The Cheapest West Virginia Health Insurance for Individuals and Families
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In West Virginia, you can purchase private health insurance through the state’s insurance exchange if you cannot get it through the state’s government programs, like Medicaid and Medicare, or through your employer.
The cost of health insurance in West Virginia varies depending on several factors, including the amount of coverage, age and deductible amount. MoneyGeek analyzed the most affordable plans bought via the West Virginia insurance marketplace across these factors to ensure that you find the ideal coverage for your needs.
Typically, plans that feature low monthly premiums tend to have higher MOOPs and deductibles. If you choose this type of plan, you will need to pay more for your medical expenses.
The Cheapest Health Insurance in West Virginia by Metal Tier
Health insurance plans in West Virginia are divided into four different metal tiers. The metal tier system lets you choose your monthly premiums by determining the deductibles and out-of-pocket expenses you are willing to pay. Plans that feature low monthly premiums often have higher deductibles and out-of-pocket costs, and vice versa. That means your cost of insurance will vary depending on the tier you purchase.
The four tiers available in West Virginia are Catastrophic, Expanded Bronze, Silver and Gold. The plans named after less valuable metals typically cost less per month but have higher out-of-pocket costs and deductibles.
The monthly averages for each tier in West Virginia are:
- Catastrophic: $482 per month
- Expanded Bronze: $641 per month
- Silver: $695 per month
- Gold: $874 per month
If you normally have high medical costs per month, then getting a gold plan may be more cost-effective since it comes with lower out-of-pocket costs. However, if you are a healthy individual, you may want to consider purchasing a cheaper tier if you wish to save on your premiums.
In the West Virginia marketplace, health insurance costs, out-of-pocket maxes and deductibles vary significantly for each metal tier. The table below lists the lowest monthly costs for the different tiers in West Virginia.
Shoppers with low income in West Virginia qualify for cost-sharing reductions that come with silver plans. This form of discount can lower your deductibles significantly, giving you access to more coverage at lower costs.
The costs mentioned above represent all types of plans in the state for a sample 40-year-old male. They represent HMO and EPO plans. The HMO plan is the most common in the state.
Cheapest Health Insurance in West Virginia by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- Catastrophicmy Blue Access WV Major Events EPO 8550 - 3 Free PCP VisitsHighmark Blue Cross Blue Shield West Virginia$482$8,550
- Expanded BronzeCareSource Marketplace BronzeCareSource$598$8,550
- SilverCareSource Marketplace Low Premium SilverCareSource$632$8,550
- Goldmy Blue Access WV EPO Gold 0Highmark Blue Cross Blue Shield West Virginia$856$7,500
The Cheapest Health Insurance in West Virginia by Age and Metal Tier
While several factors influence the cost of health insurance in the West Virginia marketplace, age is one of the most important influencers. A 26-year old buying a silver plan, for instance, will pay an average of $557 per month, while a 60-year old will pay roughly $919 more. These costs are based on the HMO plans.
Health Insurance Costs in West Virginia by Age and Metal Tier
The costs used in this study are based on a sample profile and do not represent your actual premiums. Depending on your age and income, you may be required to pay less for a particular insurance marketplace plan due to regulations and tax premiums. Therefore, you will only get your exact cost after you apply for your preferred plan.
Check out the table below to toggle between metal tiers and plan buyer ages. You can also review our guide on health insurance in West Virginia to do a deeper dive into which metal tier to buy.
Cheapest Health Insurance in West Virginia by Age And Metal Tier
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- PlanCompanyMonthly Rate
- CatastrophicEPOHighmark Blue Cross Blue Shield West Virginia$344
- Expanded BronzeHMOCareSource$427
- Expanded BronzeHMOCareSource$439
- Expanded BronzeEPOHighmark Blue Cross Blue Shield West Virginia$462
- Expanded BronzeHMOCareSource$468
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The Cheapest Health Insurance in West Virginia by County
Where you live in West Virginia impacts how much you pay for health insurance. The state is divided into 11 rating areas, and insurance providers charge different rates for each area.
The 11 rating areas cover the 55 counties within the state. The most populous county is Kanawha, with the cheapest Silver plan costing an average of $717 per month. This cost is for the Caresource Marketplace Low Premium Silver plan from Caresource.
You can search below for the cheapest plan for each metal tier within your county.
The average costs listed are for medical coverage for a 40-year-old male buying a health insurance plan within the stated county in the state.
