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Medicare in West Virginia

Medicare beneficiaries in West Virginia may have several Medicare coverage options. Find out about Original Medicare, Part A and Part B, and private Medicare coverage available from insurance companies in West Virginia.

Original Medicare for West Virginia beneficiaries

Original Medicare refers to Medicare Part A (hospital insurance) and Part B (medical insurance). Medicare Part A includes inpatient services in hospitals and skilled nursing facilities, limited home health services in certain situations, and hospice care. Medicare Part B covers services and items including doctor visits, diabetic supplies, flu shots and other preventive services, and other medically necessary services and items.

In West Virginia, as in every state, to be eligible for Medicare, you must be at least 65 years old or have a qualifying disability. Most Americans are automatically enrolled in Medicare when they turn 65 or collect disability benefits, but if you don’t qualify for automatic enrollment, you can sign up using the information below. To avoid late enrollment penalties, you generally need to sign up during your Initial Enrollment Period (a seven-month period starting three months before your 65th birthday month, including your birthday month, and ending three months after your birthday).

To apply for Medicare Part A and Part B, you can contact Social Security:

If you get Railroad Retirement Board (RRB) benefits, call the RRB to apply for Medicare. Dial 1-877-772-5772 (TTY users, call 1-312-751-4701) Monday through Friday, from 9AM to 3:30PM.

Original Medicare doesn’t include prescription drug coverage (except for medications administered when you’re a hospital inpatient or outpatient). Original Medicare comes with certain costs, such as copayments, coinsurance, and deductibles, depending on the service or item you receive. Private Medicare insurance, described below, can provide this coverage.

Medicare private insurance in West Virginia

In West Virginia, just as in all states, you may have a choice of various Medicare insurance options beyond Original Medicare. Here’s a summary of the Medicare plan options; availability can vary depending on your zip code. All of these types of Medicare insurance are sold by private companies that contract with Medicare.

  • Medicare Advantage (Medicare Part C) offers a way to get your Medicare coverage through a private company instead of directly through the federal government. Although Medicare Advantage plans provide the same Medicare Part A and Part B benefits you get through Original Medicare, it’s the insurance company that administers the plan. Often, Medicare Part C plans include additional benefits, such as prescription drug coverage. A Medicare Advantage Prescription Drug plan lets you get your Medicare health and drug benefits in a single policy. You still pay your Medicare Part B premium if you have a Part C plan.See more about Medicare Advantage plans in West Virginia.
  • Medicare Supplement (Medigap) plans can help pay some of the costs associated with Original Medicare, such as deductibles, copayments, and coinsurance. In general, Medicare Supplement plans don’t work with Medicare Advantage plans.For more information, see how Medigap works in West Virginia.
  • Medicare Part D is prescription drug coverage. You can get this benefit through a stand-alone Medicare Part D plan to work alongside your Original Medicare coverage. Alternatively, you can get this coverage through a Medicare Advantage Prescription Drug plan. Drug coverage is optional, but if you don’t sign up for Part D when you’re first eligible for Medicare, you might face a late enrollment penalty.Read more about Medicare Part D plans in West Virginia.

West Virginia resources for Medicare beneficiaries

As a West Virginia resident, you might find these additional resources helpful.

  • For free health insurance counseling, contact the West Virginia State Health Insurance Assistance Program (SHIP); visit the website or call 304-558-3317 or 877-987-4463.
  • For a wide variety of health-care information, such as questions to ask your doctor, contact the Agency for Healthcare Research and Quality (AHRQ); visit the website or call 800-358-9295 (TTY users call 888-586-6340).
  • To learn about services for the elderly in your community, contact the West Virginia Bureau of Senior Services; visit the website or call 304-558-3317 or 877-987-3646.
  • For information about health insurance in West Virginia, contact the West Virginia Offices of the Insurance Commissioner; visit the website or call 304-558-3386.