Updated: May 22, 2024
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BestHealth InsuranceWest VirginiaBest Health Insurance in West Virginia
Why Trust MoneyGeek? We downloaded plan data for West Virginia directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.
CareSource in West Virginia has a MoneyGeek score of 58 out of 100, making it the provider with the best health insurance in the state. It provides the most affordable plan options and has the lowest average out-of-pocket costs. The company denies more claims than average.
For this analysis, we evaluated 13 health insurance plans in West Virginia.
Offers affordable premium rates
Low out-of-pocket costs
Variety of plan types available
Denies more claims than average
MoneyGeek's top pick for the best health insurance in West Virginia is CareSource. The provider offers ten Silver plans at an average rate of $873 per month. The average MOOP cost for these plans is $8,900.
CareSource provides several Silver HMO plans, typically requiring patients to select a primary care physician and get referrals to see specialists. CareSource has a denial rate of 19.58%, which means it denies more claims than average.
Plan Recommendations
MoneyGeek recommends the following Silver plans from CareSource:
Highmark (BCBS) offers the best health insurance in West Virginia for low out-of-pocket costs, scoring 100 out of 100. Its health insurance plans are among the most affordable options in West Virginia and have some of the lowest out-of-pocket costs. The company is better than most at processing eligible claims.
For this analysis, we evaluated 12 Gold plans, including HMO and PPO types.
Affordable premium rates
Low out-of-pocket costs
Very few claims denied
Offers a variety of plan types
MoneyGeek's top pick for the best health insurance in West Virginia for low out-of-pocket costs is Highmark (BCBS). It offers six Gold plans at an average monthly cost of $903 and an average maximum out-of-pocket cost of $7,133.
Health insurance plans from Highmark (BCBS) are of the PPO type, which tends to provide more out-of-network coverage. Highmark (BCBS) has a lower denial rate than most of the competition at 13%.
Plan Recommendations
MoneyGeek recommends the following Gold plans:
CareSource is the best provider of cheap health insurance in West Virginia, with a MoneyGeek score of 74 out of 100. The company offers plans with low costs and low out-of-pocket expenses. It has a higher-than-average rate of claims denial.
For this analysis, we looked at 13 Silver plans in West Virginia, which included 10 Silver HMO plans and three Silver PPO plans. We gave more weight to plans with lower monthly premiums. Note that these plans often come with higher out-of-pocket costs.
Low out-of-pocket costs
Affordable premium rates
Prone to denying more claims than average
MoneyGeek's top pick for the best cheap health insurance in West Virginia is CareSource. It offers ten different Silver plans at an average cost of $878 per month and an average maximum out-of-pocket cost of $9,150.
CareSource has HMO plans, which often require you to stay within the provider's network for the lowest out-of-pocket costs. The company has a denial rate of 19.6%, which is higher than most of the competition.
Plan Recommendations
MoneyGeek recommends the following cheap Silver plans:
CareSource, scoring 54 out of 100, offers the best health insurance in West Virginia for those with low income. It provides plans with the lowest rates but with high out-of-pocket costs. The company has a high percentage of claim denials.
We evaluated 10 Silver CSR HMO plans and three Silver CSR PPO plans in West Virginia.
To decide which insurance is best for individuals with low income, we looked at plans with low monthly costs and those that give extra help with medical bills. This help is called cost-sharing reductions (CSRs). These special Silver plans pay for more of your medical costs than the usual Silver plan. Here's how much they can help you depending on your annual income:
Remember, the income brackets change if more people live with you.
Low premium rates
High denial of claims
Low variety of plan options
MoneyGeek's top pick for the best health insurance in West Virginia for those with low income is CareSource. It has cost-effective plans for people earning below 250% of the Federal Poverty Level. The company offers West Virginians ten Silver CSR plans at an average cost of $878 per month. The average MOOP for these plans is $7,460.
Although CareSource does not offer PPO or POS plans, it provides HMO plans. A common benefit of HMO plans is that they usually have lower premiums than other types of plans. The company's denial rate is 19.58%, indicating it denies more plans than average.
Plan Recommendations
CareSource's top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. Here are some of the lower overall out-of-pocket costs based on income levels:
Highmark Blue Cross Blue Shield offers the best health insurance in West Virginia for young adults, with a MoneyGeek score of 100 out of 100. The company offers competitive plan rates, has lower out-of-pocket costs and denies fewer claims than most providers.
We assessed one Bronze PPO plan, six Expanded Bronze plans combining HMO and PPO, and one Catastrophic PPO plan for this category. Remember, only individuals under the age of 30 can purchase Catastrophic coverage.
Affordable premium rates
Low out-of-pocket costs
Very few claims denied
Wide variety of plan types
MoneyGeek's top pick for the best health insurance in West Virginia for young adults is Highmark (BCBS). Young adults might choose plans with less coverage because they typically need fewer medical services than older people. Highmark offers one Catastrophic plan and four Expanded Bronze plans. The average cost of these plans is about $473 a month, and the average maximum out-of-pocket cost is $8,875 per year.
