Virginia Medicare Advantage Plans – Instantly Compare

Medicare Advantage coverage in Virginia provides Seniors with affordable MA health insurance options through reputable companies. These Part C plans are issued by licensed and registered insurance companies that provide a very cost-effective alternative to original Medicare. Part A and Part B benefits are included, and also Part D (prescription drugs) on specified plans.

Plan types include:

HMO (Health Maintenance Organization)

PPO (Preferred Provider Organization)

POS (Point Of Service)

PDP (Prescription Drug Plan)

SNP (Special Needs Plan)

PFFS (Private Fee For Service)

 

We annually review Va  products and provide unbiased and expert information regarding details, costs, and availability. Medicare also provides information regarding doctor and health professional network availability, the claims and appeal process, needed forms and resources, and help with finding medical equipment and supplies. Illustrated below is current data and details of popular plans offered to State residents. Each county typically has different policy options and prices. Rates, copays, deductibles, and out-of-pocket expenses shown in plans below, may vary, depending upon your county of residence.

Medicare Supplement plans and Part D prescription drug plans in Virginia are also reviewed by our website. Stand alone Part D drug plans are offered by many carriers, including Anthem Blue Medicare Rx, Express Scripts Medicare, SilverScript, AARP MedicareRx, Aetna MedicareRX, First Health, Cigna-HealthSpring, Envision, Humana, and UnitedHealthcare.

 

Compare Senior Health Plans In Virginia

Most Medicare Advantage Plans In Virginia Include Prescription Drug Coverage

 

Virginia Medicare Advantage Plans Without Prescription Drug Coverage

Erickson Advantage Signature -- Available in Fairfax County. $5,000 maximum out-of-pocket expenses. You pay nothing for in-network inpatient hospital care and primary-care physician visits. Specialist visits are subject to a $35 copay. Lab services are also covered at 100% while outpatient x-rays cost only $20. ER and Urgent Care visits cost $50 and $30 respectively. Dental, vision, and eye benefits are provided with annual office visit copays from $20-$35.

Kaiser Permanante Medicare Plus Basic -- Available on several counties, including Arlington, Fairfax, Loudon, and Prince William. $6,700 maximum out-of-pocket expenses with $35 and $50 office visit copays. Lab services and diagnostic tests are covered at 100%, and the ER copay is $75. Ambulance service is subject to a $375 copay while Urgent Care visits are subject to a $65 copay. Dental, vision, and eye benefits are covered with $50 copay on most visits. Additional Kaiser plans are Plus High and Plus Standard.

HumanaChoice -- $0 monthly premium with $5,500 maximum out-of-pocket expenses. The inpatient hospital copay is $245 for the first six days.  The outpatient hospital copay is $245 per visit. Office visit copays are $10 and $35 while diagnostic tests, x-rays, and lab expenses are typically subject to a  copay of $0-$85. The ER copay is $80 and the Urgent Care copay can vary between $10 and $35.  Rehab therapy visits are subject to $10-$40 copays. Foot care, vision, and hearing service visits are covered with copays.

UnitedHealthcare MedicareDirect Essential -- Available in several counties, including Augusta, Greensville, Henry, Mecklenburg, Patrick, Spotsylvania, and Waynesboro City. Hospital care copay is $395 for four days while office visit copays are $25 and $50. You must pay 20$ of the cost of diagnostic tests, although lab services and x-rays are subject to only a $13 or $16 copay respectively. The ER copay is $75 while the Urgent Care copay is $40. Foot care and dental office visit expenses are often subject to a $40 copay while hearing and eye exams are covered with $20 and $50 copays. This UHC plans is available in the following counties: Mecklenburg, Greensville, Brunswick, Sportsylvania, Augusta, Emporia City, Staunton City, Rockingham, Waynesboro City, Patrick, Harrisonburg City, and Carroll.

 

Virginia Medicare Advantage Plans With Prescription Drug Coverage

Erickson Advantage Champion -- No out-of-pocket costs for Hospital care, although there is a 30% coinsurance if you are treated out-of-network. Primary-care physician office visits have no copay while specialist visits will cost $35. Diagnostic radiology services are subject to a $50 copay, while the x-rays copay is $20 and the lab services copay is $0. ER and Urgent Care copays are $50 and $30 respectively. Note: This is classified as a "Special Needs" plan.

Tier 1 and Tier 2 drugs have no copay with 90-day cost-sharing mail order. Tier 3 copay is $125 (90 days) or $45 (30 days). Tier 5 (Specialty Tier) has 33% coinsurance.

