Medicare Supplement Plans in West Virginia

Mike Olmos by Mike Olmos | Licensed since 2010

This article was updated on: 10/12/2018

According to the Centers for Medicare and Medicaid Services (CMS) there are over 295,000 Original Medicare beneficiaries in West Virginia in 2018. If you have Original Medicare in West Virginia, you may be eligible for a Medicare Supplement plan in West Virginia to help cover your Medicare out-of-pocket costs including copayments, coinsurance and deductibles.

Keep in mind that Medicare Supplement in West Virginia only works with Original Medicare (Part A and Part B). You cannot use Medicare Supplement to cover costs of a Medicare Advantage plan.

Why would I need a Medicare Supplement plan in West Virginia?

Medicare Part A covers various costs of being a hospital inpatient. Medicare Part B covers doctor visits and outpatient medical costs, including durable medical equipment, such as walkers and wheelchairs.

However, there are limits to this government coverage. For example, you may be responsible for all your hospital costs after your lifetime reserve days are used up. And when you get an item of durable medical equipment such as an electric wheelchair, you may be responsible for 20% of costs. Further, Original Medicare has no out-of-pocket maximum, meaning there is no upper limit on what you could pay out-of-pocket for medical care.

Medicare Supplement plans are offered by private insurance companies and can help cover your out-of-pocket costs. Some Medicare Supplement plans in West Virginia have out-of-pocket maximums. This means that after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medicare Supplement plan pays 100% of covered services for the rest of the calendar year. An out-of-pocket maximum can give you the assurance that no matter how intensive your medical treatment, you will generally not pay more than a pre-determined amount for your care.

What does Medicare Supplement in West Virginia cover?

There are up to 10 lettered Medicare Supplement plans available in West Virginia: A, B, C, D, F, G, K, L, M and N. These plans are “standardized” which means that all plans of the same letter offer the same basic benefits, regardless of which company offers the plan.

All Medicare Supplement plans must provide basic benefits as follows:

  • Hospital coinsurance and costs up to an additional 365 days after your Medicare Part A hospital benefits have run out.

At least a portion, if not all of the cost related to

  • Medicare Part A hospice coinsurance or copayment
  • Medicare Part B coinsurance or copayment (including the 20% you’d have to pay for the wheelchair)
  • The first three pints of blood received in the hospital

Beyond covering these basic benefits, Medicare Supplement plans in West Virginia may provide other benefits including:

  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B excess charge
  • Foreign travel emergency up to plan limits

Compare Medicare Supplement plans in West Virginia with this chart.

How much does Medicare Supplement in West Virginia cost?

Companies that offer Medicare Supplement in West Virginia are free to set their premiums, so plan cost may be different from insurer to insurer.

Keep in mind that Medicare Supplement plans in West Virginia don’t cover the premiums for Medicare Part A and Part B. Medicare Supplement plans also generally don’t cover prescription drugs, which are covered by Medicare Part D, nor the premiums for these plans.

If you have Medicare Part A, Medicare Part B, Medicare Supplement, and a stand-alone Medicare Part D Prescription Drug Plan, you could be paying four separate premiums. If you qualify for premium-free Medicare Part A, you could be paying three separate premiums for all your health care coverage.

When can I enroll in Medicare Supplement in West Virginia?

Medicare Supplement plans are sometimes allowed to use medical underwriting when deciding who to cover and how much to charge for coverage. Medical underwriting considers your health history, medical problems, and the possible costs to insure you. If you have health problems, you may be denied coverage.

You may not need to go through medical underwriting during your Medicare Supplement Open Enrollment Period. This is a six-month period that begins the first day of the month in which you are 65 or older and enrolled in Medicare Part B.

During this period you can generally enroll in any Medicare Supplement plan offered in your area without being turned down for a health problem. Medicare beneficiaries under 65 generally are not granted a Medicare Supplement Open Enrollment Period.

If you are selecting a Medicare Supplement plan in West Virginia during your Open Enrollment Period, it may be a good idea to predict what you will need in the future. After your Open Enrollment Period is over it may be difficult to change plans or enroll in a plan with better coverage.

To begin looking at Medicare Supplement plans in West Virginia, enter your zip code on this page.

Mike Olmos |
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