Best Medicare Advantage Plans in West Virginia for 2023
Find Plans in your area with your ZIP Code
If you live in West Virginia and you're thinking about enrolling in a Medicare Advantage plan, you're not alone. This year nearly half (48%) of all people with Medicare will join a Medicare Advantage plan because they want lower costs, more benefits, and access to more healthcare providers.
MedicareWireMedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer. can help you find top-rated Medicare Advantage plans in your region of West Virginia. The overview of West Virginia's market below will give you a clear picture of your top options and who the best providers are. It also shows you how much you can expect to pay each month for a plan.
NOTE: Our analysis does not include West Virginia's Medicare Advantage SNP Plans. We evaluate these plans separately. We also did not include plans without Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... benefits, employer plans, or Medicare-Medicaid Plans (MMPs).
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Who Has The Best Medicare Advantage Plans in West Virginia?
Every year, the Centers for Medicare & Medicaid ServicesThe Centers for Medicare & Medicaid Services (CMS) is the U.S. Federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs. (CMS) rates all Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). in West Virginia based on a 5-star scale. Input for the ratings comes from information that each plan self-reports, as well as individual member complaints. (Read more about Medicare star ratings.)
West Virginia has 5-star Medicare Advantage plans available in 2023. Not all states and locations do. This year, the highest rated Medicare plans available in West Virginia come from:
- Highmark
We recommend evaluating the health plans from these West Virginia providers ahead of all others. Here's why. Simply put, more stars generally mean members will get better results. Members might get better service and care from a 5-star than they would from a four-star plan.
CRUCIAL: Benefits are not the same throughout West Virginia. That's why it is so important to fully understand the advantages and disadvantages of Medicare Advantage plans specifically for you and your personal situation.
Complete List of West Virginia's 2023 Medicare Advantage Plan Providers
West Virginia's Medicare Advantage plans are offered by 6 plan providers, including:
- Aetna Medicare
- Highmark
- Humana
- Lasso Healthcare
- The Health Plan
- UnitedHealthcare
Top Ranked 2023 Medicare Advantage Plans in West Virginia
According to the Centers for Medicare & MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. Services, here are the top 2023 Medicare Advantage Plans available in West Virginia:
Top Medicare Advantage Plans in West Virginia
| Provider | Plan ID | Plan Name | Premium | Limit | Stars |
|---|---|---|---|---|---|
| Highmark | H5106-029 | Freedom Blue PPO Distinct (PPO) | $33.00 | $6,500 | 5.0 |
| Highmark | H5106-031 | Freedom Blue PPO Merit (PPO) | $0.00 | $8,300 | 5.0 |
| Highmark | H5106-032 | Freedom Blue PPO Prestige (PPO) | $48.00 | $6,000 | 5.0 |
| Highmark | H5106-030 | Freedom Blue PPO Signature (PPO) | $0.00 | $7,550 | 5.0 |
| Highmark | H5106-013 | Freedom Blue PPO Standard (PPO) | $163.00 | $6,500 | 5.0 |
| Humana | H5216-124 | HumanaChoice H5216-124 (PPO) | $136.00 | $6,700 | 4.5 |
| Humana | H5216-182 | HumanaChoice H5216-182 (PPO) | $18.00 | $6,700 | 4.5 |
| Humana | H5216-327 | HumanaChoice H5216-327 (PPO) | $0.00 | $7,200 | 4.5 |
| Humana | H5216-328 | HumanaChoice H5216-328 (PPO) | $0.00 | $7,550 | 4.5 |
| Humana | H5216-021 | HumanaChoice H5216-021 (PPO) | $44.00 | $5,500 | 4.5 |
| Humana | H5216-052 | HumanaChoice H5216-052 (PPO) | $47.00 | $6,700 | 4.5 |
| The Health Plan | H3672-020 | The Health Plan SecureCare - Option II (HMO) | $33.00 | $6,700 | 4.5 |
| The Health Plan | H8604-011 | The Health Plan SecureChoice - Option II (PPO) | $113.00 | $6,700 | 4.5 |
| The Health Plan | H3672-023 | The Health Plan SecureCare Capitol Plan (HMO) | $0.00 | $6,700 | 4.5 |
| The Health Plan | H8604-013 | The Health Plan SecureChoice Capitol Plan (PPO) | $78.00 | $6,700 | 4.5 |
The top providers listed above do not tell the full story. That's because your West Virginia County may or may not have one of the top-rated plans. Unlike Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., Medicare Advantage plans are regional. Read How Does Medicare Advantage Work to learn more.
Best 2023 Medicare Advantage Plans by West Virginia County
Choose your West Virginia County below to see the best (and the worst) 2023 plans.
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How to Find the Best Medicare Advantage Plan Available in West Virginia
You may be looking at plans for several different reasons, including turning 65 or the Annual Enrollment PeriodThe Annual Enrollment Period is when Medicare beneficiaries can join, drop or change Medicare Advantage and Medicare Part D prescription drug plans. AEP begins on 15 October and ends on 7 December.. Or, perhaps you are navigating a special enrollment event, such as moving to a new area. In all of these cases, there are a few important details you need to consider.
