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How Much Is Health Insurance In West Virginia

Cheapest Health Insurance Plan By County

How much does a COVID-19 hospitalization cost in West Virginia?

Depending on where you live, you may pay a different premium for a particular health insurance policy since prices are determined by county. But the CareSource Marketplace Low Premium Silver plan, which is the cheapest Silver plan in each county, is the same price no matter where you live. A 40-year-old will pay the same rate of $757.93 anywhere in West Virginia.

Below we have provided a list of each West Virginia county and rates for the CareSource Marketplace Low Premium Silver plan depending on the size of your family.


Cheapestepo/hmohealth 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.

What Small Business Group Health Insurance Providers Are In West Virginia

There are tons of small business group health insurance providers in West Virginia that employers can choose from. However, some popular ones include Blue Cross Blue Shield, Aetna, Kaiser Permanente, CareSource, and UnitedHealthcare. Youll need to find the best insurance provider that resonates with your needs and your budget, as they all offer very different prices for each of their packages. However, they may be able to develop a plan that matches your budget. Also, for a business to qualify for small group health insurance, it must have between 2 to 50 employees.

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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.

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.

Hospital & Doctor Insurance

West Virginia Health Insurance

Health ProtectorGuard fixed indemnity insurance,3 underwritten by Golden Rule Insurance Company, can supplement your major medical plan by paying cash for eligible, covered medical services, like a doctor visit, a trip to urgent care or a surgical procedure.

  • No deductibles or copays to pay first
  • Benefits paid regardless of other insurance
  • Money to pay costs not covered by major medical plans, like a deductible

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How Much Does Long

Several factors influence the cost of long-term health insurance including where you live. The cost of treatment and service rates in your area also influences insurance premiums. Heres a look at a few average costs for common long-term care services in West Virginia.

Average costs of long-term care in West Virginia:

  • Home health aide daily rates: $103
  • Nursing home care daily rates: $275 for a semi-private room, $286 for a private room
  • Assisted living facility monthly rates: $3,263 for a private room

West Virginia Long Term Care Costs 2018

$265/month for a benefit amount of $2,500 $371/month for a benefit amount of $3,500 $477/month for a benefit amount of $4,500

Clearly the cost of monthly premiums increases significantly with age, which is a big reason many long-term care policyholders first purchase coverage in their 40s to lock themselves into a much lower premium.

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West Virginia Business Insurance Requirements

The State of West Virginia requires certain types of business insurance. Like most states, workers compensation insurance is required for businesses with employees. Otherwise, the employer must be self-insured.

West Virginia employers must also participate in the state unemployment program by paying unemployment taxes. Unemployment benefits depend on hours worked and compensation. There is no legal requirement, however, for employers to provide disability insurance.

Read Also: How Much Do Employers Cover For Health Insurance

What Large Group Health Insurance Providers Are In West Virginia

In West Virginia, the market for large group health insurance providers is very competitive. Because there are so many providers competing for the same customers in the area, it may be challenging to find one that matches your requirements. Highmark, Humana CareSource, Golden Rule, and UnitedHealthcare are some of West Virginias most popular large health group insurance providers. Choosing health insurance providers is critical because it will determine how much you spend on your employees insurance premiums.

How Much Are West Virginia Short

US Affordable Care Act: West Virginia relies on health coverage

There is more to pay for with a West Virginia short-term health insurance plan than just the monthly premium. Here are other costs to consider:

  • Deductible: This is the amount you pay for covered services before your plan starts paying for care.6
  • Coinsurance: This cost is a percentage of a covered item or service that you pay after youve paid your deductible.7
  • Copayment: Copayments, or copays, are a set dollar amount you pay for an item or service.8
  • Out-of-pocket maximum: This is the most youll pay out of pocket for covered healthcare services.9
  • Maximum benefit: This is the most the plan will pay toward your care.10

Here are examples of how much plans cost in West Virginia. A 35-year-old, non-tobacco-using woman living in Morgantown, West Virginia, would pay:

  • $126.03 for a plan from Pivot Health with a $5,000 deductible, a maximum benefit of $1 million, and no prescription coverage.
  • $241.34 for a plan from Pivot Health with a $5,000 deductible, a maximum benefit of $1 million, and prescription coverage.

