We found the 26 best Medicare Part D Plans in West Virginia. Sign-up for 2024 Medicare Part D plan notification HERE.
- The average premium is $59.17 per month, however the lowest premium is just $5.20.
- The average drug plan deductible is $367 per year, but 5 plans have a zero-dollar deductible.
- Medicare rated 8% of all plans available in West Virginia 4 stars or higher.
- There are 10 basic benefit plans and 16 enhanced benefit plans.
- A total of 7 plans offer full low-income subsidy (LIS) for those who qualify.
- There are 5 plans that have additional coverage in the coverage gap phase (aka, "donut hole").
- 2024 Medicare Prescription Drug Plans (PDP) will be published in early October. Sign-up to be notified.
We also ranked the best Medicare Advantage plans with Part D in West Virginia for 2024.
West Virginia Medicare Part D Plans
|Plan Name||Premium||Deductible||Benefit Type||LIS||Gap
|AARP MedicareRx Preferred||$112.20||$0||Enhanced||No||Yes||Yes|
|AARP MedicareRx Saver Plus||$37.00||$505||Basic||Yes||No||No|
|AARP MedicareRx Walgreens||$32.60||$350||Enhanced||No||No||No|
|Blue Rx PDP Complete||$192.60||$0||Enhanced||No||Yes||No|
|Blue Rx PDP Plus||$121.10||$505||Basic||No||No||No|
|Cigna Extra Rx||$57.80||$100||Enhanced||No||Yes||Yes|
|Cigna Saver Rx||$12.40||$505||Enhanced||No||No||No|
|Cigna Secure Rx||$38.30||$505||Basic||Yes||No||No|
|Clear Spring Health Premier Rx||$20.50||$505||Enhanced||No||No||No|
|Clear Spring Health Value Rx||$30.60||$505||Basic||Yes||No||No|
|Humana Basic Rx Plan||$42.00||$505||Basic||Yes||No||No|
|Humana Premier Rx Plan||$88.40||$200||Enhanced||No||Yes||Yes|
|Humana Walmart Value Rx Plan||$30.60||$505||Enhanced||No||No||No|
|Mutual of Omaha Rx Essential||$19.90||$505||Enhanced||No||No||No|
|Mutual of Omaha Rx Plus||$90.60||$505||Basic||No||No||No|
|Mutual of Omaha Rx Premier||$71.40||$505||Enhanced||No||No||Yes|
|SecureRx - Option 1||$126.30||$0||Enhanced||No||No||Yes|
|SecureRx - Option 3||$78.10||$315||Basic||No||No||No|
|Wellcare Medicare Rx Value Plus||$71.40||$0||Enhanced||No||No||No|
|Wellcare Value Script||$11.10||$505||Enhanced||No||No||Yes|
Please note that 2024 Medicare Part D plan information for West Virginia beneficiaries will not be available until early October.
Sign-Up for 2024 Medicare Part D Plan Notification
The Four Phases of Every West Virginia Medicare Part D Plan
West Virginia Medicare prescription drug plans help beneficiaries pay for their prescription medications. If you are new to Medicare, some of the Part D plan concepts may be foreign to you. So we'll start with an overview of the four cost-sharing phases.
The Deductible Phase
The deductible (up to $505 in 2023) is the amount that you pay before your Medicare Part D plan begins paying its share of the costs. So, if you enroll in a 2023 prescription drug plan with a $480 deductible, you'll spend $480 out-of-pocket before cost-sharing coverage begins. Most Medicare Part D plans have a deductible, but some Medicare Part D plans exclude Tier 1 drugs from the deductible, giving immediate coverage on most generic medications.
Phase 2 is the Initial Coverage Limit
For 2023, the Part D Initial Coverage Limit (ICL) is $4,660. Your Part D plan will pay the bulk of your prescription cost during the ICL phase. If your costs exceed $4,660, then you will be in the coverage gap phase (aka "doughnut hole")
Phase 3 is the Coverage Gap
After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic drugs might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,400 in True Out Of Pocket Costs (TrOOP).
Some plans offer additional gap coverage, so look for it on the plan information pages.
The Fourth Phase is Catastrophic Coverage
All Part D plans offer catastrophic coverage once you have paid $7,400 in true out-of-pocket costs for covered drugs. This amount includes the cost of covered drugs as well as some additional costs. In the catastrophic coverage phase, your copays or coinsurance will be significantly lower for the remainder of the year.
The out-of-pocket costs that help you get catastrophic coverage include:
- Your plan's deductible;
- What you paid during the initial coverage limit period;
- Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
- The amount paid by others, including family members, most charities, and other persons on your behalf; and
- The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.
Choose Your Part D Plan with Care
Evaluate Part D Medicare plans wisely. If you have a regular prescription or two, we suggest that you verify that the plan you want offers your medication(s) at a good price. You find this information in the formulary. We post links to the formulary and pharmacy web pages, as well as the plan's phone number, on each of the PDP pages listed above.
VITAL: Identifying the best Medicare Part D Plans requires research. What works the best for you is all about your regular prescriptions (if any), your health, and what you can afford.
Medicare Part D is Included in Most 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 available in West Virginia. The second way is to get prescription coverage through one of the many West Virginia Medicare Advantage Plans that include Part D benefits. Most Medicare Advantage plans available in West Virginia include Part D as an additional benefit.
Combining a Medicare Supplement and Medicare Part D Benefits
Are you thinking about supplemental Medicare insurance that can offer you more coverage? It's a smart move. Original Medicare only covers about 80 percent of your major medical bills, leaving you to cover the rest. We make it easy to find the lowest rates on West Virginia Medicare Supplements, also known as Medigap plans. The choice is yours because all Part D plans are compatible with the full range of West Virginia Medicare Supplements.
Getting Medicare Part D with West Virginia Medicaid
If you meet the requirements for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") in West Virginia, you will automatically receive a Medicare Prescription Drug Plan, as well as Extra Help from Social Security. If you qualify for Extra Help, the program will cover most of the costs of your prescriptions. Even if you qualify, the dual eligible option may not suit your needs. In this case, enroll in the prescription drug plan of your choice. If you receive Medicaid now, call your local Medicaid office for assistance with your dual eligible benefits.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.
Citations & References
- Medicare.gov, "Drug coverage (part D)", Last Accessed September 21, 2022
- Medicare.gov, "What Medicare Part D drug plans cover", Last Accessed August 1, 2022
- Medicare.gov, "Medicare costs at a glance", Last Accessed September 11, 2022
- Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed June 7, 2022
- SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
- CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
- CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023