bestMedicare AdvantageWest VirginiaBest West Virginia Medicare Advantage Plans
Updated: May 6, 2024
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MoneyGeek conducted its research to determine which Medicare Advantage Plans are widely available in West Virginia with the highest rating based on the Centers for Medicare & Medicaid Services (CMS) five-star quality rating system. We also identified which is the best plan depending on plan type, drug coverage and the amount of out-of-pocket costs.
These recommendations are generalizations, and you should do your due diligence by shopping around and comparing plans to find one that best fits your needs. It is also important to check that your preferred hospitals and health care providers are included in the network of the plan you decide to buy.
MoneyGeek also analyzed the best medicare supplement plans in West Virginia for those focused on covering out-of-pocket expenses.
bestMedicare AdvantageWest VirginiaBest Medicare Advantage Plans in West Virginia
Best plan overall - Highmark Blue Cross Blue Shield
Best HMO plan - Aetna Medicare
Best plan without drug coverage - Highmark Blue Cross Blue Shield
Best plan for low out-of-pocket costs - Highmark Blue Cross Blue Shield
Best Medicare Advantage Plan in West Virginia - Overall
Your specific needs and personal situation will dictate which is the best Medicare Advantage Plan for you. Based on MoneyGeek’s analysis, a typical buyer in West Virginia who is looking for a PPO plan with drug coverage, six core benefits and a high star rating from the Centers for Medicare & Medicaid Services (CMS) will find that Freedom Blue PPO Signature, offered by Highmark, Inc., is the best plan overall, with a total of nine benefits.
If you want flexibility and can afford to pay a higher price for access to a wider network, then a PPO might be the perfect choice. This plan will not require you to present a referral just to see a specialist.
Highmark Blue Cross Blue Shield
Freedom Blue PPO Signature might be the best option for someone who is looking for a PPO plan in West Virginia. But, always keep in mind that the best Medicare Advantage Plan for you will depend on your specific needs.
In a nutshell, Freedom Blue PPO Signature has the following advantages:
- Monthly premium of $0.
- Offers drug coverage with a drug deductible of $0.
- In-network maximum-out-of-pocket payment of $7,550.
- CMS overall star rating of 4.5 out of 5.
All the six core Medicare Advantage benefits are included in this plan. These benefits are vision, dental, hearing, fitness, worldwide emergency and telehealth services. On top of these, the plan also covers transportation, over-the-counter drugs and home safety devices and modifications. It has a near-perfect CMS rating of 4.5 out of 5 and offers Part D drug coverage. Travelers will also appreciate the inclusion of worldwide emergency services among its benefits.
Best HMO Medicare Advantage Plan in West Virginia
The best HMO Medicare Advantage Plan for you will depend on your individual needs. But in general, based on MoneyGeek’s research, Aetna Medicare Advantra Elite, offered by Aetna Medicare, is the best plan, with a total of seven benefits, for a sample shopper in West Virginia who needs an HMO plan with drug coverage, six core benefits and a high star rating from CMS.
Broadly speaking, an HMO plan is cheaper than other plan types. It is the best option if you want lower monthly payments and if in-network providers are easily available to you. However, its downside is that you will need a referral to see a specialist, and you must stay within your provider network to have your required services covered, except in an emergency.
Aetna Medicare
Someone who is searching for an HMO plan in West Virginia should examine whether the top-rated Aetna Medicare Advantra Elite best fits their needs.
Below are the features of the Aetna Medicare Advantra Elite plan:
- Monthly premium of $0.
- Offers drug coverage with a drug deductible of $0.
- In-network maximum-out-of-pocket payment of $7,000.
- CMS overall star rating of 4 out of 5.
This HMO plan has all the six core Medicare Advantage benefits, which are vision, dental, hearing, fitness, worldwide emergency and telehealth services. In addition to these, the plan covers over-the-counter medications. It has a high CMS rating of 4 out of 5 and also offers Part D drug coverage.
Best Medicare Advantage Plan in West Virginia Without Drug Coverage
You will be spoilt for choice with the number of plans that are available to you and at cheaper rates if you do not take any prescription drugs. MoneyGeek found that Freedom Blue PPO Signature, offered by Highmark, Inc., is the best plan for a sample buyer in West Virginia who wants a Medicare Advantage Plan with or without drug coverage, six core benefits and a high star rating from the CMS. This is also the best plan overall, so this could be your best option if you do not need drug coverage.
