 7830 34% 21 7 52.9%
Calhoun 563 26% 17 5 85.5%
Clay 1019 38% 18 6 89.7%
Doddridge 621 35% 20 6 52.4%
Fayette 3944 33% 18 7 53.3%
Gilmer 505 32% 20 7 73.5%
Grant 729 22% 16 6 40.0%
Greenbrier 2623 26% 17 6 46.9%
Hampshire 1295 21% 12 6 66.5%
Hancock 2365 28% 19 6 46.9%
Hardy 833 23% 20 6 70.8%
Harrison 5151 30% 18 6 56.0%
Jackson 2331 31% 19 6 91.7%
Jefferson 2427 21% 20 6 66.7%
Kanawha 18055 37% 22 8 43.8%
Lewis 1647 36% 20 6 58.9%
Lincoln 2262 40% 18 8 40.1%
Logan 3541 38% 20 7 35.4%
Marion 5007 36% 20 6 51.9%
Marshall 3468 46% 19 6 23.0%
Mason 2356 33% 17 6 49.4%
McDowell 2021 33% 16 6 36.2%
Mercer 5759 33% 21 7 63.2%
Mineral 1304 19% 14 6 39.1%
Mingo 2645 36% 21 7 15.8%
Monongalia 5365 36% 17 6 49.2%
Monroe 1079 27% 18 7 37.9%
Morgan 997 20% 14 6 70.8%
Nicholas 2830 38% 19 6 95.7%
Ohio 4830 41% 20 6 23.1%
Pendleton 588 26% 18 6 33.3%
Pleasants 579 31% 12 5 76.7%
Pocahontas 658 27% 18 7 18.9%
Preston 2432 30% 12 5 53.1%
Putnam 5037 38% 22 8 43.0%
Raleigh 6499 31% 18 7 37.4%
Randolph 2034 27% 15 5 63.9%
Ritchie 845 30% 21 7 48.8%
Roane 1433 33% 17 5 87.3%
Summers 963 26% 14 4 85.3%
Taylor 1122 28% 20 6 53.8%
Tucker 698 34% 17 6 62.5%
Tyler 892 36% 16 5 44.5%
Upshur 2273 37% 20 6 51.1%
Wayne 3560 33% 20 7 49.4%
Webster 915 34% 17 5 86.8%
Wetzel 1699 40% 20 6 40.6%
Wirt 472 28% 18 7 64.9%
Wood 6139 27% 18 7 68.3%
Wyoming 2568 41% 21 7 51.9%

WV Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 West Virginia Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of West Virginia enrollees (2019)
Local PPO 51.6%
Local HMO 47%
Regional PPO <1%
PFFS 0.69%

The major types of Medicare Advantage plans include:

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 West Virginia Medicare Advantage plans that are available where you live.

Local health insurance resources in West Virginia

  • West Virginia’s State Health Insurance Assistance Program is part of a nationwide network offering free help for the state’s beneficiaries of Medicare and other related programs.

    The objective and confidential counseling is provided by trained volunteers, with the goal of helping West Virginia’s seniors make the best use of their insurance.

    The program may be reached at 877-987-4463 or 304-558-3317.

  • You can also explore more information about the insurance industry in California by visiting the state’s Offices of the Insurance Commissioner website.

  • West Virginia Prescription Drug Assistance Programs
    The state of West Virginia has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.