Virginia Medicare Advantage Plans – Instantly Compare

Medicare Advantage (MA) 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. Dental, vision, and hearing benefits are often included, and you must reside in the designated service area of the plan you join.

Part C plans must follow the rules and regulations of Medicare, and may charge different out-of-pocket costs. A referral may be needed to visit a specialist and non-emergency visits may require a specific network of providers in your area that must be used.

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.

CMS Plan ratings are available upon request. The 1-5 star rating compares customer service, member plan experience, and Rx cost information. The standard CMS plan initial deductible is $545. Several plans have lower deductibles or a $0 deductible. However, the cost of these plans is typically higher. Also, specific Tiers (often 1 and 2) may not be subject to the plan deductible. When you enroll for a plan, your Medicare number and the dates your Parts A and B coverage began, will be required. Credit card, checking account, and other financial information should not be disclosed.

Services that are not considered medically necessary by Medicare may not be covered on Advantage (Part C) plans. All original services must be covered and ER and Urgent Care services are always provided. Customers can appeal the decision of the carrier if a service is denied.

 

Counties With The Most Available 2024 MA Plans

76 -- Henrico County
75 -- Richmond City County
74 -- Chesterfield County
72 -- Hanover County
70 -- Chesapeake City County
69 -- Goochland County
68 -- Virginia Beach City County
68 -- Portsmouth City
68 -- Hampton City County
68 -- Loudoun County
67 -- Suffolk City County
67 -- Petersburg City County
66 -- Norfolk City County
65 -- Colonial Heights City County
64 -- Newport News City County
64 -- Hopewell City County
63 -- Isle Of Wight County
63 -- Roanoke County
62 -- Salem City County
61 -- James City County
61 -- Fairfax County
61 -- Poquoson City County
61 -- Franklin County
60 -- York County
60 -- Botetourt County
59 -- Williamsburg City County
59 -- Arlington County
59 -- Gloucester County

Compare Senior Health Plans In Virginia

Most Medicare Advantage Plans In Virginia Include Prescription Drug Coverage

 

Virginia Medicare Advantage Plans Without Prescription Drug Coverage

Kaiser Permanante Medicare Advantage Liberty -- $0 per month premium with office visit copays of $10 and $35 (pcp and specialist). Urgent Care and ER visit copays are $35 and $95. $6,900 maximum out-of-pocket expenses with $225 inpatient hospital copay for days 1-5. Outpatient mental health group and individual therapy visit copays are $10 and $20. The ground ambulance copay is $250 and outpatient lab test and x-ray copays are $0 and $10. Prescription drug benefits are not included.

Humana Honor (Regional PPO) -- $0 per month premium with office visit copays of $20 and $50 (pcp and specialist). Urgent Care and ER visit copays are $20-$50 and $90. $7,550 maximum out-of-pocket expenses with $395 inpatient hospital copay for days 1-5. Outpatient group and individual mental health therapy visit copays are $40. The ground ambulance copay is $290 and outpatient lab test and x-ray copays are $0-$50 and $20-$110. Prescription drug benefits are not included.

Humana Honor (PPO) -- $0 per month premium with office visit copays of $0 and $35 (pcp and specialist). Urgent Care and ER visit copays are $25 and $110. $5,900 maximum out-of-pocket expenses with $345 inpatient hospital copay for days 1-5. Outpatient group and individual mental health therapy visit copays are $35. The ground ambulance copay is $300 and outpatient lab test and x-ray copays are $0-$50 and $0-$95. Prescription drug benefits are not included.

HumanaChoice -- $0 per month premium with office visit copays of $0 and $35 (pcp and specialist). Urgent Care and ER visit copays are $0-$35 and $120. $6,950 maximum out-of-pocket expenses with $275 inpatient hospital copay is $500. Outpatient mental health group and individual therapy visit copays are $35. The ground ambulance copay is $270 and outpatient lab test and x-ray copays are $0-$85 and $0-$95. Prescription drug benefits are not included.

Humana Gold Choice -- $28 per month premium with office visit copays of $20 and $50 (pcp and specialist). Urgent Care and ER visit copays are $20-$50 and $90. $345 inpatient hospital copay for days 1-5. Outpatient mental health group and individual therapy visit copays are $40. The ground ambulance copay is $290 and outpatient lab test and x-ray copays are $0-$50 and $20-$110. Prescription drug benefits are not included.