1. Consider Your Expected Utilization
Do you think you’ll take maximum advantage of your benefits? If so, prioritize plans with lower out-of-pocket maximums and lower copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service., even if they have higher monthly premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. . Otherwise, look for plans with low monthly premiums. Just be aware that plans with low or no monthly premiums tend to have higher out-of-pocket maximums and/or higher deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share..
2. Evaluate Your Prescription Costs
Prescriptions are often the main reason that people pay more for healthcare. Because most Medicare Advantage plans include Part D coverage for prescriptions, it is important to ensure you get the right plan that covers your medications at a cost you can afford.
3. Understand Your Additional Coverage Needs
Original Medicare doesn't cover all costs related to health care. It covers major medical expenses and preventative care services, however, it doesn't cover prescriptions, vision, hearing, or dental. Many of the essential services your Part A or Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. benefits don't cover are covered by Medicare Advantage plans.
4. Consider Your Healthcare Providers
Medicare Advantage plans have healthcare provider networks. Unfortunately, not all specialists and primary care doctors accept all plans. Many people on Medicare in West Virginia tell us it's difficult to find a plan their doctor accepts. We can help!
Should I Choose an HMO or PPO plan?
There are many plan options available when shopping for Medicare Advantage plans in West Virginia, including HMO and PPO options. These are some of the differences you should consider before making a plan selection.
- With an HMO you may pay less out-of-pocket, but you will need to choose a primary physician to coordinate your care. Referrals for specialists are often required. Except in an emergency, you must remain within the provider network.
- With a PPO you are not required to get referrals for specialty care. You have the option to get health care outside of the plan's provider network. However, typically you will pay more and the out-of-pocket maximum for out-of-network care will be higher.
Need help choosing? Call 1-855-728-0510 (TTY 711) for plan assistance. There's no obligation.
Find Plans in your area with your ZIP Code
Frequently Asked Questions
Still have questions? These common questions and answers might help. Or, call 1-855-728-0510 (TTY 711) to speak with a licensed advisor.
What are the disadvantages of a Medicare Advantage plan?
Medicare Advantage plans may have several disadvantages. Most plans require that their members use their network providers. It is also difficult to budget for healthcare costs as costs are largely determined by your use of healthcare services. Many plans require that members obtain referrals to a specialist before they are authorized to receive a service. Discover more disadvantages of Medicare Advantage plans.
How much do Medicare Advantage plans cost in West Virginia?
A Medicare Advantage plan in West Virginia costs an average of $33.86. This is just the monthly premium. You should also consider the out-of-pocket expenses of a plan if you have any chronic conditions, which include a plan's copays and deductibles. Prescription drug benefits are also included in most Medicare Advantage plans, but they have their own out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments..
What are Medicare Advantage plans required to cover?
At a minimum, every Medicare Advantage plan sold in West Virginia must cover all of the benefits offered in Original Medicare. However, plans are not required to cover healthcare services in the same way. Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. covers 80% of hospital stays, skilled nursing, home health careHealth care services and supplies a doctor decides you may receive in your home under a plan of care established by your doctor. Medicare only covers home health care on a limited basis as ordered..., and hospiceHospice is a special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional, and spiritual needs of the patient. care. Part B covers 80% of doctor visits, lab tests, and other outpatient services. But, Medicare Advantage plans can set their own copays, and often charge more than 20%. On the positive side, plans must set an annual out-of-pocket limit.
Methodology and Sources
Our analysis of the top-rated Medicare Advantage plans in West Virginia excludes employer group plans, Medicare-Medicaid Plans (MMPs), Medicare Savings Account Plans (MSAs), Special Needs Plans (SNPs), and plans that do not include Part D benefits.
CMS rates health plans in several categories, including delivery of health care, member experience and customer service. When comparing plan ratings, we use state-specific data, not CMS' nationwide figures.
Medicare Advantage plan data is sourced from CMS public use files (see: Citations & References). When needed, we combined affiliated companies to calculate insurer averages.
Citations & References
- CMS.gov, 2023 Medicare Part C Landscape Source Files, Last Accessed October 15, 2022
- Medicare.gov, "5-star special enrollment period", Last Accessed October 20, 2022
- Medicare.gov, "Medicare Advantage Plans", Last Accessed October 1, 2022
- KFF.org, "Medicare Advantage in 2022: Enrollment Update and Key Trends", Last Accessed August 25, 2022
- Medicare.gov, "Things to know about Medicare Advantage Plans", Last Accessed October 12, 2022
- CMS.gov, Part C and D Performance Data, Last Accessed October 19, 2022
- CMS.gov, Monthly MA Enrollment by State/County/Contract, Last Accessed October 1, 2022
- CMS.gov, Biden-Harris Administration Announces Lower Premiums for Medicare Advantage and Prescription Drug Plans in 2023, Last Accessed September 29, 2022
This Medicare Advantage state information page was last updated on .