Highmark provides PPO plans that include out-of-network coverage, allowing for more flexibility. The company's denial rate is around 13%, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following plans for young adults in West Virginia:
Health insurance companies have different plans. In West Virginia, 10 Silver HMO plans and three Silver PPO plans are available. The best providers for all plan categories are:
MoneyGeek's recommendations only used Silver plans. Silver plans balance the money you pay each month and the money you pay when you go to the doctor, also known as the maximum out-of-pocket (MOOP) cost. Silver plans are good if you need to see the doctor often.
MoneyGeek's top pick for the best health insurance in West Virginia for Silver PPO plans is Highmark (BCBS). It offers three Silver PPO plans at an average monthly rate of $885 and an average maximum out-of-pocket cost of $9,217. The provider has a denial rate of 13.2%, which means it denies fewer claims than average.
Silver PPO plans give you the freedom to choose your doctors and go to specialists without needing referrals. These features make PPO plans very flexible. However, these plans can be pricier compared to HMO plans, which might make them less suitable for those watching their spending. PPOs are quite popular, being the second most common plan type.
Plan Recommendations
We suggest the following Silver PPO plans from Highmark (BCBS):
MoneyGeek's top pick for the best health insurance in West Virginia for Silver HMO plans is CareSource. It offers plans at an average cost of $878 per month and an average maximum out-of-pocket of $9,150. The provider's denial rate is 19.6%, which is higher than most of the competition.
Silver HMO plans tend to be more affordable compared to other plan types. However, you must see doctors in the plan's network, except for emergencies. To see a specialist, you need a referral from your primary doctor. If you're okay with these rules and in-network doctors are close by, Silver HMOs could be a good choice for saving on monthly payments.
Plan Recommendations
We suggest the following Silver HMO plans from CareSource:
National General Accident & Health ranks as the best short-term health insurance provider in West Virginia, with a MoneyGeek score of 95 out of 100.
Short-term health insurance best suits individuals who want to fill temporary gaps if there are lapses in coverage. But, it doesn’t provide all the vital health benefits of plans compliant with the Affordable Care Act (ACA).
We identified National General Accident & Health as our top pick due to its high coverage limits across different insurance providers in West Virginia. It offers flexible contract terms between three months and three years.
The best health insurance in West Virginia depends on your unique profile and needs. It’s up to you whether you’d rather pay more each month and pay less when you need care or the other way around. Consider the following tips when getting health insurance:
Understand when a health insurance plan will cover you
Health insurance helps pay for your doctor visits and medicine. In-network doctors have an agreement with the insurance company to give services at lower prices. On the other hand, out-of-network doctors do not have these deals with the insurance company, so you may pay more to see them. Different plans may cover out-of-network costs in different ways. In West Virginia, some plans cover more out-of-network care but might cost more overall.
There are three PPO plans and 10 HMO plans in West Virginia. PPO plans let you see more out-of-network doctors, while HMO plans need you to see in-network doctors.
Weigh the cost of premiums vs. the cost of care
When looking for health insurance, it's important to consider how much you pay each month and your maximum out-of-pocket costs (MOOP). The best plan for you depends on what you need from your insurance. Some plans have low monthly fees but have high MOOP. If you use the medical services often, you might pay more by the end of the year. Paying more each month can be better if it means having lower out-of-pocket costs when you access care.
The Silver plan from CareSource costs $873 a month and has the lowest MOOP of $8,900. This plan costs more than the average monthly rate of $879 for Silver plans from the same company. If you need to visit the doctor often, the plan might save you money. It's great when you can find a plan with low monthly fees and low maximum out-of-pocket costs that lets you see good doctors.
Adults who are 65 and older or who have a qualifying illness or comorbidities may be eligible for Medicare. It’s a federal health insurance program that subsidizes health care services for qualified individuals.
Medicare has three parts:
We have resources on finding West Virginia's best Medicare Advantage plans and the best Medicare Supplement plans in West Virginia.
Medicaid is another federal health care program. It offers coverage for people with incomes below a state-specific threshold. You may qualify for Medicaid if your household income is at or below 133% of the Federal Poverty Level (FPL) for your household size. You may also get West Virginia Medicaid if you’re pregnant or have a disability.
Finding an ideal health insurance plan can be complicated due to concerns about price and availability. MoneyGeek answers some frequently asked questions to help you research options.
The best health insurance in West Virginia for 2024 is provided by CareSource. However, the best choice for you will depend on your unique circumstances and needs.
A plan with reasonable prices and sufficient coverage is what you should be looking for. Despite offering reduced prices, some plans and companies might only offer a few services that may not suit all your medical needs. Your unique needs will determine what the best health insurance plan for you is.
About Mark Fitzpatrick
Mark Fitzpatrick has analyzed the property and casualty insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. Currently, he leads P&C insurance content production at MoneyGeek. Fitzpatrick has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