Cheapest Health Insurance Plans in West Virginia by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- BraxtonCatastrophicHighmark Blue Cross Blue Shield West Virginiamy Blue Access WV Major Events EPO 8550 - 3 Free PCP Visits$520
- CalhounCatastrophicHighmark Blue Cross Blue Shield West Virginiamy Blue Access WV Major Events EPO 8550 - 3 Free PCP Visits$520
- ClayCatastrophicHighmark Blue Cross Blue Shield West Virginiamy Blue Access WV Major Events EPO 8550 - 3 Free PCP Visits$520
- FayetteCatastrophicHighmark Blue Cross Blue Shield West Virginiamy Blue Access WV Major Events EPO 8550 - 3 Free PCP Visits$520
- GreenbrierCatastrophicHighmark Blue Cross Blue Shield West Virginiamy Blue Access WV Major Events EPO 8550 - 3 Free PCP Visits$520
The Cheapest Health Insurance in West Virginia With High Out-of-Pocket Maxes
If you are still young, you might decide to purchase a low-cost plan with higher out-of-pocket costs since you are less likely to incur huge medical costs every year. With these plans, you will pay lower monthly premiums. However, it’s important to remember that you will pay more out of pocket should your medical expenses be high.
The plan with the lowest rates and the highest out-of-pocket cost in West Virginia is my Blue Access WV Major Events EPO 8550 from Highmark Blue Cross Blue Shield West Virginia, costing an average of $386 for a 26-year-old.
MoneyGeek defined a high out-of-pocket cost at $8,250 per year.
Highmark Blue Cross Blue Shield West Virginia
The most affordable health insurance in West Virginia with the highest out-of-pocket cost is my Blue Access WV Major Events EPO 8550. The plan is only available to individuals who are less than 30 years of age and those that qualify for affordability or hardship exemption since it is a Catastrophic plan.
The Cheapest Health Insurance in West Virginia With Low Out-of-Pocket Maximums
If you are sure you will have higher than normal medical expenses, a plan with higher premiums and lower out-of-pocket costs may work best for you. Although you will pay more for these plans upfront, recurring expenses such as prescription drugs and appointment fees can help you reach your out-of-pocket limits faster. This means that your insurance carrier will start paying for the subsequent expenses sooner.
Highmark Blue Cross Blue Shield West Virginia provides the cheapest health insurance plan with low out-of-pocket costs in the state in its myBlue Access WV EPO Gold 800 plan. The average cost for this plan for a 40-year-old male is $873 per month.
According to MoneyGeek, plans with a maximum out-of-pocket below $4,250 are considered to be low MOOP plans. The myBlue Access WV EPO Gold 800 plan has $6,000 as its out-of-pocket cost, meaning that it has a low out-of-pocket max as well as the cheapest premium.
Highmark Blue Cross Blue Shield West Virginia
myBlue Access WV EPO Gold 800 has the cheapest out-of-pocket max in West Virginia. The plan is in the Gold tier, which features higher monthly costs than the rest of the plans within the state. One advantage of this plan is that it has a low out-of-pocket max and covers most of your medical expenses once you reach your MOOP limits.
Cheapest EPO/HMO Health Insurance Plan in West Virginia
The type of health insurance plan you choose depends on your medical needs as well as your preferred level of coverage. HMO plans usually require you to stay in your provider network to have services covered, but they often have lower premiums. EPO plans are similar to HMO plans, but unlike HMOs, they may not require a referral to see a specialist.
HMO plans are cheaper than EPO plans. However, you can only get covered when you get treatment within your provider network unless it is an emergency. You will also need a referral to get treated by a specialist. While EPO plans are more expensive, you do not need a referral to see a specialist.
Based on MoneyGeek, the most affordable silver plans for the HMO and EPO health insurance coverage are:
- HMO: CareSource Marketplace Low Premium Silver plan from CareSource at roughly $632 per month for an average 40-year-old.
- EPO: my Blue Access WV EPO Silver 3450 HSA plan from Highmark Blue Cross Blue Shield West Virginia at about $731 per month for an average 40-year-old male.
Cheapest Plan in West Virginia With an HSA
If you are less likely to go to the doctor, you can consider purchasing a Health Savings Account (HSA) that allows you to make pre-tax contributions and use these as savings in case you do not incur any medical expenses. An HSA is more affordable than other health insurance plans.