AARP Medicare Advantage Patriot -- $0 per month premium with office visit copays of $0 and $40 (pcp and specialist). Urgent Care and ER visit copays are $40 and $90. $6,700 maximum out-of-pocket expenses with $345 inpatient hospital copay for days 1-5. Outpatient group and individual therapy visit copays are $20. The ground ambulance copay is $250 and outpatient lab test and x-ray copays are $0 and $15. Prescription drug benefits are not included.

Optima Medicare Salute -- $0 per month premium with office visit copays of $0 and $30 (pcp and specialist). Urgent Care and ER visit copays are $25 and $100.  $3,400 maximum out-of-pocket expenses with $275 inpatient hospital copay for days 1-6. Outpatient group and individual therapy visit copays are $30. The ground ambulance copay is $265 and outpatient lab test and x-ray copays are $0-$85. Prescription drug benefits are not included.

Erickson Advantage Liberty Without Drugs -- $0 per month premium with office visit copays of $20-$30 and $50 (pcp and specialist). Urgent Care and ER visit copays are $30 and $90. $6,700 maximum out-of-pocket expenses with $300 for days 1-7 inpatient hospital copay. Outpatient group and individual therapy visit copays are $40. The ground ambulance copay is $250 and outpatient lab test and x-ray copays are $0-$15. Prescription drug benefits are not included.

Aetna Medicare Eagle -- $0 per month premium with office visit copays of $0 and $50 (pcp and specialist). Urgent Care and ER visit copays are $0-$65 and $90. $7,550 maximum out-of-pocket expenses with $275 inpatient hospital copay for days 1-6. Outpatient group and individual therapy visit copays are $40. The ground ambulance copay is $250 and outpatient lab test and x-ray copays are $0 and $50. Prescription drug benefits are not included.

Anthem MediBlue Service -- $0 per month premium with office visit copays of $0 and $45 (pcp and specialist). Urgent Care and ER visit copays are $45 and $90. $6,700 maximum out-of-pocket expenses with $290 inpatient hospital copay for days 1-5. Outpatient group and individual therapy visit copays are $30. The ground ambulance copay is $350 and outpatient lab test and x-ray copays are $0-$15 and $50-$110. Prescription drug benefits are not included.

 

Virginia Medicare Advantage Plans With Prescription Drug Coverage

Erickson Advantage Champion (SNP) -- $0 deductible with inpatient hospital care copay of $0 per stay. PCP and specialist office visit copays are $0 and $25. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $15. The ER and Urgent Care copays are $75 and $30. Inpatient and outpatient mental health individual and group therapy visits are subject to $0-$30 copays.

30-day prescription drug copays are $0 (Tier 1), $5 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $15 (Tier 2), and $135 (Tier 3).

 

Erickson Advantage Freedom -- $0 deductible with with maximum out-of-pocket expenses of $4,300. The inpatient hospital copay is $225 per day for seven days. Office visit copays are $0-$20 and $40. Diagnostic radiology services are subject to a $0-$50 copay, while the x-rays copay is $15 and the lab services copay is $0.  ER and Urgent Care copays are $75 and $30 respectively.

30-day prescription drug copays are $0 (Tier 1), $10 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $30 (Tier 2), and $135 (Tier 3).

 

Erickson Advantage Liberty With Drugs -- $0 deductible with with maximum out-of-pocket expenses of $7,550. The inpatient hospital copay is $300 per day for seven days. Office visit copays are $0-$30 and $50. Diagnostic radiology services are subject to a $0-$105 copay, while the x-rays copay is $15 and the lab services copay is $0.  ER and Urgent Care copays are $90 and $30 respectively.

30-day prescription drug copays are $0 (Tier 1), $15 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $45 (Tier 2), and $135 (Tier 3).

 

Erickson Advantage Signature With Drugs -- $0 deductible with with maximum out-of-pocket expenses of $2,600. The inpatient hospital copay is $0. Office visit copays are $0.  Diagnostic radiology services are subject to a $0-$50 copay, while the x-rays copay is $15 and the lab services copay is $0.  ER and Urgent Care copays are $75 and $30 respectively.

30-day prescription drug copays are $0 (Tier 1), $5 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $15 (Tier 2), and $135 (Tier 3).

