Why Does Medicare Cost More Than Expected in West Virginia?
Understanding Part B, Medigap, Part D and what you may be able to comparison shop.
Question:
My parent recently enrolled in Medicare, and we thought we understood
what everything would cost.
Then we added the Part B premium, a Medicare Supplement policy and
prescription drug coverage, and the total monthly cost was much higher
than we expected.
We chose Medigap Plan G, but I noticed that different insurance
companies can charge very different premiums even though they are all
selling Plan G.
Is there really a way to comparison shop Medicare Supplement insurance
in West Virginia, and how do you know whether you are paying a reasonable rate?
Answer: Yes — Medicare Can Cost More Than Many People Expect
One of the biggest Medicare surprises is discovering that Medicare is
not necessarily free once you turn 65.
Many people qualify for Medicare Part A without a monthly premium because
they or their spouse paid Medicare taxes long enough while working.
But Medicare Part B normally has a monthly premium.
For 2026, the standard Medicare Part B premium is
$202.90 per month. Higher-income beneficiaries may pay
more because of the Medicare income-related monthly adjustment amount,
commonly called IRMAA.
If you choose Original Medicare and also purchase a Medicare Supplement
policy and a separate Part D prescription drug plan, those premiums are
added on top of your Part B premium.
Your monthly Medicare budget might include:
Medicare Part B + Medicare Supplement premium + Part D prescription
plan premium + any applicable income-related Medicare surcharges.
Why Can Plan G Prices Be So Different?
This is one of the most important things to understand when shopping for
Medicare Supplement insurance.
Medicare Supplement plans are standardized.
That means a standard Plan G from Company A provides the same
standardized basic Plan G benefits as Plan G from Company B.
But the insurance companies can charge different premiums for that coverage.
Medicare specifically advises consumers to compare the same plan letter
among different insurance companies because premiums can vary widely.
What Should You Compare Besides Today’s Premium?
Finding the lowest initial premium is certainly important, but it should
not necessarily be the only consideration.
When evaluating Medicare Supplement carriers in West Virginia, consider:
- The current monthly premium
- Available household or automatic-payment discounts
- How the policy is priced
- Whether premiums have increased over time
- The insurer’s financial strength
- Customer service and administrative experience
- Whether medical underwriting would apply if you switch later
Why Plan G Is Popular
Plan G is one of the more comprehensive Medicare Supplement options
available to people who became newly eligible for Medicare after
January 1, 2020.
It helps cover many of the cost-sharing amounts left by Original Medicare.
However, Plan G does not pay the Medicare Part B deductible.
The 2026 Medicare Part B deductible is $283.
After that deductible is satisfied, Plan G generally provides extensive
coverage for Medicare-approved Part A and Part B cost sharing according
to the standardized Plan G benefits.
Don’t Forget About Part D
New Medicare Supplement policies do not include outpatient prescription
drug coverage.
Someone using Original Medicare and Medigap may therefore also choose a
separate Medicare Part D prescription drug plan.
Part D premiums vary by plan. CMS projected the average premium for a
stand-alone Part D plan at approximately $34.50 per month for
2026, but an individual’s actual premium may be higher or lower.
More important than premium alone is whether the plan covers your
prescriptions and how much they may cost at your preferred pharmacy.
Can Medicare Really Add Up to $400 or More Per Month?
It certainly can.
Consider someone paying the standard $202.90 Part B premium. Add a
Medicare Supplement premium and a separate Part D premium, and the total
can easily reach several hundred dollars per month.
That doesn’t necessarily mean the person selected the wrong coverage.
Original Medicare combined with Medigap can offer very broad access to
healthcare providers who accept Medicare.
But it does mean that Medicare costs should be evaluated as a
total monthly and annual healthcare budget, rather than
looking at each premium separately.
Can You Shop for a Less Expensive Medigap Plan G?
Yes, but timing matters.
When you first become eligible for your six-month Medigap Open Enrollment
Period, federal rules generally allow you to purchase any Medigap policy
available to you without being denied because of pre-existing health
conditions.
After that initial enrollment period, changing Medicare Supplement
companies may involve medical underwriting unless you qualify for a
guaranteed-issue right under federal or state law.
That is why it is important to comparison shop carefully when you first
enroll rather than automatically accepting the first Plan G quote you receive.
New for West Virginia: A Medigap Birthday Opportunity
West Virginia added an important Medicare Supplement consumer protection
effective in 2026.
Under the new West Virginia law, certain people who already have a
Medicare Supplement policy may have an annual guaranteed-issue opportunity
beginning on the first day of their birthday month and continuing for
60 days.
There are important restrictions.
Among other requirements, the existing Medicare Supplement policy
generally must have been continuously in force for at least
24 months, and the replacement coverage generally must
provide the same or lesser standardized benefits.
The carrier options available under this West Virginia rule also depend
on the circumstances, so consumers should verify eligibility before
cancelling an existing Medicare Supplement policy.
Should You Automatically Switch to the Cheapest Company?
Not necessarily.
If another insurer offers the same standardized Plan G benefits for a
significantly lower premium, it is certainly worth investigating.
But before changing policies, make sure you understand:
- Whether you can qualify for the new policy
- When the new coverage becomes effective
- Whether underwriting applies
- Any discounts included in the quoted premium
- Whether your existing coverage should remain in place until the new policy is approved
Never cancel an existing Medicare Supplement policy simply because you
received a lower quote. Make sure the replacement coverage has been
properly approved and coordinated first.
The Question Isn’t Just “What Does Medicare Cost?”
A better question may be:
Am I getting the Medicare coverage I want at a competitive cost?
If you have Medicare Part B, Medigap and Part D and suddenly realize the
combined monthly cost is higher than expected, you are not necessarily
doing anything wrong.
But that is a good reason to review what you have.
You may discover that your current coverage is appropriately priced.
Or you may discover that another carrier offers the same standardized
Medigap plan letter at a more competitive premium.
Either way, knowing what you are paying — and why you are paying it —
can make Medicare feel considerably less confusing.
Paying Too Much for Medicare Supplement Insurance in West Virginia?
Mintco Financial can help you review Medicare Supplement options,
compare available carriers and understand how your Medicare costs
fit together.
Medicare Disclosure:
Mintco Financial is not connected with or endorsed by the U.S.
government or the federal Medicare program.
Medicare Supplement insurance plans are standardized under federal
and state law. Premiums, discounts, underwriting requirements and
availability vary by insurance company and applicant.
Medicare Supplement insurance is not Medicare Advantage. You generally
cannot use a Medicare Supplement policy together with a Medicare
Advantage plan.
Medicare Part B and Part D premiums, deductibles, income-related
adjustments and other Medicare costs may change annually.
West Virginia’s guaranteed-issue provisions contain eligibility,
timing, continuous-coverage, carrier and benefit-level requirements.
Consumers should confirm eligibility and obtain approval for replacement
coverage before terminating an existing policy.
Prescription drug plan premiums, formularies, pharmacy networks and
cost-sharing vary by plan and may change annually.
This material is provided for educational purposes only and is not
intended as legal, tax or medical advice. For complete Medicare
information, visit Medicare.gov or call 1-800-MEDICARE.