Last Updated on by Edward Harris
2025 Medicare Part D coverage in Virginia provides comprehensive prescription drug benefits. You can choose stand-alone plans (PDPs) that meet your medical and budget needs. Many Advantage contracts also offer drug benefits. Prices, copays, and deductibles vary, depending on the carrier and policy. HMO and PPO Advantage plans are offered. Generic drugs are the least expensive option and are typically considered as "Tier 1" drugs. Tier 2 (preferred brand name) and Tier 3 (non-preferred brand-name) drugs are also popular.
A total of 16 PDP plans are available for 2025, including 9 enhanced (EA) plans and 7 basic (AE, DS, and BA) plans. Two $0 deductible options are also offered. The average monthly premium of all plans is $52.88, which slightly decreased from last year's premium. The lowest cost for a $0 deductible plan is $84.30 (AARP Medicare Rx from UHC). Humana Premier Rx Plan is also available for $105.40.
Six plans are offered with monthly premiums less than $25. The least expensive plan is Wellcare Value Script at $0 per month. The Humana Basic Rx Plan is priced at $5.20 per month. The other four plans are Clear Spring Health Value Rx, Wellcare Classic, Humana Value Rx Plan, and Cigna Healthcare Saver Rx.
The most expensive plan is Cigna Healthcare Extra Rx at $111.90 per month. Plans with the largest number of in-state members (last year) are SilverScript Choice, SilverScript SmartSaver, AARP MedicareRX Preferred from UHC, Humana Walmart Value Rx, Wellcare Classic, and Wellcare Value Script.
Your 2025 Part D plan works with your Part A and/or Part B coverage. Provided pharmacy networks may lower your out-of-pocket costs. Formularies list covered generic and brand-name medications, and help customers work with their doctors and specialists to choose the best option. Five plans previously offered some additional gap coverage (Donut Hole). They were SilverScript Plus, Humana Walmart Value Rx Plan, Humana Premier Rx Plan, AARP Medicare Rx Walgreens from UHC, and Cigna Extra Rx. The donut hole has now been eliminated.
A Formulary can change, but not without written notice. The standard initial deductible of $590 increased $45 from last year. There are four LIS Qualifying plans. The national PDP providers are Aetna Medicare Cigna Healthcare, Humana, UnitedHealthcare, and Wellcare.
Virginia Medicare Supplement plans and Advantage policies can also be purchased in all counties. Rates and benefits will vary.
Listed below are all of the available prescription drug plans in Virginia.
Anthem MediBlue Rx Standard -- $76.80 monthly cost with $590 deductible and 2,934 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), 17% (Tier 3), 50% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2), 17% (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5596-005. 10,111 members are enrolled in the plan statewide. Available drugs are 161 (Tier 1), 966 (Tier 2), 251 (Tier 3), 1,103 (Tier 4), and 265 (Tier 5). $0 premium not offered. Formulary exception Tier 4.
Anthem MediBlue Rx Plus -- $58.40 monthly cost with $590 deductible and 3,228 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $4 (Tier 2), 15% (Tier 3), 41% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $12 (Tier 2), 15%1 (Tier 3), 41% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5596-006. 26,961 members are enrolled in the plan statewide. Available drugs are 308 (Tier 1), 1,009 (Tier 2), 232 (Tier 3), 1,199 (Tier 4), and 476 (Tier 5). $0 premium not offered. Formulary exception Tier 4.
WellCare Value Script -- $0 monthly cost with $590 deductible and 3,272 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $5 (Tier 2), 25% (Tier 3), 42% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $15 (Tier 2), 25% (Tier 3), 42% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S4802-142. 135,382 members are enrolled in the plan statewide. Available drugs are 356 (Tier 1), 637 (Tier 2), 335 (Tier 3), 1,278 (Tier 4), and 694 (Tier 5). $0 premium not offered. Formulary exception Tier 4.
WellCare Classic -- $11.30 monthly cost with $590 deductible and 2,976 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $5 (Tier 2), 22% (Tier 3), 36% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $15 (Tier 2), 22% (Tier 3), 36% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S4802-069. 36,075 members are enrolled in the plan statewide. Available drugs are 124 (Tier 1), 430 (Tier 2), 657 (Tier 3), 1,101 (Tier 4), and 693 (Tier 5). $0 premium not offered. Formulary exception Tier 4.
