West Virginia Medicare – What You Need to Know

Medicare beneficiaries in West Virginia can enroll in either Original Medicare or a Medicare Advantage Plan. Original Medicare covers hospital and medical insurance, while a Medicare Advantage Plan offers additional coverage like fitness programs, discounts on hearing aids, and more. West Virginia Medicare Advantage Plans are bundled plans offered by private insurance companies. In addition to the benefits that are part of Medicare Parts A and B, these plans typically include a primary care provider and referrals for specialists. Some also offer drug coverage. They are available in many different types, such as HMOs, PPOs, and regional PFFS plans.

West Virginia Medicare Eligibility

The first step is to determine your eligibility for Medicare. If you’re 65 or older, you can enroll during the Initial Enrollment Period that begins three months before your birthday and ends three months after. You can also enroll if you’re receiving SSDI for 24 months or more or have ALS or end-stage renal disease (ESRD). Some people opt for Medicare Advantage plans, which are private insurance plans that offer more benefits than Original Medicare. In addition, some seniors choose to purchase a Medicare Supplement plan, which covers the costs of Part A and B.

You can also qualify for a Medicare Advantage plan if you receive Social Security or Railroad Retirement Board disability payments for at least 24 months or have end-stage renal disease or amyotrophic lateral sclerosis (ALS). The best time to enroll in a Medicare Advantage plan is during your Initial Enrollment Period, which begins three months before your birthday and ends three months after.

West Virginia Medicare Supplement Plans

There are 12 standardized Medicare Supplement plans in West Virginia that are designated by letters (A, B, C, D, F, G, K, L, M, N). Plan F is the most popular option and will remain available through 2020. There are also a number of savings programs available to help lower the cost of prescription drugs.

West Virginia’s spend-down program allows seniors who are over the Medicare income limit to become income-eligible for Medicaid through submitting medical bills equal to their excess income. The program lasts six months, and enrollees must submit new medical expenses during that time. The state will then subtract that amount from the enrollee’s income to determine their excess income and if they meet the asset limit.

In West Virginia, there are many senior organizations that help residents with Medicare enrollment. These groups also offer a variety of other services. Some of these services include nutrition, fitness classes, and transportation. In addition, some communities have local public health agencies that collaborate with senior organizations. Lastly, some communities have Area Agencies on Aging that provide information and support to seniors. In addition to these resources, many states have programs that help with Medicare premiums.