Guide to Medicare Advantage Plans in Monroe County, WV for 2025
There are 27 Medicare Advantage plans available in Monroe County, WV for the 2025 plan year, including 17 plans with $0 premiums. Most plans include prescription drug coverage. These counts exclude Special Needs Plans.
Not in Monroe County? Enter your ZIP code to see plans in your area.
- Top 3 Plans by Enrollment:
1. Freedom Blue PPO Prestige (PPO) — 227 enrollees
2. Humana USAA Honor Giveback with Rx (PPO) — 121 enrollees
3. HumanaChoice H5216-327 (PPO) — 101 enrollees - Average Monthly Premium: $20.15
- Average Maximum Out-of-Pocket Limit: $6,824
- Average Prescription Drug Deductible: $215.75
- Ratings (Plan Mix): 4+ Stars: 44% · 3 Stars: 56% · Below 3: 0%
- Plan Type Breakdown 3 HMO · 21 PPO · 1 PFFS · 2 REGIONAL PPO
Monroe County, West Virginia Medicare Advantage Plans
📊 At a Glance: Medicare Advantage in Monroe County
- Average Monthly Premium
- $20.15
- Plans with $0 Premium
- 17
- Average MOOP Limit
- $6,824 ($9,350 max. in 2025)
- Average Rx Deductible
- $215.75
- Plans Without Drug Coverage
- 4 (standalone West Virginia Part D plans)
- Plans with 5-Star Ratings
- No 5-star plans available.
- Stars Ratings (Plan Mix)
- 4+ Stars: 44% · 3 Stars: 56% · Below 3: 0%
- Plans Available
- 27 (excluding Monroe County SNP plans)
- Plan Type Breakdown
- 3 HMO · 21 PPO · 1 PFFS · 2 REGIONAL PPO
- Countywide Enrollments
- 1,005 (excluding SNP plans)
- Top 3 Plans by Enrollment
- 1. Freedom Blue PPO Prestige (PPO) — 227 enrollees
2. Humana USAA Honor Giveback with Rx (PPO) — 121 enrollees
3. HumanaChoice H5216-327 (PPO) — 101 enrollees
Data Sources: CY2025 Landscape, PBP Benefits, Star Ratings Data, Monthly Enrollment by CPSC, and SimpleMaps U.S. Counties. Enrollment data last updated . County demographic data last updated .
Understanding Your Medicare Advantage Options
Medicare Advantage Plans, also known as Medicare Part C, are private health plans that provide all-in-one coverage, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). On top of the core benefits, many of the plans in Monroe County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Monroe County looking for something more than Original Medicare.
🏥 Health Maintenance Organization (HMO) Plans
HMO plan members must use the plan's network of doctors and hospitals in Monroe County, and typically need a referral to see a specialist. Some Medicare Advantage HMO Plans may have lower costs but offer less flexibility in choosing healthcare providers. There are 0 residents enrolled in HMO plans in this county. The most popular plan is {top_enrolled_HMO}.
🔓 Preferred Provider Organization (PPO)
A PPO allows more flexibility in choosing healthcare providers, with the option to see specialists without referrals, though often at a higher cost. Medicare Advantage PPOs usually have higher premiums and out-of-pocket expenses. There are 988 Monroe County residents enrolled in PPO plans. The most popular of these plans by enrollments is Freedom Blue PPO Prestige .
🪟 Private Fee-for-Service (PFFS)
Allows members to visit any Medicare-approved doctor or hospital in their area that accepts the plan's payment terms. Medicare PFFS plans offer more flexibility but may result in higher costs. There are 17 Monroe County residents enrolled in PFFS plans. The most popular of these plans by enrollments is Humana Gold Choice H8145-052 .
Advantages of Enrolling in Medicare Advantage
Many Medicare Advantage Plans offer extra benefits that go beyond Original Medicare, making them an attractive option for some people. These plans provide comprehensive coverage, often including additional services like prescription drug coverage, dental, vision, and wellness programs, all bundled into one plan. By choosing a Medicare Advantage Plan, you can simplify your healthcare and potentially save on costs.
