Original Medicare gives you fairly comprehensive coverage and lets you see any doctor in the country who accepts Medicare. But it’s not perfect, and you might find, like many Medicare recipients do, that the 20% Medicare Part B coinsurance and other out-of-pocket costs are too much for you. If this is the case for you, or even if you just want to save some extra money, you should look into a West Virginia Medicare Supplement Plan to get more coverage.
Private insurance companies sell West Virginia Medicare Supplement Plans to fill the gaps in Medicare Parts A and B. These plans usually cover your Part A deductible and your 20% Part B coinsurance. Among other expenses associated with Original Medicare. But even though these plans are sold by private companies, the Centers for Medicare & Medicaid Services (CMS) regulates Medicare Supplement Plans. The CMS requires that all plans with the same letter name cover the same benefits everywhere in the country.
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Still, premiums can vary depending on which insurance company you choose. So, you need to compare both Medicare Supplement Plans and insurance companies to find the best one for you. EZ can help you compare both of them. But before you do that, you should read our guide to Medicare Supplement Plans in West Virginia.
West Virginia Medicare Supplement Plans
A Medicare Supplement Plan is your best option if you need extra coverage to fill the gaps in Original Medicare. So, if you live in West Virginia and want a Medicare Supplement Plan, the first thing you should know is that there are ten standardized plans. Each named with a different letter of the alphabet (A, B, C, D, F, G, K, L, M, and N). All insurance companies must offer Plan A to their customers. However, only people who qualified for Medicare before January 1, 2020 can get Plans C and F.
Depending on the plan and where you live in West Virginia, monthly premiums for these plans can cost anywhere from $50 to $1,744. With so many choices, it can be hard to keep track of everything. However, to help you get started, we’ve laid out what each plan covers.
Plan A
Plan A is the most basic Medicare Supplement Plan available. But even though it is basic, it will cover what is probably the most important thing that Medicare Supplement Plans cover: the 20% of outpatient treatments that Medicare doesn’t pay for. It also covers a handful of other major expenses, so if this is the only plan you can get, you will still have your out-of-pocket costs significantly reduced.
Plan A must be offered by all Medicare insurance companies, but some states don’t require insurers to offer it to Medicare disability beneficiaries under the age of 65.
In West Virginia, Plan A premiums cost anywhere from $85 to $1,344 per month.
Plan B
Medicare Supplement Plan B covers everything that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day. Additionally, if your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
Plan B is a bit less basic than Plan A, though, because it also covers your Medicare Part A hospital deductible, which Plan A doesn’t. In 2023, the Medicare Part A deductible is $1,600 per benefit period. Since this deductible isn’t charged once a year but instead every 60 days, you may have to pay it more than once in a single year. That means that having a plan that covers this could be very helpful.
Plan B premiums in West Virginia range from $117 to $350 per month.
Plan C
This is one of the most comprehensive Medicare Supplement Plans on the market, but it is not available to all beneficiaries. Plan C covers everything except for Medicare Part B excess charges. This means Plan C covers both your Parts A and B deductibles, as well as the 20% coinsurance you’d normally have to pay for all outpatient care.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Plan C is no longer available to Medicare recipients who became eligible for Medicare after January 1, 2020. If you had Plan C prior to that date, you can keep it, and if you were Medicare-eligible prior to January 1, 2020 but have not yet enrolled, you may still be able to purchase it.
Plan C monthly premiums in West Virginia range from $152 to $427 per month.
Plan D
Medicare Supplement Plan D covers the majority of out-of-pocket medical expenses including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
Plan D does not cover the Medicare Part B deductible or Part B excess charges. If your doctor doesn’t accept Medicare assignment, they can charge you more for a service than Medicare will pay, and you will have to pay the difference, known as an excess charge. Since Plan D does not cover excess charges, you should look for another plan if you think you will be seeing providers who don’t accept Medicare assignment.
In West Virginia, Plan D premiums can cost anywhere from $108 to $295 a month.
