April 24th 2024
By Ari Parker
Find the best Medicare Advantage plan that works for your health and financial situation.
By Ari Parker
Medicare Advantage plans are a popular option among people on Medicare. While Medicare Advantage enrollment varies across the US, about half of Medicare beneficiaries in West Virginia are enrolled in a Medicare Advantage plan.
Medicare is notoriously confusing. It’s important to know what you’re getting into before you choose a plan. In this article, we’ll help you understand how Medicare Advantage plans in West Virginia work, so you can make the right choice for your health and financial needs.
Even though there are top-rated plans in every state, the best Medicare Advantage plan for you needs to take care of your specific needs.
West Virginia residents generally have between 29 and 39 plans available to them, but plan availability and pricing depends on where you live.
Insurance providers that carry highly-rated plans in West Virginia include Humana and Highmark Blue Cross Blue Shield.
West Virginia Medicare Advantage plan premiums, networks, and benefits vary. Below are some quick facts that will help you understand options available and choices made by people on Medicare in WV.
49% of Medicare beneficiaries in West Virginia are enrolled in a Medicare Advantage plan.
There are between 29 and 39 Medicare Advantage plans available, depending on where you live in West Virginia.
Insurance providers that carry top-rated plans in West Virginia include Humana and Highmark Blue Cross Blue Shield.
The main thing to know about Medicare Advantage plans is that private insurance companies manage them, giving them greater flexibility to craft their own policies. Original Medicare, which is operated by the federal government, is the exact same for everyone on Medicare. Medicare Advantage plans, on the other hand, are not standardized. Different policies will have varying costs and benefits. That said, Medicare Advantage plans have to cover the same services and equipment as Original Medicare. These plans then offer additional benefits such as:
Routine dental, hearing, and vision services
Credits for over-the-counter (OTC) items
Prescription drug (Part D) coverage
Fitness memberships
While the extra benefits can be useful, there are some disadvantages to Medicare Advantage plans. These plans:
Often require prior authorization to receive coverage, which can delay your access to care
Operate under provider networks, which can restrict access to doctors and specialists
Have varying out-of-pocket costs, which can make it difficult to compare plans and predict healthcare expenses
Now that you know a few of the pros and cons of Medicare Advantage plans, you can make an informed decision about the best plan for you.
Every year, the Centers for Medicare and Medicaid (CMS) rates Medicare Advantage plans for their performance and quality. Using a star rating system, you can see which policies are one-star, low-quality plans through five-star, high-quality plans. Using these ratings can be a good way to review plans, so you don’t end up choosing one that performs poorly.
While there are no Medicare Advantage plans that received 5 stars in West Virginia, insurance providers that carry top-rated, 4.5-star plans include Humana and Highmark Blue Cross Blue Shield.
You can use Medicare’s plan finder tool to filter by 4 and 5 star Medicare Advantage plans in your zip code.
Medicare is not one size fits all. Even though there are top-rated plans in West Virginia, it doesn’t mean that these plans are suitable for your needs. These plans may have higher out-of-pocket costs or restrictive networks and prior authorization requirements that limit your coverage for treatment.
When choosing the right Medicare Advantage plan for you, it’s best to make note of some of your healthcare needs so you don’t forget something when comparing plans. Focus on the following:
Write down a list of your healthcare priorities. Think about how often you go to the doctor, the preventive screenings you need, health concerns you have, medications you take, and any other important priorities. This can help you make sure you focus on your health when choosing your health insurance.
Understand your healthcare budget. Once you have a list of the services you may need coverage for, you can think about premiums, deductibles, and out-of-pocket costs that work for your budget. Make sure you pick a plan with a low maximum so you keep out-of-pocket costs down.
Make a note of any other health and wellness perks you’re interested in: One of the main reasons people choose to enroll in a Medicare Advantage plan is because they come with extra benefits. Familiarize yourself with the different benefits that are offered, and determine which are most important to you. Once you’ve narrowed down your plan options to those that work best for your health and financial needs, you can choose the best plan for you based on the extras!
If you need help finding your best Medicare Advantage plan in West Virginia, you can get in touch with a licensed Medicare Advisor at Chapter. Our Advisors compare plans, answer Medicare questions, and help you choose and enroll in a policy fit for you. Call us at 855-900-2427 or schedule a time to chat for a free consultation tailored to your needs.
