2025 WV Health Insurance Marketplace Data

STATE OF WEST VIRGINIA Offices of the Insurance Commissioner Allan L. McVey Insurance Commissioner Legal Division We are an Equal Opportunity Employer Telephone (304) 558-0401 Post Office Box 50540 Charleston, West Virginia 25305-0540 Facsimile (304) 558-1908 www.wvinsurance.gov CONSUMER ALERT 2025 WEST VIRGINIA HEALTH INSURANCE MARKETPLACE DATA On May 12, 2025, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) and the Center for Consumer Information and Insurance Oversight (CCIIO) released their annual Health Insurance Marketplaces 2025 Open Enrollment Report. During the most recent open enrollment period, 67,113 West Virginians obtained health insurance coverage through the West Virginia Marketplace representing a ~31% increase in West Virginia Marketplace enrollment from 2024. West Virginia saw the second largest increase in Marketplace enrollment in the country. Importantly, more than 97% of 2025 West Virginia Marketplace enrollees were eligible for Advanced Premium Tax Credits (APTCs) to help offset the cost of monthly health insurance premiums. Additionally, ~39% of the West Virginia Marketplace enrollees were also eligible for cost sharing reductions (CSRs), which lower co-payments, deductibles and other out-of-pocket spending.1 For 2025, the average premium for West Virginia Marketplace coverage is $101 per month for an individual plan. However, more than 48% of West Virginia Marketplace enrollees were able to purchase a health insurance plan for a monthly premium of less than $10.00 due to the available APTCs. The average premium for West Virginia Marketplace enrollees eligible for APTC is $74 per month. The West Virginia Navigator Program is available to assist West Virginians with enrollment in a plan. West Virginians may call the West Virginia Navigator Program at 1-844-WV-CARES or contact the program online at www.wvnavigator.com. The OIC also maintains a list of insurance agents that may be able to assist new enrollees. You can find this information, as well as additional resources regarding health insurance, at www.wvinsurance.gov/HealthPolicy. West Virginians may also enroll in the Marketplace directly at www.healthcare.gov. While monthly premiums vary greatly based upon income and plan choice, approximately 97% of 2025 enrollees are eligible for some type of financial assistance. If you need assistance regarding your health insurance, you may contact the OIC’s Life & Health Consumer Services Division at 1-888-TRY-WVIC. You may also contact the OIC via email to OICConsumerServices@wv.gov. Issued: August 1, 2025 1 Only health insurance plans purchased on the West Virginia Marketplace are eligible for APTCs and/or CSRs.