Other Erickson options include the Freedom, Guardian, and Signature With Drugs plans. The Freedom plan has a $3,400 deductible while the Guardian and Signature plans have a $0 deductible. Each of the four Erickson plans are available in Fairfax County.
 

Kaiser Permanente Medicare Plus Basic w/D (AB) Cost -- Available in various Counties including Arlington, Fairfax, Falls Church City, Loudoun, and Prince William. $360 deductible with maximum out-of-pocket expenses of $6,700. Office visit copays are $35 and $50, while diagnostic radiology services have a 20% copay. no out-of-pocket expense for diagnostic tests, lab services, and outpatient x-rays. ER and Urgent Care copays are $75 and $65 respectively. Most outpatient  therapy copays are $35 or $40.

Other Kaiser options include Plus High and Plus Standard plans. The Plus High plan has a $0 deductible with maximum out-of-pocket expenses of $3,400. The Plus Standard plan also has a $0 deductible with maximum out-of-pocket expenses of $5,500.

 

Aetna Medicare Select --  $50 deductible with $6,500 maximum out-of-pocket expenses. The inpatient hospital copay is $275 per day for six days and the office visit copays are $10 and $40. The copays for in-network lab services and diagnostic x-rays are $40 and $20. ER and Urgent Care copays are $80 and $10-$65.

Preferred 90-day mail-order copays are $6 and $15 for Tiers 1 and 2. Tier 3 and 4 copays are $126 and $300.

 

Aetna Medicare Essential -- $0 deductible with $5,000 maximum out-of-pocket expenses. The inpatient hospital copay is $279 for six days and the office visit copays are $15 and $45. The copays for in-network lab services and diagnostic x-rays are $45 and $25. ER and Urgent Care copays are $80 and $15-$65.

Standard 90-day mail-order copays are $6 and $15 for Tiers 1 and 2. Tier 3 and 4 copays are $126 and $300.

Other Aetna options include Better Health, Prime, and Choice.

 

Anthem MediBlue Care To You -- Available in Chesterfield, Goochland, Hanover, Henrico, Powhatan, and Richmond City Counties. 0 deductible with $200 copay for five days for in-hospital stays. There is no out-of-pocket expenses for pcp and specialist office visits. Diagnostic tests, x-rays, and lab tests also have $0 copays. The ER copay is $75 and Urgent Care visits have no copay. Ambulatory services are subject to a $195 copay. Routine foot, eye, dental, and hearing care are covered at 100%.

All Tier 1 generic drugs have a $0 copay. Tier 2 generic 90-day mail order copay is $18.75. Tier 3 preferred brand 90-day copay is $100.

Other Anthem options include MediBlue COPD, MediBlue Diabetes, MediBlue Local, MediBlue Access, and  MediBlue Smart Fit.

 

UnitedHealthcare Nursing Home Plan -- Available in these Counties: Alexandria City, Arlington, Chesapeake City,  Fairfax City, Henrico, Norfolk City, and Virginia Beach City. $360 deductible with no copays on pcp and specialist office visits. Diagnostic radiology services cost 0%-20%, depending on the type of service. ER copay is $75, and Urgent care copay is 20% (maximum $65).  Routine hearing, dental, vision, and foot care visits are covered at 100%, subject to policy maximums.

Specific prescription coverage is provided upon request. UnitedHealthcare also has a plan website for drug information.

Other UnitedHealthcare options include MedicareDirect Rx.

 

Piedmont Select Medicare Option One -- Available in these Counties: Amherst, Appomattox, Bedford, Campbell, Charlotte, Halifax, Lynchburg City, Pittsylvania, and Price Edward. $0 deductible with $5,500 maximum out-of-pocket expenses. $175 copay for first five days of in-hospital treatment. Office visit copays are $15 and $30, while  diagnostic tests and x-rays are generally subject to a $30 copay or 20% coinsurance. ER and Urgent care copays are $75 and $30. Many dental, vision, eye, and foot expenses are covered with a $30 copay.

Standard mail-order 90-day cost-sharing for Tier 1, 2, and 3 drugs are $12, $36, and $80 respectively. Tier 5 (Specialty)  drugs are subject to a 33% coinsurance.

Other Piedmont options include Select Medicare Option Three and Two.

 

Optima Medicare Basic -- Available in these Counties: Hampton City, Newport News City, Chesapeake City, Norfolk City, Poquoson City, Portsmouth City, and Virginia Beach City. $0 deductible with $4,700 maximum out-of-pocket expenses. In-hospital copay is $225 for the first seven days. Office visit copays are $0 and $40 while the diagnostic radiology service copay varies between $40 and $175. Lab services are covered at 100% and ER copay is $75.

