West Virginia Medicare Part D Plans (PDP) 2018 Medicare Prescription Drug Plans

People with Medicare benefits in West Virginia have fewer Medicare Part D Plan (PDP) choices in 2018. However, premiums are about the same, and in some cases have decreased. The maximum annual deductible is now $405, up from $400 last year.

Choose from the available Part D Medicare plans carefully, and don't settle on a Part D plan until you know that your most expensive medications are covered at a price you can afford. This information is available in the plan's formulary. You'll find links to the formulary information, pharmacy information, and the customer service phone number on each PDP page (above).

CRITICAL: The best Medicare Part D Plans for you can only be determined by factoring in what you can afford, your regular prescriptions and your health. A bit of time spent on research will pay off in the long run.

The 2018 Medicare Part D Coverage Gap is Closing

If you have expensive prescriptions, chances are that you will reach the Medicare coverage gap (aka, donut hole). The Affordable Care Act eventually closes the gap, but it's still with us in 2018. Until it's gone, use a pharmacy discount card. It will help with most of your uninsured prescriptions throughout West Virginia. We recommend the Rx Discount Card and coupons from GoodRx.com.

The 2018 Initial Coverage Limit (ICL) is $3,750. The Coverage Gap (donut hole) starts when you reach the ICL ($3,750) and ends when you spend a total of $4,950. This year, Part D enrollees will get a 60% discount on the total cost of brand-name drugs purchased while in the donut hole. A 50% discount, paid by the brand-name drug manufacturer, applies to getting out of the donut hole. But, the additional 10% paid by your PDP does not count toward your True Out-of-Pocket (TrOOP) costs.

For instance, if you reach the donut hole and purchase a brand-name medication with a retail cost of $100, you'll pay $40 for the prescription and get a $90 credit toward meeting your total out-of-pocket spending limit.

PDP enrollees pay a 51% co-pay (maximum ) on all generic drugs purchased while in the coverage gap. For example, if you fall in the Donut Hole in 2018, and your generic medication retails for $100, you'll pay only $51. This amount counts toward your TrOOP.

Some plans offer additional gap coverage, so look for it on the plan information pages.

Medicare Part D is Included with Most West Virginia Medicare Advantage Plans

There's more than one way to get prescription drug coverage with your Medicare benefits. The first way is by enrolling in one of the Medicare Prescription Drug Plans listed above. The second way to get help paying for your prescriptions is through one of the West Virginia Medicare Advantage Plans that include Part D.

Combining a Supplement and Medicare PartD Benefits

The new healthcare law did not change the coverage you get from Medicare for major medical. You are still responsible for paying the remaining 20 percent of all hospital and doctor bills. Even a brief hospital stay can cost you thousands. That's why we maintain a complete catalog of West Virginia Medicare Supplement Insurance, also known as Medigap. We make it easy to find the best price on the plan you want. All Medigap plans are 100% compatible with the Medicare PartD pland listed above.

West Virginia Medicaid and Your Medicare Part D

West Virginia seniors who qualify for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) may be enrolled in a West Virginia Medicare Prescription Drug Plan automatically, as well as Social Security's Extra Help program. The Extra Help program pays for most of your prescriptions, but only if you meet the strict eligibility requirements. If the dual eligible option does not meet your needs, you have the option to enroll in a West Virginia Part D plan that does. If you are already receiving Medicaid, contact the your local Medicaid office for assistance in the transition to Medicare.

Related Information

• Who Qualifies For Medicare Part D Coverage?
• How Much Does Medicare Part D Cost?
• When Should I Get Medicare Part D Coverage?
• Can Changing My Medicare Part D Plan Lower My Drug Costs?