Plan F
Medicare Supplement Plan F has long been the best-selling plan on the market, but like Plan C, it is not available to everyone. It covers all of your out-of-pocket expenses. So, you’ll only pay your monthly Plan F premium if you have this plan. The covered expenses include:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
People who became eligible for Medicare after 2020 cannot sign up for Plan F. You can buy one of these plans if you became eligible for Medicare before 2020. If you have already bought Plan F and are “grandfathered in,” you can keep your plan for as long as you like.
Plan F premiums in West Virginia range from $115 to $1,744 a month.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
The only thing Plan G doesn’t cover is the Medicare Part B deductible. And the good news is that Plan G premiums are frequently very competitive, with premiums ranging from $101 to $1,401 a month in West Virginia, making these plans a better value than Plan F.
Plan K
Medicare Supplement Plan K reduces your Original Medicare out-of-pocket expenses. But it does not completely fill the gaps. Plan K only pays 50% of some expenses until you reach what’s known as your out-of-pocket maximum. These expenses include:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of the remaining 20%. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will cover the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800.
Plan K has higher out-of-pocket costs than other plans. But its maximum out-of-pocket is a feature that most other plans don’t have. Having this maximum means that the most you’ll have to pay for Plan K each year is $6,620 (as of 2023). Once this limit is reached, Medicare Supplement Plan K will pay for the rest of your approved costs for the year. At the start of every year, your limit will be reset.
Plan K also covers 100% of Medicare Part A coinsurance, even though it only pays 50% of most costs. So if you have to stay in the hospital for more than 60 days, you will not have to pay for this out-of-pocket. This is the only basic benefit that Medicare Supplement Plan K completely covers.
Plan K premiums are less than most other plans, costing between $50 and $157 per month.
Plan L
Medicare Supplement Plan L also covers the majority, but not all, of the costs associated with Original Medicare, but it covers them at a higher percentage than Plan K does. It also has an out-of-pocket maximum, but Plan L’s is lower than Plan K’s ($3,310 in 2023). Once you pay that amount in expenses for the year, your insurer will pay your approved bills in full.
Medicare Supplement Plan L covers all of Medicare Part A coinsurance and hospital costs. It also covers a percentage of:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period.
Plan L premiums cost between $63 and $264 a month in West Virginia.
Plan M
Like Plan K and Plan L, Medicare Supplement Plan M covers the majority of the costs associated with Original Medicare, but not all of them. This plan, though, covers far more of them in full than either of the other plans do.
Medicare Supplement Plan M covers all of Medicare Part A coinsurance and hospital costs. It also covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Plan M premiums range from $116 to $310 per month in West Virginia.
Plan N
Most of the gaps in Original Medicare coverage are filled by Medicare Supplement Plan N. Only the Medicare Part B deductible ($226 in 2023) and any Medicare Part B excess charges, which are parts of doctor bills that are more than the Medicare-approved amount, are not covered. However, Plan N does have something that other plans do not: copayments for some Part B services.
Everything on the list below is covered by Medicare Supplement Plan N:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
The price for Plan N can range from $73 to $1,052 a month in West Virginia.
When to Enroll
You can technically buy a Medicare Supplement Plan at any time, and there is no set annual enrollment period. However, federal rules give you a six-month “guaranteed-issue” window, which starts when you turn 65 and sign up for Medicare Part B. This six-month Medicare Supplement Open Enrollment Period is the only time you’ll be given these guaranteed-issue rights. Meaning insurance companies cannot deny you or charge you more for coverage based on your health.
But federal rules do not guarantee that someone under 65 who is eligible for Medicare because of a disability will be able to get a Medicare Supplement Plan. Most states have rules that make sure people under 65 can get at least some access to Medicare Supplement Plans. But West Virginia is not one of them.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything and give you guidance when it comes time to sign up. EZ can assist you in enrolling in Medicare, looking for a West Virginia Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. So, they can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs with you and help you find a plan that works for you. To start, simply enter your zip code in the bar below or give one of our agents a call at 877-670-3602.