A 35-year-old, non-tobacco-using woman living in Charleston, West Virginia, would pay:

  • $143.71 for a plan from Pivot Health with a $5,000 deductible, a maximum benefit of $1 million, and no prescription coverage.
  • $278.24 for a plan from Pivot Health with a $5,000 deductible, a maximum benefit of $1 million, and prescription coverage.

Rates for men will be different.

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West Virginia Childrens Health Insurance Program

CHIP provides quality and comprehensive health insurance to eligible children. It is a free or low-cost plan that covers children from birth to age 19. CHIP covers preventive care, immunizations, prescriptions, and well-child visits.

Your family can qualify for CHIP in West Virginia if you earn up to 300% of the federal poverty level. A family with one child cannot earn more than $32,200 a year, with two children $43,550 a year and three children $54,900 a year. Households with more than eight family members can add $11,350 per person to the income limit.

In September 2019, the West Virginia Legislature passed a law enabling pregnant women to receive maternity care under CHIP.

West Virginia Large Group Health Insurance Plans

For large employers in West Virginia and elsewhere, rising costs are a constant concern related to offering health insurance that meets the needs of employees and follows the ACA requirements. Premiums have increased on average by 22 percent over the last ten years, even with many companies implementing cost-saving measures like higher deductibles. Even with the high pace of inflation, large employers note that spending on health insurance has been rising faster than overall inflationwith no signs of slowing, according to benefits adviser Mercer.

The ACA requires that insurance plans include coverage for ten essential benefit areas which are designated as necessary for patient protection:

  • Ambulatory patient services
  • Emergency services
  • Preventative and wellness services, including chronic disease management
  • Pediatric services, including dental and vision care for children under the age of 19
  • Many states, including West Virginia, have added to that list. For example, West Virginia requires coverage for skilled nursing services, clinical trials, diabetes care, and reconstructive surgery following mastectomy. However, companies that self-fund their coverage can avoid the state-specific requirements. For example, in West Virginia, 69 percent of employers fully self-fund their health insurance.

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    Will I Be Penalized If I Don’t Have Health Insurance

    You won’t be fined by the IRS for not having health coverage in 2022but there are several disadvantages to being uninsured. The tax penalty under Obamacare vanished in 2019, so if you don’t have health insurance, you won’t be penalized.

    However, some states have passed their own health insurance requirements, resulting in a state-level tax fine if you go without coverage.

    Massachusetts, New Jersey, Vermont, California, Rhode Island, and Washington D.C are among the states that have enacted their own health insurance rules.

    Average Price Of Medical Health Insurance By Family Dimension In Western Virginia

    The Virginia Health Care Landscape

    Along with time and your region of residence, how big is your loved ones will affect Health insurance West Virginia charges straight. For example, the common Silver medical health insurance policy that covers a grouped category of three, with a couple of and something child, will be 30% more costly in West Virginia when compared to a policy made to supply coverage for a couple.

    The stand below programs the common regular prime charges for households in line with the number of people protected. As you can plainly see, the common cost to include a child beneath the age of 15 is $394. That is much lower compared to the average expense of adding a grown-up to your wellbeing insurance policy that is $658.

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    Dental Insurance In West Virginia

    West Virginia uses the federally facilitated health insurance marketplace HealthCare.gov for the sale of certified individual/family dental plans.

    Not all insurers who offer medical plans through the West Virginia exchange include dental coverage with their health plans, but stand-alone dental plans are available for purchase that cover both adults and children.

    Public Health Issues In West Virginia

    In every situation, health insurance is about your specific medical needs and health. However, public trends can impact your rate. Some factors and statistics that may impact costs include the following:

    Obesity in West Virginia

    High obesity levels in West Virginia area are a key factor for health insurance prices. In 2017, 38.1 percent of adults in the state where considered obese. That raises costs because those who are obese are more likely to need ongoing medical care.

    Diabetes in West Virginia

    In West Virginia, 15.2 percent of adults in 2017 had a diagnosis of diabetes. That is much higher than most of the rest of the country, increasing rates for health insurance.

    Childhood Obesity in West Virginia

    Children in the state are also more likely to suffer from health risk factors if they are overweight or obese. In 2016, 35.1 percent of children between the ages of 10 and 17 in West Virginia were considered within these limits, making this another key factor in the state.