Tier 1 preferred drugs are covered at 100%. Tier 2 mail order and retail copays are $16 and $8 respectively. Tier 3 copays are  $100 and $40.

Other Optima options are the "Enhanced" plan.

 

LifeWorks Advantage I-SNP -- Newer plan available in the following counties: Roanoke City, Nelson, Culpeper, Appomattox, Sussex, Southampton, Danville City, Henrico, Albemarle, Hanover, Roanoke, Pulaski, Salem, Richmond City, Franklin, and Louisa. $183 deductible, maximum out-of-pocket expenses of $6,700,  with monthly premium of approximately $28. Primary-care physician visits are covered at 100% while specialist visits are subject to a 20% coinsurance. Inpatient hospital expenses are subject to a $1,316 deductible each benefit period. Days 1-6- have 0% coinsurance, while days 61-90 have a $329 per day benefit, and days 91 and beyond have a $658 coinsurance per each lifetime reserve day.

The ER copay is $75, and the Urgent Care coinsurance is 20% (maximum $65). Lab services are covered at 100% and diagnostic tests and outpatient x-rays are subject to 20% coinsurance. Outpatient prescription drug coverage cost-sharing is 25% after deductible has been met.

 

AARP MedicareComplete Plan 1 -- $235 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $250 for the first five days. PCP and specialist office copays are $10 and $40. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $5 to $200. The ER and Urgent Care copays are $80 and $30-$40. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $3 (Tier 1), $12 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $9 (Tier 1), $36 (Tier 2), and $145 (Tier 3).

 

Aetna Medicare Prime Plan -- $195 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $260 for the first six days. PCP and specialist office copays are $10 and $40. Diagnostic tests, lab fees and x-rays are subject to a copay of $40. The ER and Urgent Care copays are $80 and $10-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $2 (Tier 1), $5 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $6 (Tier 1), $15 (Tier 2), and $126 (Tier 3).
 

Anthem MediBlue Plus -- $325 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $300 for the first five days. PCP and specialist office copays are $5 and $45. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $90. The ER and Urgent Care copays are $80 and $35. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $4 (Tier 1), $10 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $12 (Tier 1), $30 (Tier 2), and $126 (Tier 3).

 

Humana Choice -- $290 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $345 for the first five days. PCP and specialist office visit copays are $15 and $45. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $105. The ER and Urgent Care copays are $80 and $15-$45. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $7 (Tier 1), $17 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $21 (Tier 1), $51 (Tier 2), and $141 (Tier 3).

 

Humana Gold Plus -- $190 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $295 for the first six days. PCP and specialist office copays are $0-$15 and $40. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $100. The ER and Urgent Care copays are $80 and $0-$40. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $4 (Tier 1), $12 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $12 (Tier 1), $46 (Tier 2), and $141 (Tier 3).

 

Humana Value Plus -- $400 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $400 for the first three days. PCP and specialist office visits are subject to 20% coinsurance. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to 20%. The ER and Urgent Care copays are $80 and 20%. Inpatient and outpatient mental health individual and group therapy visits are subject to 20% coinsurance.

30-day prescription drug copays are $0 (Tier 1), $17 (Tier 2), and $41 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $51 (Tier 2), and $141 (Tier 3).

 

Innovation Health Medicare Connection Plan -- $95 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $225 for the first six days. PCP and specialist office visit copays are $5-$25 and $35-$50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $10 to $50 or 20%. The ER and Urgent Care copays are $80 and $5-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $2 (Tier 1), $5 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $6 (Tier 1), $15 (Tier 2), and $126 (Tier 3).

 

Kaiser Permanente Medicare Plus -- $300 deductible with maximum out-of-pocket expenses of $6,000. Inpatient hospital care copay is $850 per stay. PCP and specialist office visit copays are $20 and $45. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $ to $20. The ER and Urgent Care copays are $75 and $45. Inpatient and outpatient mental health individual and group therapy visits are subject to $10 and $20 copays.

30-day prescription drug copays are $7 (Tier 1), $15 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $21 (Tier 1), $45 (Tier 2), and $126 (Tier 3).

 

The US Department of Health and Human Services also provides a  Medicare Health Plans in Virginia report. It helps consumers  determine costs of coverage in specific areas. Some of the servicing areas include Richmond, Danville City, Newport News, Roanoke, Fairfax County, Mathews County, Tidewater area, and Hampton Roads.