WellCare Medicare Rx Value Plus -- $102.30 monthly cost with $590 deductible and 3,271 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $4 (Tier 2), 15% (Tier 3), 50% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $12 (Tier 2), 15%1 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S4802-069. 12,496 members are enrolled in the plan statewide. Available drugs are 338 (Tier 1), 689 (Tier 2), 296 (Tier 3), 1,363 (Tier 4), and 613 (Tier 5). $0 premium not offered. Formulary exception Tier 4.
Cigna Saver Rx -- $12.70 monthly cost with $505 deductible and 3,308 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $10 (Tier 2), $40 (Tier 3), 50% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $30 (Tier 2), $120 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.0. Plan ID is S5617-357. 6,239 members are enrolled in the plan statewide. Available drugs are 232 (Tier 1), 358 (Tier 2), 1,205 (Tier 3), 1,005 (Tier 4), and 517 (Tier 5).
Cigna Secure Rx -- $34.50 monthly cost with $505 deductible and 3,185 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $8 (Tier 2), $38 (Tier 3), 50% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $24 (Tier 2), $114 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.0. Plan ID is S5617-216. 9,746 members are enrolled in the plan statewide. Available drugs are 142 (Tier 1), 489 (Tier 2), 784 (Tier 3), 1,242 (Tier 4), and 507 (Tier 5).
Cigna Secure-Extra Rx -- $60.30 monthly cost with $100 deductible and 3,363 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $4 (Tier 1), $10 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 31% (Tier 5). The preferred pharmacy copays for a 90-day supply are $12 (Tier 1), $30 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.0. Plan ID is S5617-252. 9,168 members are enrolled in the plan statewide. Available drugs are 175 (Tier 1), 582 (Tier 2), 889 (Tier 3), 1,176 (Tier 4), and 525 (Tier 5).
Mutual Of Omaha Rx Premier -- $35.00 monthly cost with $480 deductible and 2,994 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $13 (Tier 2), 23% (Tier 3), 44% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $39 (Tier 2), 23% (Tier 3), n/a (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S7126-076. 3,084 members are enrolled in the plan statewide. Available drugs are 137 (Tier 1), 605 (Tier 2), 709 (Tier 3), 1,073 (Tier 4), and 470 (Tier 5).
Mutual Of Omaha Rx Plus -- $92.80 monthly cost with $480 deductible and 2,938 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2), 19% (Tier 3), 41% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $9 (Tier 2), 19% (Tier 3), n/a (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S7126-006. 504 members are enrolled in the plan statewide. Available drugs are 137 (Tier 1), 607 (Tier 2), 643 (Tier 3), 1,101 (Tier 4), and 459 (Tier 5).
AARP MedicareRx Saver Plus -- $30.90 monthly cost with $480 deductible and 3,153 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $7 (Tier 2), $40 (Tier 3), 40% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $21 (Tier 2), $120 (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 4.0. Plan ID is S5921-352. 29,265 members are enrolled in the plan statewide. Available drugs are 89 (Tier 1), 818 (Tier 2), 711 (Tier 3), 891 (Tier 4), and 661 (Tier 5).
AARP MedicareRx Walgreens -- $28.90 monthly cost with $310 deductible and 3,150 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $10 (Tier 2), $40 (Tier 3), 40% (Tier 4), and 27% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $30 (Tier 2), $120 (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 4.0. Plan ID is S5921-394. 17,729 members are enrolled in the plan statewide. Available drugs are 54 (Tier 1), 516 (Tier 2), 1,035 (Tier 3), 895 (Tier 4), and 691 (Tier 5).
AARP MedicareRx Preferred -- $97.30 monthly cost with $0 deductible and 3,562 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $5 (Tier 1), $10 (Tier 2), $45 (Tier 3), 40% (Tier 4), and 33% (Tier 5). The preferred pharmacy copays for a 90-day supply are $15 (Tier 1), $30 (Tier 2), $135 (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5820-006. 52,296 members are enrolled in the plan statewide. Available drugs are 155 (Tier 1), 714 (Tier 2), 975 (Tier 3), 1,038 (Tier 4), and 703 (Tier 5).
Humana Premier Rx Plan -- $73.20 monthly cost with $480 deductible and 3,242 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), $45 (Tier 3), 49% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2), $135 (Tier 3), 49% (Tier 4), and n/a (Tier 5). Summary Star Rating is 4.0. Plan ID is S5884-153. 35,545 members are enrolled in the plan statewide. Available drugs are 259 (Tier 1), 585 (Tier 2), 758 (Tier 3), 1,085 (Tier 4), and 601 (Tier 5).
