Insurance

Best Ways To Get Affordable Health Insurance in West Virginia

West Virginia Health Insurance Marketplace 

Name: West Virginia uses the Marketplace facilitated by the federal government

Open Enrollment Period: November 1, 202,1 to January 15, 2021

Website: healthcare.gov

Helpline: 1-800-318-2596

TTY: 1- 855-889-4325

Under the Affordable Care Act (ACA), health insurance marketplaces are available in every state, where people can purchase coverage on their own.

Those who are not opportune to have affordable coverage from an employer or other source may be eligible for subsidies to make it more affordable.

People who buy coverage through the Marketplace can’t be denied or charged more because they have a pre-existing condition, including HIV or COVID-19.

Marketplace plans are also required to provide a minimum package of “Essential Health Benefits,” which include prescription drugs, doctor visits, hospital care, mental health care, and certain preventive services. Health plans sold outside of the Marketplace may not offer the same comprehensive benefits or protections.

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People can buy coverage in the Marketplace during the open enrollment period, a specific time at the end of the year, for coverage to be effective on the first day of the following year. People experiencing certain changes in their lives can join or change plans at other times of the year.

If merit qualification for Medicaid or the Children’s Health Insurance Program (CHIP), you can sign up at any time. To sign up, visit the website (or call the helpline) above.

Financial assistance may be a possibility to help with monthly premiums and out-of-pocket costs. To see if you may be eligible for financial assistance in the Marketplace, use the Kaiser Family Foundation grant calculator.

The amount of any financial assistance will also be calculated when you purchase coverage in the Marketplace.

Medicaid

Name: West Virginia Medicaid

Website: dhhr.wv.gov

Helpline: 1-304-558-1700

Medicaid is the nation’s health insurance program for people with the lowest incomes who are US citizens or have been legal residents for at least five years. Your state has expanded Medicaid to cover more people. If you earn about $17,774 or less annually as a single person (or $24,040 or less as a family of two), you may be able to get coverage through the program.

In simpler terms, Medicaid is a partnership between the federal government and the state government that provides medical coverage to needy people who qualify for this benefit.

The goal of Medicaid Virginia is to improve the health of Virginians who would otherwise be left without health care for themselves and their children.

are no enrollment fees or premiums for Medicaid coverage if you are eligible. Low copays will be charged for certain Medicaid services.

To qualify for Virginia Medicaid benefits, you must be a resident of the state of Virginia and a legal resident of the United States, or a United States citizen, and you must also need health assistance/insurance. Your economic situation must be in the range characterized as low or very low. It must also be one of the following:

  • Be pregnant, or
  • Be responsible for a child 18 years of age or younger, or
  • suffer from blindness, or
  • Have a disability or must have a member of your household with a disability, or
  • You must be 65 years of age or older.

Medicare

Website: www.medicare.gov

Helpline:  1-800-633-4227

Medicare is a federal health insurance program for retirees and young people with disabilities. To be eligible, you must also be a US citizen or legal resident for at least 5 years.

The open enrollment period for those who are already Medicare beneficiaries is from October 15 to December 7. If you’ll soon be eligible for Medicare because of your age, you can sign up for a seven-month period that starts three months before you turn 65 and ends three months after.

If you’re under 65 and have a disability, you can sign up for Medicare during a seven-month period that begins three months before your 25th month of getting benefits and ends three months after your 25th month of getting benefits.

Finding Your Best Health Insurance Coverage in West Virginia

The best health insurance coverage for you in West Virginia should be determined based on your county, income level, and anticipated medical expenses.

West Virginia chose to expand its Medicaid plan under the Affordable Care Act (ACA). This allows people whose family income is below 138% of the federal poverty level to be eligible for Medicaid coverage.

If you don’t fall into this category, you may be able to purchase health insurance from the West Virginia Stock Exchange. The plans available to you will depend on your county, but all eligible residents can choose from policies at all mental levels. Levels vary based on typical amounts of premiums, deductibles, and other out-of-pocket expenses.

Start by buying Silver plans

Silver plans are generally intermediate policies that fall between the Gold and Expanded Bronze plans when it comes to premiums and deductibles.

For example, in West Virginia, the average monthly cost of health insurance for a Silver plan for a 40-year-old male is $831. That’s $62 less than the premium for a Gold plan, which is $893 per month. So unless you think you’re in very good health or know you’ll have significant medical costs, we recommend you consider a Silver Health Plan.

All metal levels offer premium tax credits, but Silver plans are eligible for additional cost-sharing reductions if your household income falls below 250% of the federal poverty level.

In this case, you would be eligible to receive reductions on your deductible, co-payments, and coinsurance.

The cheapest Silver plan in West Virginia is CareSource Marketplace Low Premium Silver.

Gold plans: best if you expect high medical costs

Gold plans are the highest plans available in West Virginia. A Gold health plan has the highest monthly premiums, but also the lowest deductible.

Gold plans work well if you expect high medical costs throughout the year. For example, if you need prescription drugs, a Gold plan with a low deductible could save you money.

The cheapest Gold plan in West Virginia is my Blue Access WV EPO Gold 0. Compare all levels in West Virginia above.

Expanded Bronze Plans

Expanded Bronze plans are health insurance policies with lower premiums and higher deductibles. These health plans are best suited for healthy young people who expect to have low medical expenses throughout the year.

These policies only provide most of your coverage if you exceed the high deductible level, such as in an extreme medical emergency where medical costs are very high.

The cheapest Expanded Bronze plan in West Virginia is the CareSource Marketplace Bronze First. Compare all levels in West Virginia above.

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