West Virginia Medicare insurance is a federal program that offers affordable health insurance coverage to senior citizens in the USA who are over 65 as well as to workers with certain disabilities. This is a relief for many residents in West Virginia, which has the 2nd-lowest median household income in the country and a poverty rate of 18.3%. West Virginia’s state government also offers various assistance programs for low-income Medicare beneficiaries.
Medicare coverage begins with the combination of Medicare Part A and Part B. Together, they’re known as Original Medicare. Part A focuses on hospital insurance, covering services such as inpatient hospital or psychiatric care. Part B concentrates on medical insurance, which covers such services as outpatient care, preventive services, and durable medical supplies.
The costs of Medicare premiums are more affordable than West Virginia’s average cost of health insurance, which averages $561 per month. Part A doesn’t require beneficiaries to pay premiums for most cases. Part B normally requires premium payments, but for workers who earn less than $85,000 a year, these premiums cost only $134 a month.
Both Part A and Part B do come with deductibles, copays, and coinsurance costs. These are out of pocket expenses that Medicare beneficiaries are customarily required to bear.
Some beneficiaries may feel that the coverage of Original Medicare is insufficient. To cover these perceived “gaps” in the Original Medicare coverage, beneficiaries can obtain Medicare supplemental plans, which are also known as Medigap policies. These plans can be purchased from private carriers in West Virginia, which have Medicare approval. These supplemental plans will also require an additional premium.
The benefits of supplemental plans can cover the cost of Medicare prescription drugs, and this coverage is known as a Medicare Part D. A supplemental plan can cover other health services that Part A and Part B do not cover. It can even help pay for out of pocket Medicare expenses.
These Medicare-approved private health insurance companies can also offer Medicare Advantage Plans, which are known as Medicare Part C. A plan like this combines the coverage of Original Medicare with additional coverage benefits. Often this means the addition of Part D coverage as well as the coverage of more healthcare services not covered by original Medicare.
Beneficiaries need to look at each Medicare Advantage Plan carefully, as they will have different extra benefits and costs. They all have at least the coverage offered by Original Medicare.
A considerable number of Medicare beneficiaries in West Virginia cannot afford to pay for Medicare expenses on their own. The state government of West Virginia offers various Medicare Savings Programs (MSPs) for residents with low incomes and assets.
The Qualified Medicare Beneficiary (QMB) program is undoubtedly the most helpful of the MSPs, as it pays for virtually all the expenses associated with Medicare. It pays for the premiums of Part A and Part B, as well as the other Medicare copays, coinsurance, and deductibles. To qualify, an individual has to earn a monthly income of less than $1,032. A married couple can have a combined income of no more than $1,392 a month.
The Specified Low-Income Medicare Beneficiary (SLMB) program pays for just the Part B premium. An individual can qualify with a monthly income of no more than $1,234. A married couple cannot earn a combined income of more than $1,666.
The program for Qualified Individuals (QI) also pays for just the Part B premium. However, the funding is limited, and QI beneficiaries cannot receive Medicaid benefits as well. An individual can be eligible with an income of less than $1,386 a month, while the income limit for a married couple is $1,872 a month.
These programs also come with an asset limit of $7,560 for individuals and $11,340 for married couples. These 3 MSPs also qualify beneficiaries for the “Extra Help” Low Income Subsidy (LIS). This pays for Medicare Part D prescription drug coverage.
Another program is for Qualified Disabled and Working Individuals (QDWI). This pays for the premium for Part A. The limits for an individual are $$4,132 for monthly income and $4,000 for assets. For married couples, the limits are $5,572 for monthly income and $6,000 for assets.
West Virginia has State Health Insurance Assistance Programs (SHIP) that provide free counseling for Medicare beneficiaries. To contact SHIP, call 877-987-4463 or 304-558-3317.