Humana Basic Rx Plan -- $33.00 monthly cost with $480 deductible and 3,060 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $1 (Tier 2), 20% (Tier 3), 35% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $3 (Tier 2), 19% (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 4.0. Plan ID is S5884-132. 31,001 members are enrolled in the plan statewide. Available drugs are 142 (Tier 1), 639 (Tier 2), 753 (Tier 3), 999 (Tier 4), and 588 (Tier 5).
Humana Walmart Value Rx Plan -- $22.70 monthly cost with $480 deductible and 3,184 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), 18% (Tier 3), 41% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2), 18% (Tier 3), 41% (Tier 4), and n/a (Tier 5). Summary Star Rating is 4.0. Plan ID is S5884-186. 39,027 members are enrolled in the plan statewide. Available drugs are 156 (Tier 1), 684 (Tier 2), 736 (Tier 3), 1,056 (Tier 4), and 603 (Tier 5).
SilverScript Choice -- $29.20 monthly cost with $480 deductible and 3,108 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $5 (Tier 2), 17% (Tier 3), 40% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $15 (Tier 2), 17% (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5601-014. 67,102 members are enrolled in the plan statewide. Available drugs are 97 (Tier 1), 594 (Tier 2), 830 (Tier 3), 1,024 (Tier 4), and 572 (Tier 5).
SilverScript Plus -- $62.40 monthly cost with $0 deductible and 3,278 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $2 (Tier 2), $47 (Tier 3), 50% (Tier 4), and 33% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $0 (Tier 2), $120 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5601-015. 8,937 members are enrolled in the plan statewide. Available drugs are 195 (Tier 1), 639 (Tier 2), 810 (Tier 3), 1,057 (Tier 4), and 586 (Tier 5).
SilverScript SmartRx -- $7.10 monthly cost with $480 deductible and 3,601 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $19 (Tier 2), $46 (Tier 3), 49% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $57 (Tier 2), $138 (Tier 3), 49% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5601-182. 36,638 members are enrolled in the plan statewide. Available drugs are 250 (Tier 1), 614 (Tier 2), 789 (Tier 3), 1,371 (Tier 4), and 584 (Tier 5).
Clear Spring Health Value Rx -- $28.90 monthly cost with $480 deductible and 3,147 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2), $42 (Tier 3), 39% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $9 (Tier 2), $126 (Tier 3), 39% (Tier 4), and 25% (Tier 5). Summary Star Rating is 2.0. Plan ID is S6946-004. 3,623 members are enrolled in the plan statewide. Available drugs are 209 (Tier 1), 596 (Tier 2), 501 (Tier 3), 1,261 (Tier 4), and 585 (Tier 5).
Clear Spring Health Premier Rx -- $23.20 monthly cost with $480 deductible and 3,160 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $5 (Tier 2), $42 (Tier 3), 45% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $15 (Tier 2), $126 (Tier 3), 45% (Tier 4), and 25% (Tier 5). Summary Star Rating is 2.0. Plan ID is S6946-033. 2,294 members are enrolled in the plan statewide. Available drugs are 212 (Tier 1), 234 (Tier 2), 854 (Tier 3), 1,277 (Tier 4), and 588 (Tier 5).
Elixir RxPlus -- $58.40 monthly cost with $480 deductible and 3,157 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $6 (Tier 2), $43 (Tier 3), 45% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $18 (Tier 2), $129 (Tier 3), 45% (Tier 4), and 25% (Tier 5). Summary Star Rating is 3.0. Plan ID is S7964-127. 1,553 members are enrolled in the plan statewide. Available drugs are 208 (Tier 1), 555 (Tier 2), 570 (Tier 3), 1,245 (Tier 4), and 592 (Tier 5).
Elixir RxSecure -- $34.50 monthly cost with $480 deductible and 3,085 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), 15% (Tier 3), 33% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2), 15% (Tier 3), 33% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.0. Plan ID is S7964-007. 5,848 members are enrolled in the plan statewide. Available drugs are 208 (Tier 1), 544 (Tier 2), 551 (Tier 3), 1,213 (Tier 4), and 583 (Tier 5).
Medicare Part D Prescription drug plans in Virginia are an optional benefit. You can enroll online or by using a paper application. Your Medicare number and the dates your Parts A and B benefits began may be needed.
