West Virginia Health Insurance

Last Updated on September 21, 2020 by Andrew Lee

The health sector of West Virginia is in for a number of quite major changes, starting with the health insurance rate increases this 2017, which is then ultimately followed by higher premiums. However, considering that many other places in the country saw double-digit hikes greater than this particular state, its residents can still access plans that they can still afford.

Read on to learn more about these changes so you can better prepare yourself as you search for a plan that best suits your needs and finances.

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Does WV fare well in health rankings?

Although the Mountain State showed an above average performance in the “Prevention & Treatment” indicator of the 2015 Commonwealth Fund’s Scorecard on State Health System Performance, it definitely can do a lot better overall. For reference, it scored a score of quintile 3 in both Access and Equity, and a 4 under Avoidable Hospital Use & Costs.

  • Take a look at these findings related to the “Healthy Lives” category:
  • Mortality amenable to healthcare: 103 out of 100,000 people
  • Breast cancer fatalities: 21.6 out of 100,000 women
  • Colorectal cancer fatalities: 19.8 out of 100,000 people
  • Percentage of adult smokers: 26%
  • Adult obesity: 37%
  • Obesity in children aged 10-17: 34%
  • As for the state’s performance in the Access category, below are just some of the key takeaways from the study:
  • 13% of adults (19 to 64 years old) don’t have insurance, compared with the national average of 15%
  • 3% of children (infants to 18 years old) are uninsured, as opposed to the countrywide average of 6%
  • 17% of the adult population chose not to obtain insurance due to the high costs associated with it
  • 17% of adults had expensive out-of-pocket medical bills

A drastic drop of 8.6% in the state’s uninsured rating

In a U.S. Department of Health & Human Services study conducted from 2010 to 2015, it revealed that the WV saw a significant decrease in its uninsured rating. At the beginning of the study, this was at 14.6%. Over the course of five years, it went down by 8.6%, and at the time of the study’s conclusion, it was just at 6.0%. In other words, 156,000 more of the state’s residents gained coverage, at the time when it had an estimated population of 1,844,128 (2015, latest data).

Prepare yourself for these changes in premiums

It only follows that premiums in the state will go up, after the application of the rate hikes. For instance, benchmark premiums will increase at an average of 32%; 7% higher than the national median. However, your individual quotes will still depend on a myriad of other factors, the primary one being the overall status of your health.

You can use the following projections from the United States Department of Health & Human Services as a way to gauge your premiums:

  • Average lowest-cost, monthly premium within metal level: $652
  • The average net premium for the lowest-cost plan within the metal tier: $164
  • Second-lowest silver before advance premium tax credit (for a 27-year old with a $25,000 household income): $386
  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $142
  • Second-lowest silver before advance premium tax credit (for a family of four with a $60,000 household income): $1,399
  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $405

The impact of improving the health care system in WV

West Virginia should strive hard to improve its health care system in order to make health insurance easier for its residents to obtain. If it becomes on par with Minnesota, the state that secured the first place in the 2015 Commonwealth Fund Health Rankings, more than 97,000 of its residents can become insured. This will also reduce the number of emergency department visits among Medicare consumers by nearly 13,300.