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Frequently Asked Questions

What is a Medicare Advantage Plan?

A Medicare Advantage plan is another way to get your Medicare Part A and Part B coverage. Medicare Advantage plans, sometimes called “Part C” or “MA” plans, are offered by Medicare-approved private companies (including Peak Health) that must follow rules set by Medicare. Most Medicare Advantage plans include drug coverage (Part D) and supplemental benefits like dental, vision, and hearing.

I have Original Medicare. Why would I consider a Medicare Advantage plan?

Medicare Advantage plans cover everything Original Medicare does and more. If you want things like prescription drugs, dental, vision, hearing, and fitness benefits, a Medicare Advantage plan may be right for you. Many Medicare Advantage plans have a $0 monthly plan premium. You just continue to pay your monthly Part B premium … just like you do if Original Medicare is your only insurance.

Why is the Annual Election Period so important?

It’s your once-a-year opportunity to make changes to your existing Medicare coverage and, if you want to, change to something different for the upcoming year. The Annual Election (or Enrollment) Period runs from October 15 through December 7 of each year. During that time, you should look at any pros/cons of your current Medicare coverage and review other options available in your area that may suit you better. You can:

  • Switch from Original Medicare to a Medicare Advantage plan
  • Change from one Medicare Advantage plan to another
  • Change from one Medicare Part D prescription drug plan to another
Is it hard to switch my Medicare coverage?

It’s not. And it’s especially easy during Medicare’s Annual Election Period (AEP). For example, during AEP if you’re currently enrolled in a Medicare Advantage plan and want to switch to another Medicare Advantage plan, your Enrollment Application (once submitted by the new insurance plan to CMS and approved) is all it takes. You do not need to disenroll from your current plan (that plan will be notified by CMS that you are no longer a member), and your new plan starts on the effective date.

Can I switch plans outside of Medicare’s Annual Election Period?

Typically, you can only enroll in a different Medicare Advantage plan or switch between Original Medicare and Medicare Advantage during specific times each year — such as Medicare’s Annual Election Period each fall. Coverage begins on January 1 of the following year.

The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 each year. During this period, you can switch from your Medicare Advantage plan to another Medicare Advantage plan, or to Original Medicare with or without a standalone Part D prescription drug plan. Changes made during this period take effect the first of the month following the month you enroll.

Under certain circumstances, you may be eligible for a Special Enrollment Period. These allow you to change your health and/or drug coverage outside normal enrollment periods. For example, if your Medicare Advantage plan would leave your area or you would move out of your plan’s service area, you would be eligible for a Special Enrollment Period to switch to another Medicare Advantage plan or to Original Medicare.

Who is Peak Health?

Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. We are owned by four not-for-profit health care providers: WVU Health System, Marshall Health, Mountain Health Network, and Valley Health. This allows us to have a completely collaborative approach to insurance that will connect the bridge between the provider and the payer. Our Vision is to be an inclusive, provider-led health plan that helps residents of West Virginia and beyond live healthier and fuller lives.

Peak Health is the only West Virginia-based insurance company to offer Medicare Advantage plans created by two of the state’s top health systems — WVU Medicine and Marshall Health. This partnership allows us to offer a completely collaborative approach to health coverage that was created by and for West Virginians.

Why should I look at Peak Advantage Health Plans?

Peak Advantage was created exclusively for West Virginians by West Virginia doctors who know how to make Medicare work for you. Because of our strong connections to top doctors and hospitals, you get more collaboration between your health care and your coverage with less red tape. National plans based in other states don’t have the same relationship with your local doctors and hospitals, or your community.

Plans start at $0 monthly premium and provide comprehensive, all-in-one coverage with the benefits you want most. Like prescription coverage, dental, vision, eyewear, fitness, and transportation assistance. You also get an annual OTC allowance plus a Flexible Spending Card to help you save money.

Does Peak Advantage limit me to only select providers?

It doesn’t. Peak Advantage Vista and Peak Advantage Summit are both Medicare Advantage PPO plans. This means you have the flexibility to use providers both in and out of network without a referral. Compare this with Medicare Advantage HMO plans: Except for emergency situations, you must use network providers or you won’t be covered. And with an HMO plan, you need a referral from your primary care doctor before seeing a specialist.

Will I find the doctors, specialists, hospitals, and pharmacies I want in the Peak Advantage network?

You will have thousands of West Virginia doctors, specialists, hospitals, and other medical professionals at your fingertips — including all providers in the WVU Medicine and Marshall Health health systems. You can fill your prescriptions at hundreds of pharmacies across the state, including most of the big national chains and local grocery stores. Be sure to check if your favorite pharmacy is in our Preferred Pharmacy network to get the lowest possible price.