According to the MoneyGeek research, the cheapest health insurance in West Virginia with an HSA is from the following tiers:
- Expanded Bronze: The CareSource Marketplace HSA Eligible Bronze plan by CareSource with an average of $656 per year for a 40-year-old male.
- Silver: my Blue Access WV EPO Silver 3450 HSA plan by Highmark Blue Cross Blue Shield West Virginia priced at an average of $731 per year for a 40-year-old male.
One drawback of an HSA is that they feature high deductibles, so you may end up using up the savings should you incur unexpectedly high medical costs.
What to Know About Health Insurance in West Virginia
For this study, the sample rates used by MoneyGeek are based on private plan data from the state’s insurance marketplace. You might be able to find more affordable options if you apply for a plan from the marketplace. Older residents of West Virginia, as well as individuals with low income, may also be eligible for Medicare and Medicaid. This is cheaper than private plans.
Private Health Insurance on the West Virginia Marketplace
West Virginia health insurance companies break their plans into various metal tiers. In most cases, the catastrophic and bronze plans feature the lowest average monthly costs but attract higher out-of-pocket costs. Silver plans balance between the premiums and out-of-pocket charges, while gold plans have the most expensive monthly premiums.
While the four tiers in West Virginia meet statutory requirements, each has its own advantages and disadvantages.
- Catastrophic: Plans in this tier provide the fewest benefits. While they offer lower monthly premiums, they also have high out-of-pocket costs and deductibles. In West Virginia, Catastrophic plans are limited to individuals under 30 years as well as those with a hardship exemption. You may want to consider getting this plan if you do not anticipate high medical costs in the future.
- Expanded Bronze: Plans in this tier provide more benefits than the Catastrophic plan, but they cost more. They are ideal for individuals with limited medical expenses and those who need a cheap plan to protect them in case of an emergency. Their deductibles and out-of-pocket costs are still higher than other plans in the marketplace, although lower than Catastrophic plans.
- Silver: Silver plans provide a good balance between the monthly premiums and out-of-pocket costs. They have lower deductibles and out-of-pocket costs but feature a higher premium than Catastrophic and Expanded Bronze plans.
- Gold: Gold plans feature the highest monthly premiums in West Virginia. However, they also offer lower out-of-pocket costs and deductibles. Health insurance plans in this tier are ideal for you if you anticipate having huge medical costs in the next year.
You can also get more affordable plans or more coverage in West Virginia depending on your level of income. Individuals with an income that falls between 100% and 400% of the federal poverty level are entitled to premium tax credits. That means if your income ranges from $17,420 to $69,680 per year, you can get these credits. You can use the Healthcare.gov calculator to get more details.
Open enrollment allows you to register for a new health insurance plan or renew an existing plan via the health insurance marketplace. Typically, the period to do this in West Virginia is between November and December. Due to COVID-19, however, the dates have been extended by the government.
You also qualify for cost-sharing reductions (CSR) if you purchase a silver plan and your income falls between 138% and 250% of the federal poverty level. CSRs reduce your out-of-pocket max, deductible and copayments significantly and allow you to purchase a gold plan at the rates of a silver plan. Any two-person household with an income of $24,040 to $43,550 qualifies for cost-sharing reductions in West Virginia
Medicaid in West Virginia
Medicaid provides a free health insurance alternative for qualifying residents of West Virginia. West Virginia is an expansion state, meaning that you qualify for Medicaid if your income is below 138% of the federal poverty level.
Medicare in West Virginia
If you are 65 years or older or have an outlined disability or sickness, you may qualify for Medicare in West Virginia. Unlike Medicaid, you may need to pay part of your medical expenses with Medicare. However, this amount is significantly lower than what you would pay if you were to get your plan from a private insurer.
Medicare coverage comes in three sections:
- Part A: This covers your stay in hospital, hospice or nursing facility care. It also includes some home care services. Most people don’t pay a premium for Part A.
- Part B: This covers outpatient and in-doctor services as well as preventive services and necessary medical supplies. The cost is based on your income.
- Part D: This covers the cost of prescription drugs. It also includes vaccines.
Medicare insurance comes with various limitations, so it is essential to read through the policy before applying for it.
Methodology
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in West Virginia for you
MoneyGeek collected plans and premiums for health insurance in West Virginia from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About Mark Fitzpatrick
sources
- Healthcare.gov. "How to Pick a Health Insurance Plan." Accessed June 13, 2021.
- Medicare.gov. "What's Medicare?." Accessed June 14, 2021.