West Virginia Medicare Plans

The state flag of West Virginia | West Virginia Medicare InsuranceMedicare is a federally sponsored health insurance program available to those over the age of 65, as well as to individuals who have certain disabilities. At the state level, however, there exist specific organizations that help beneficiaries better understand the Medicare process, and Medicare recipients may even qualify to receive state subsidies, depending on their circumstances. Consider the following information if you are interested in obtaining Medicare coverage in the state of West Virginia.

Medicare Supplement (Medigap) Policies

Federal law doesn’t require insurance companies to sell Medigap policies to people under the age of 65. West Virginia does not require this either on the state level. Some insurance companies may voluntarily sell Medigap policies to residents under 65, but they may cost more than Medigap policies sold to people over 65. Read more about Medigap policies at CMS.gov.

Mini-COBRA Policies (small group)

Mini-COBRA policies vary by state. In West Virginia, if you work for an employer with less than 20 employees, you will fall under the West Virginia continuation state law.  This law states that you may be eligible for up to 18 months of continuation coverage through your previous employer if you retired or lost coverage due to quitting a job or reduced work hours.

West Virginia Medicare Savings Program

West Virginia has four Medicare Savings Programs.

*The following data is from 2016 and is based on federal amounts.  These amounts may increase in 2017.  If your income and resources are slightly higher, you should still apply, you may qualify for benefits even if your income is higher than the limits listed.

  • *Qualified Medicare Beneficiaries (QMBs): For individuals with a monthly income under $1,010 and for couples with a monthly income under $1,355, the state pays all premiums for Part B and all Co-Pays and Deductibles for Parts A & B
  • *Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with a monthly income under $1,208 or couples with monthly income under $1,622, the state pays premiums for Part B.
  • *Qualified Individuals (QIs): For individuals with a monthly income under $1,357 or for couples with monthly income under $1,823 the state pays premiums for Part B.
  • *Qualified Disabled and Working Individuals (QDWIs): This is available for individuals or couples who make under $4,045 or $5,425 per month, respectively, and pays for Medicare Part A premiums only.

*Data from Medicare.gov

According to ssa.gov, you should be aware that several States may even disregard all resources for individuals or couples in certain categories.

State Health Insurance Assistance Program (SHIP)

West Virginia SHIP provides assistance to Medicare beneficiaries through personal counseling sessions, by telephone, group presentations, and through the media. Counselors are located in the senior centers of all 55 counties and information is provided on a variety of topics, including Part A (hospital benefits), Part B (out-patient services), Part D (prescription drug coverage), preventive services, Medigap policies, and Medicare Savings Programs. The program is also able to provide guidance with Medicare billing issues and appeals.

Low-Income Subsidy (“extra-help”) for Prescription Drugs

In 2017, you may qualify if you have up to $18,060 in yearly income ($24,264 for a married couple) and your assets are below specified limits.  Even if your income or assets are above the limit, you may still qualify for Extra Help because certain assets and types of income may not count. If you are enrolled in a Medicare Savings Program, you are automatically qualified for Extra Help but you will still need to fill out an application.

If you live in West Virginia, you can consult with one of our MedicareSolutions.com licensed sales agents to get personal assistance that is specific to your area. One of our licensed sales agents can compare West Virginia Medicare Insurance Plans in your area and help you find the plans that are right for your needs.