 

Kaiser Permanente Medicare Advantage High VA -- $0 deductible with maximum out-of-pocket expenses of $5,700. Office visit copays are $5 and $25, while diagnostic radiology services have a $40 copay. $0 copay for diagnostic tests and lab services. Outpatient x-rays have a $10 copay. ER and Urgent Care copays are $110 and $25 respectively. Outpatient therapy copays are $25.

30-day prescription drug copays are $0 (Tier 1), $10 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $30 (Tier 2), and $126 (Tier 3).

 

Kaiser Permanente Medicare Advantage Value VA -- $0 deductible with maximum out-of-pocket expenses of $6,500. Office visit copays are $10 and $45, while diagnostic radiology services have a $175 copay. No out-of-pocket expense for diagnostic tests and lab services. Outpatient x-rays have a $20 copay. ER and Urgent Care copays are $90 and $45 respectively. Outpatient therapy copays are $40.

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 $135 (Tier 3).

 

Kaiser Permanente Medicare Advantage Standard VA -- $0 deductible with with maximum out-of-pocket expenses of $6,200. Inpatient hospital care copay is $200 for the first 5 days. PCP and specialist office visit copays are $5 and $35. Diagnostic tests, lab fees and x-rays are subject to coinsurance ranging from $0-$10. The ER and Urgent Care copays are $90 and $35. Inpatient and outpatient mental health individual and group therapy visits are subject to $10 and $20 copays.

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 $135 (Tier 3).

 

Kaiser Permanente Medicare Advantage Liberty -- $0 deductible with with maximum out-of-pocket expenses of $6,900. Inpatient hospital care copay is $225 for the first 5 days. PCP and specialist office visit copays are $10 and $35. Diagnostic tests, lab fees and x-rays are subject to coinsurance ranging from $0-$10. The ER and Urgent Care copays are $90 and $35. Inpatient and outpatient mental health individual and group therapy visits are subject to $10 and $20 copays. Prescription drug benefits are not included.

 

UnitedHealthcare Nursing Home Plan -- $480 deductible. Inpatient hospital care copay is $1 per stay. PCP and specialist office visit copays are $0 and $0-20%. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to 20%. The ER and Urgent Care copays are $90 and $65. Inpatient and outpatient mental health individual and group therapy visits are subject to $0 and 20% copays.

30-day prescription drug copays and 90-day prescription drug copays are 25%.

 

UnitedHealthcare Nursing Home Plan 2 -- $480 deductible. Inpatient hospital care copay is $1 per stay. PCP and specialist office visit copays are $0 and $0-20%. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to 20%. The ER and Urgent Care copays are $90 and $65. Inpatient and outpatient mental health individual and group therapy visits are subject to $0 and 20% copays.

30-day prescription drug copays and 90-day prescription drug copays are 25%.

 

Optima Medicare Value -- $150 deductible with with maximum out-of-pocket expenses of $4,000. Inpatient hospital care copay is $275 for the first 6 days. PCP and specialist office visit copays are $0 and $20. Diagnostic tests, lab fees and x-rays are subject to coinsurance ranging from $0-$85. The ER and Urgent Care copays are $90 and $25. Inpatient and outpatient mental health individual and group therapy visits are subject to $30 copays.

30-day prescription drug copays are $0 (Tier 1), $10 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $25 (Tier 2), and $105 (Tier 3).

 

Optima Medicare Prime -- $130 deductible with with maximum out-of-pocket expenses of $4,500. Inpatient hospital care copay is $250 for the first 6 days. PCP and specialist office visit copays are $0 and $25. Diagnostic tests, lab fees and x-rays are subject to coinsurance ranging from $0-$80. The ER and Urgent Care copays are $90 and $25. Inpatient and outpatient mental health individual and group therapy visits are subject to $25 copays.

30-day prescription drug copays are $0 (Tier 1), $8 (Tier 2), and $40 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $20 (Tier 2), and $100 (Tier 3).

 

Optima Medicare Salute -- $0 deductible with with maximum out-of-pocket expenses of $3,400. Inpatient hospital care copay is $275 for the first 6 days. PCP and specialist office visit copays are $0 and $30. Diagnostic tests, lab fees and x-rays are subject to coinsurance ranging from $0-$85. The ER and Urgent Care copays are $100 and $25. Inpatient and outpatient mental health individual and group therapy visits are subject to $25 copays.