    < twitter> Children in the state are also more likely to suffer from health risk factors if they are overweight or obese. In 2016, 35.1 percent of children between the ages of 10 and 17 in West Virginia were considered within these limits.< /twitter>

    West Virginia Mental Health Statistics

    West Virginia STD Statistics

    In West Virginia, STD risks are slightly less than other states. However, the state does have a high rate of chlamydia and gonorrhea diagnosis in the last few years.

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    Types Of West Virginia Business Insurance

    General Liability Insurance

    The vast majority of West Virginia companies purchase general liability insurance from an insurance company even though it is not legally required. This type of business liability insurance covers third-party bodily injury, third-party property damage, advertising liability, libel, slander, copyright issue, and other common claims faced by companies across various industries.

    General liability insurance is one of the most important types of business insurance your company can purchase.

    Business Owners Policy

    A business owners policy is an affordable way to bundle business insurance coverages. This type of policy includes commercial general liability insurance with commercial business property insurance. Many small business owners with a physical business space opt for this coverage.

    Commercial Auto Insurance

    You need to carry commercial auto insurance if your company uses vehicles to transport people or goods. This type of insurance is very similar to personal auto insurance and covers liability, medical costs, collisions, and uninsured/underinsured motorists. A commercial auto policy also covers vehicles rented or owned by your company and employees who use their own vehicles for company business.

    Workers Compensation Insurance

    Employee Health/Life/Disability Insurance

    Professional Liability Insurance

    Professional liability insurance includes errors and omissions insurance.

    Data Breach Insurance

    Cyber Liability Insurance

    What Benefits Do Employers Offer In West Virginia

    What Medicaid patients in West Virginia want from health care reform

    What an employee receives as part of their employee benefits package is primarily determined by their employer. Medical insurance, paid time off, life insurance, dental insurance, retirement, flexible savings accounts, paid vacations, and sick leave are some of the standard benefits that employers commonly provide to their employees as part of their benefits packages. Paid vacations, gym memberships, and even educational assistance are examples of other benefits. While these are the most common benefits, some companies may offer additional benefits.

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    West Virginia Insurance License Application

    After you have passed your exams and submitted fingerprints, the next step is to apply for your license. If you have more than one line of authority that you tested for, be sure to apply for all of those lines.

    The fee for an online application is $50, plus a $5.60 fee from NIPR, for a total of $55.60.

    If you wish to add another line of authority at a later date, you will only need to pay the NIPR fee. If it has been longer than thirty days since your original application, you will need to redo your fingerprints.

    Apply for your license online with the NIPR West Virginia site.

    After Getting Your West Virginia Insurance License

    Once youve passed your exams and completed the licensing application, you are now a licensed insurance agent in West Virginia. A common question we hear is, I have my insurance license, now what? Here are a few things you can do or need to know:

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    Accident & Critical Illness Insurance

    Accidental injuries and critical illness happen when you least expect them. Those unexpected expenses can strain any budget. Accident insurance3 and critical illness insurance3 can help by paying cash benefits for covered injuries or illnesses.

    The Accident Pro series of products, underwritten by Golden Rule Insurance Company, combines accident insurance with critical illness, hospitalization, and accidental death and dismemberment coverage all in one. Some plans are guaranteed issue, meaning your application wont be turned down for preexisting conditions.

    West Virginia Insurance Marketplace 2020 Open Enrollment Runs From November 1 2019 To December 15 2019

    Health Insurance Companies In Virginia / Public sector employment in ...

    You can get healthcare insurance thru the West Virginia Insurance Marketplace during open enrollment.

    You can choose to compare health insurance rates directly from major health insurance carriers any time throughout the year! Right here on this site.

    Just put in your zip code in the box above to view agents near you. FOR FREE!


    Several options are available for individuals and families in the West Virginia health insurance marketplace. Because of the ACA Affordable Care Act West Virginians without access to job based health insurance coverage have many options to purchase health benefits which will qualify for minimum essential health coverage.

    West Virginia options for purchasing health insurance plans are found in the states federally facilitated exchange or apply through public programs like Medicaid and CHIP. Health insurance is also available with the private market place through websites allowing you to enroll in ACA compliant coverage.

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    How To Find The Best Long

    In order to get the protection you need and deserve, youll want to work with a trusted expert. Independent insurance agents will not only know where to find the best coverage and price, but also help to make sense of the fine print.

    Consider your unique needs, then connect with an agent to help you take it from there. Have a list of your specific concerns and desires ready before reaching out to help the process run even more smoothly.

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