West Virginia Medigap Plans, also known as Medicare Supplement (AKA Med Supp or MedSup) Insurance policies, are offered by private companies to bridge the gaps in Original Medicare coverage. While Original Medicare covers a significant portion of healthcare expenses, it doesn’t cover all costs, including copayments, coinsurance, and deductibles. MedSup policies step in to help cover these out-of-pocket expenses. In WV, MedSup here works similarly to those standardized Medigap plans available in most states.
WV MedSup Basics
If you’re new to Medigap or considering a new plan in West Virginia, here are some essential tips to remember:
- With Original Medicare and a Medigap policy, Medicare covers its share of approved health care costs before your Medigap policy takes effect.
- West Virginia Medigap policies fill in the gaps for expenses where Medicare only pays part of the cost. Some go beyond Original Medicare’s coverage, covering expenses like emergency foreign travel.
- MedSup won’t cover costs associated with other health plans, including Medicare Advantage, standalone drug plans or employer/group health coverage.
- Medigap policies differ from Medicare Advantage Plans since Medigap has no unique network of doctors. Any doctor who accepts Medicare must accept Medigap.
- Insurance companies usually can’t sell you a Medigap policy if you’re enrolled in a Medicare Advantage Plan or Medicaid.
- Medigap policies in West VA must follow the same standardized format labeled with letters (Plans A-N), as are offered in most states.
- In some states like West Virginia, excess charges are allowed. The good news is that many Medigap plans, Including Plan G, will pay these Excess Charges for you. Learn what they are and how to steer clear of them in our article: “How To Avoid Medicare Excess Charges“.
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Comparing West Virginia Medigap Plans
Plans available for those Medicare-eligible after January 1, 2020:
| Benefits | A | B | D | G* | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,632) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($240) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100%* |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,060 | $3,530 |
*Medigap Plan G High deductible ($2,800) is also available.
Note that Plans C and F are no longer available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy Plan C or Plan F. (Source)
When to enroll in a West Virginia Medigap Plan
In West Virginia, like many states, there’s a Medigap Open Enrollment Period (OEP). OEP is a one-time, six-month enrollment period. Sometimes it is referred to as your Initial Enrolment Period.
During this OEP:
- You can buy a Medicare supplement policy, and insurers must accept you, no matter your health.
- Premiums can’t increase based on your medical history.
Remember, “Open Enrollment” isn’t an annual event; it’s usually a one-time opportunity when you first qualify for Medicare in West Virginia. If you miss OEP, you can still enroll in a MedSup plan, but you may have to answer health questions before you are approved. Learn more about your Medigap enrollment options by clicking on this link.
Most Popular Plan in West Virginia State
According to the most recent data provided by America’s Health Insurance Plans (AHIP), over 87,000 West Virginia residents have chosen a MedSup policy. While Plan F used to be the most popular Med Supp plan, it’s no longer available for new enrollees since Medigap Plan F is no longer available to those new to Medicare after Jan 1, 2020. Consequently, Plan G now is the most popular Medigap plan. Plan G has 31,000 West Virginians enrolled.
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West Virginia Medigap Discounts
While Medigap benefits are standardized, insurance providers are allowed to set their own monthly premiums. Some companies offer “Household Discounts” or “HH Discounts.” These typically reduce your monthly Medicare Supplement premium when two residents from the same address are enrolled with the same Medigap insurer. Note that household discounts may not appear automatically in our Medigap quoting system. Be sure to click “show household discount” on the results page.
Medigap providers can also give discounts if you set up autopay for your monthly premiums. Learn everything about Medigap discounts and special offers right here.
What now, Mountaineers?
The next step is to find out how much Medigap costs in your county. Get a quick West Virginia Medigap quote here online.
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