Residents of West Virginia who are eligible for Medicare coverage can choose among various plan options, including Original Medicare, Medicare Advantage, Part D prescription drug plans, and Medicare supplement insurance.

Medicare eligibility in West Virginia follows the same federal guidelines as elsewhere in the country. To be eligible, a person must be at least 65 years old or living with a qualifying disability or chronic health condition.

Learn more about the options for Medicare coverage as a resident of West Virginia.

According to the Centers for Medicare & Medicaid Services (CMS), the following are some key figures about Medicare in West Virginia in 2025.

  • Enrollment: There are 450,374 residents of West Virginia enrolled in Medicare.
  • Medicare Advantage (Part C): There are 58 Medicare Advantage plans available compared to 59 the prior year.
  • Part D: There are 16 stand-alone Part D plans available to residents of West Virginia.
  • Extra Help: Roughly 29.91% of people enrolled in a stand-alone Part D plan get Extra Help.

Residents of West Virginia have various options for Medicare coverage, including Original Medicare, Medicare Advantage, Part D, and Medigap.

Original Medicare in West Virginia

Individuals eligible for Medicare may enroll in Original Medicare, which comprises Part A (hospital insurance) and Part B (medical insurance). Together, these plans meet the bulk of a person’s healthcare needs.

Part A coverage includes:

  • inpatient hospital care
  • skilled nursing facility care
  • hospice care
  • limited home healthcare

Part B coverage includes:

  • outpatient care from doctors or other healthcare professionals
  • lab and imaging tests
  • durable medical equipment (DME)
  • preventive services

Medicare Advantage plans in West Virginia

Medicare Advantage plans are an alternative to Original Medicare. These plans include the same level of coverage as parts A and B while offering additional benefits, such as vision, dental, and hearing care. Most Medicare Advantage plans also include prescription drug coverage.

In 2025, the average monthly premium for a Medicare Advantage plan in West Virginia is $16.62. The lowest available premium is $0. There are 58 different plan options.

Some of the organizations that offer Medicare Advantage plans in West Virginia include:

  • Aetna Medicare
  • Highmark Blue Cross Blue Shield
  • Humana
  • The Health Plan
  • UnitedHealthcare

A person can explore Medicare Advantage coverage options by visiting the Medicare website and entering their ZIP code.

To assist people with selecting Medicare Advantage and Part D drug plans, CMS assigns star ratings to all the plans in each state.

In 2025, there are many Medicare Advantage plans in West Virginia that receive an overall star rating of 4.5. This includes those from:

  • Aetna Medicare
  • Highmark Blue Cross Blue Shield
  • The Health Plan

Star ratings for Part C and Part D plans can be found in the CY2025 Landscape document, available on the Medicare website.

Part D in West Virginia

Medicare Part D is prescription drug coverage that individuals can purchase in addition to their Original Medicare coverage or Medicare Advantage coverage (if their plan does not include drug coverage). Private insurance companies offer these plans.

In West Virginia, there are 16 stand-alone plans available across the state. The exact plans offered to a person will depend on their county.

According to the health policy research group KFF, the average Part D premium cost for plans in West Virginia was $44.71 in 2024.

Medicare supplement plans in West Virginia

Private insurance companies offer Medicare supplement plans, also called Medigap plans, to assist with the out-of-pocket costs of Original Medicare. These costs include deductibles, copayments, and coinsurance.

Medigap plans are not available to people with Medicare Advantage.

Some of the organizations offering Medigap plans in West Virginia in 2025 include:

  • AARP – UnitedHealthcare
  • Allstate Health Solutions
  • American Home Life Insurance Company
  • Cigna
  • Globe Life and Accident Insurance Company
  • GPM Health and Life Insurance Company
  • Highmark Blue Cross Blue Shield
  • LifeShield National Insurance Company
  • Mutual of Omaha

To explore Medigap coverage options, a person can visit the Medicare website and enter their ZIP code.

Medicare resources for residents of West Virginia

For further information about Medicare plan options, coverage, and costs, consider the following resources:

  • Medicare: Contact Medicare by phone at 800-633-4227 or online. Representatives are available 24/7 to offer support.
  • West Virginia State Health Insurance Assistance Program (SHIP): SHIP is a state program that offers free, unbiased guidance to Medicare beneficiaries in West Virginia.
  • Social Security Administration (SSA): The SSA website has information about signing up, applying for Extra Help, and managing benefits.
  • WV Aging & Disability Resource Center: This organization has local offices that help connect older adults with services. It is reachable by phone at (877-987-3646).

Medicare enrollment windows are the same in West Virginia as in other states. These are important periods during which people can join, switch, or drop coverage:

  • Initial enrollment period: This is a 7-month period that starts 3 months before the month of a person’s 65th birthday. If a person qualifies for Medicare through age, this is their first opportunity to join a plan.
  • Open enrollment period: From October 15 to December 7, people can switch plans or add coverage.
  • General enrollment period: Anyone who misses initial enrollment may enroll during this period.
  • Special enrollment period: Life events that affect someone’s health insurance status can trigger a special enrollment period.
  • Medicare Advantage open enrollment: From January 1 to March 31, people enrolled in Medicare Advantage plans can switch Medicare Advantage plans or return to Original Medicare.

Sometimes, Medicare will automatically sign a person up for coverage. This can happen if they have a disability and have received Social Security Disability Insurance for 2 years or have amyotrophic lateral sclerosis (ALS).

People can join a plan by:

  • enrolling online through Medicare.gov
  • signing up through the SSA website
  • contacting the plan via phone or the web
  • calling Medicare at 800-633-4227 (TTY: 877-486-2048)

When selecting a plan, it’s important to consider factors such as:

  • Cost: Plans will have different out-of-pocket costs to consider, including monthly premiums, annual deductibles, coinsurance, and copayments. Some plans will have annual out-of-pocket maximums, whereas others will not.
  • Choice: While Original Medicare coverage works across the country with any provider who accepts Medicare, Medicare Advantage plans can put restrictions on which providers members may see.
  • Coverage: Consider coverage needs when deciding on a plan. If a person needs benefits such as vision, dental, hearing, or prescription drug coverage, they may require more than Original Medicare alone.
  • Special health concerns: Certain health conditions require tailored insurance plans. A person may wish to consider a special needs plan (SNP) if they have a condition such as diabetes or HIV.

Medicare in West Virginia follows the same federal guidelines as elsewhere throughout the United States. Residents may enroll in Original Medicare or a Medicare Advantage plan.

Private insurance companies offer the latter, and plan options vary across the state based on county of residence. A person can also choose to add a Part D plan to cover drug costs or a Medigap plan to help with the expenses of Original Medicare.

Before picking a plan, people may consider their coverage needs, provider preferences, and cost requirements. For assistance, people can reach out to Medicare, the Social Security Administration, or West Virginia’s SHIP.