Highmark Blue Cross Blue Shield
If you are on the lookout for a Medicare Advantage Plan with or without drug coverage in West Virginia, you might want to consider a Freedom Blue PPO Signature plan. Note that this plan includes drug coverage, with an enhanced drug benefit type.
Freedom Blue PPO Signature has the following key advantages:
- Monthly premium of $0.
- Offers drug coverage with a drug deductible of $0.
- In-network maximum-out-of-pocket payment of $7,550.
- CMS overall star rating of 4.5 out of 5.
This plan has all the six core Medicare Advantage benefits, which are vision, dental, hearing, fitness, worldwide emergency and telehealth services, and covers expenses related to transportation, over-the-counter drugs and home safety devices and modifications. Its near-perfect CMS rating of 4.5 out of 5 is also proof that its policyholders receive excellent care.
Best Medicare Advantage Plan in West Virginia for Low Max Out-of-Pocket Costs
Many Medicare Advantage Plans have low or no premiums, but you run the risk of paying thousands of dollars out of pocket once you reach the cap on your annual health care costs. MoneyGeek’s analysis revealed that Freedom Blue PPO Distinct, offered by Highmark, Inc., is the best plan, with a total of 10 benefits for an average policy buyer in West Virginia who is looking for a Medicare Advantage Plan with low in-network maximum-out-of-pocket (MOOP) costs, drug coverage, six core benefits and a high star rating from the CMS.
Highmark Blue Cross Blue Shield
Based on our analysis, Freedom Blue PPO Distinct could be the best option in West Virginia for those looking for a plan with or without drug coverage. We determined this by filtering out plans that had high MOOPs. Note that this plan includes enhanced drug coverage.
In summary, Freedom Blue PPO Distinct includes the following key features:
- Monthly premium of $25.
- Offers drug coverage with a drug deductible of $0.
- In-network max-out-of-pocket payment of $6,500.
- CMS overall star rating of 4.5 out of 5.
Having a lower MOOP protects you from excessive costs which is an important safeguard if you happen to have a very expensive year for health care payments. This is because your yearly out-of-pocket costs will depend on how many medical services you need, how much these services cost and your Medicare Advantage Plan’s MOOP limit. With the Freedom Blue PPO Distinct plan, after you reach a MOOP of $6,500, you will no longer be required to pay additional fees for in-network coverage. For a PPO plan, you will have a different MOOP for out-of-network coverage, which is $10,000 for Freedom Blue PPO Distinct.
This plan has all the six core Medicare Advantage benefits, which are vision, dental, hearing, fitness, worldwide emergency and telehealth services. The plan also covers additional benefits, such as transportation, over-the-counter medications, in-home support and home safety devices and modifications.
Medicare Advantage Plan in West Virginia - Statistics
There are six health care organizations offering Medicare Advantage Plans in West Virginia. The following statistics on Medicare Advantage in West Virginia can help you figure out what plan components are rare versus common.
- 1
West Virginia Medicare Advantage Plans are a mix of HMO, PPO, Private Fee-for-Service (PFFS), and Medical Savings Account (MSA) plans, with 67.1% offering drug coverage.
Shoppers who are looking to buy a Medicare Advantage plan in West Virginia will find that the most common plans based on market share are PPO and HMO plans. A large majority of these plans include enhanced drug coverage.
- 2
47% of Medicare Advantage Plans in West Virginia have a $0 premium.
There are 17 unique plans with $0 premiums, and the average premium for plans that do not have $0 premiums is $59.6.
- 3
Hearing is the most common benefit in West Virginia, with all Medicare Advantage Plans providing this coverage.
Hearing is the most common benefit in West Virginia. The other most common benefits are vision, fitness, worldwide emergency and telehealth services, which rank equally at the second spot, and with most plans offering them. Meanwhile, the rarest benefits are in-home support, home safety devices and modifications and emergency response devices.
Methodology
MoneyGeek collected data from the <a href="https://www.cms.gov/files/document/92921-state-state-fact-sheets-2022-medicare-advantage-and-part-d-landscape-final.pdf" target="_blank">Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files</a> released in October 2021. Plans in West Virginia were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of West Virginia based on county availability.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
sources
- Department of Health & Human Services: Centers for Medicare & Medicaid Services. "Fact Sheet: Medicare Open Enrollment in West Virginia, 2022." Accessed February 1, 2022.