Take a look at the main benefits provided by Medicare Advantage Plans in Monroe County:
🧑⚕️Coordinated Care
Plans often include care coordination services, which help you manage your healthcare across different providers and services.
💸 Cost Savings
Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.
🧾 Comprehensive Coverage
Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.
🧘 Wellness Programs
Many Yavapai County plans offer free gym memberships, wellness programs, and preventive care services. You need to stay healthy, right?
Tips for Selecting a Medicare Advantage Plan
When it comes to selecting from the 27 Medicare Advantage Plans available in Monroe County, it’s important to focus on these critical factors:
🏥1. Provider Network
Confirm that your doctors and preferred healthcare facilities are in the plan's network to avoid out-of-network charges.
💊 2. Prescription Drug Coverage
Review the plan's drug coverage to ensure it meets your needs, particularly for any specialty medications.
💰 3. Costs
Compare the overall costs, including premiums, copayments, and maximum out-of-pocket expenses, to find a plan that fits within your budget.
🎁 4. Additional Benefits
Determine which additional benefits are offered and how they align with your personal health and wellness needs.
⭐ 5. Plan Ratings
Research the plan’s star ratings to understand its effectiveness, quality of care, and member satisfaction.
Find out how to effectively compare Medicare Advantage Plans and make an informed choice.
Medicare Advantage Enrollment Periods
Making sense of Medicare Advantage enrollment periods can seem overwhelming, but it's worth the effort for better health coverage. Missing these key dates could delay your coverage or limit your plan choices for 2025 in Monroe County.
📅 Initial Enrollment Period (IEP)
This is your first opportunity to enroll in a Medicare Advantage Plan when you first become eligible for Medicare. Your Initial Enrollment Period lasts for seven months, starting three months before your 65th birthday.
🗓️ Annual Enrollment Period (AEP)
Occurs every year from October 15 to December 7. During the Annual Enrollment Period, you can switch, drop, or join a Medicare Advantage Plan.
🔁 Open Enrollment Period (OEP)
From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare if you’re already enrolled in a Medicare Advantage Plan.
For more detailed information on the enrollment periods and how to enroll, visit our comprehensive guide on Medicare Advantage Plan Enrollment.
Frequently Asked Questions
What are the most popular Medicare Advantage plan types in Monroe County?
Based on the 2025 plan data, PPO plans are the most common in Monroe County. The full breakdown of plan types is: 3 HMO · 21 PPO · 1 PFFS · 2 REGIONAL PPO.
How much can I expect to pay out of pocket for Medicare Advantage plans?
The average maximum out-of-pocket limit (MOOP) in Monroe County is $6,824 for 2025.
Do any Medicare Advantage plans in Monroe County have 5-star ratings?
No 5-star rated Medicare Advantage plans are available in Monroe County for the 2025 plan year. However, 44% of plans have a rating of 4 stars or higher.
What is the average monthly premium for Medicare Advantage plans in Monroe County?
The average monthly premium for Medicare Advantage plans in Monroe County is $20.15. A total of 17 offer $0 premiums, though costs vary by plan type and benefits.
More About These Plans
Carrier Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Master Plan Pages by Plan ID
The plan pages listed in the table above have been modified for localization to help consumers identify plans available in their area. Most plans are available in multiple areas. The following list of plan IDs link to each plan's master page.
Plan Availability
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Alderson, Ballard, Gap Mills, Lindside, Peterstown, Sinks Grove, Union, and all other areas of Monroe County, West Virginia, including the following zip codes: 24910, 24918, 24925, 24941, 24945, 24951, 24963, 24970, 24974, 24976, 24981, 24983, 24984, 24985, 24993.
Citations & References
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 19 March, 2025
- CMS.gov, "Special Needs Plans (SNP)", Last Accessed 24 May, 2024
- Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed 19 March, 2025
- Plan and enrollment data provided by the Centers for Medicare & Medicaid Services (CMS)
- Data processed and interpreted by MedicareWire.com editorial team.
- Read our methodology and sourcing policy.