Prescription benefits are not provided.

 

Optima Community Complete -- $0 deductible with with maximum out-of-pocket expenses of $6. Inpatient hospital care copay is $0. PCP and specialist office visit copays are $0. Diagnostic tests, lab fees and x-rays are subject to no coinsurance. The ER and Urgent Care copays are $0 and $0. Inpatient and outpatient mental health individual and group therapy visits are subject to $0 copays.

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

 

AARP Medicare Advantage Plan 1 -- $0 deductible with maximum out-of-pocket expenses of $4,900. Inpatient hospital care copay is $295 for the first six days. PCP and specialist office copays are $0 and $35. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $20. The ER and Urgent Care copays are $90 and $40. Inpatient and outpatient mental health individual and group therapy visits are subject to  $15-$25 copays.

30-day prescription drug copays are $0 (Tier 1), $14 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $28 (Tier 2), and $141 (Tier 3).

 

AARP Medicare Advantage Plan 2 -- $0 deductible with maximum out-of-pocket expenses of $3,900.  Inpatient hospital care copay is $250 for the first five days. PCP and specialist office copays are $0 and $25. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $20. The ER and Urgent Care copays are $90 and $40. Inpatient and outpatient mental health individual and group therapy visits are subject to  $15-$25 copays.

30-day prescription drug copays are $0 (Tier 1), $12 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $24 (Tier 2), and $141 (Tier 3).

 

AARP Medicare Advantage Choice -- $0 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 and $40. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $20. The ER and Urgent Care copays are $90 and $40. Inpatient and outpatient mental health individual and group therapy visits are subject to  $15-$25 copays.

30-day prescription drug copays are $0 (Tier 1), $14 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $28 (Tier 2), and $141 (Tier 3).

 

AARP Medicare Advantage Walgreens -- $195 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $395 for the first four days. PCP and specialist office copays are $0 and $35. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $20. The ER and Urgent Care copays are $90 and $40. Inpatient and outpatient mental health individual and group therapy visits are subject to $15-$25 copays.

30-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $131 (Tier 3).

 

Aetna Medicare Prime Plan -- $300 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $300 for the first six days. PCP and specialist office copays are $25 and $50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $95. The ER and Urgent Care copays are $90 and $25-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $0 (Tier 1), $5 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $15 (Tier 2), and $141 (Tier 3).

 

Aetna Medicare Select Plan -- $0 deductible with maximum out-of-pocket expenses of $4,900. Inpatient hospital care copay is $300 for the first seven days. PCP and specialist office copays are $0 and $40. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $95. The ER and Urgent Care copays are $90 and $0-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $0 (Tier 1), $5 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $141 (Tier 3).

 

Aetna Medicare Premier Plan -- $0 deductible with maximum out-of-pocket expenses of $7,550 Inpatient hospital care copay is $300 for the first six days. PCP and specialist office copays are $0 and $40. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $95. The ER and Urgent Care copays are $90 and $0-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $0 (Tier 1), $5 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $141 (Tier 3).

 

Aetna Medicare Choice Plan -- $0 deductible. Inpatient hospital care copay is $300 for the first seven days. PCP and specialist office copays are $25 and $50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $50. The ER and Urgent Care copays are $90 and $25-$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 $47 (Tier 3). 90-day prescription drug copays are $5 (Tier 1), $10 (Tier 2), and $141 (Tier 3).

 

Aetna Medicare UVA Health System Prime -- $0 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $335 for the first six days. PCP and specialist office copays are $0 and $50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $40. The ER and Urgent Care copays are $90 and $0-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $141 (Tier 3).

 

Anthem MediBlue Local -- $0 deductible with maximum out-of-pocket expenses of $3,450. Inpatient hospital care copay is $325 for the first five days. PCP and specialist office copays are $0 and $0-$35. Diagnostic tests, lab fees and x-rays are subject to $0 copays. The ER and Urgent Care copays are $120 and $20. Inpatient and outpatient mental health individual and group therapy visits are subject to a $0-$35 copay.

30-day prescription drug copays are $0 (Tier 1), $9.50 (Tier 2), and $40 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $28.50 (Tier 2), and $120 (Tier 3).

 

Anthem MediBlue Extra -- $480 deductible with maximum out-of-pocket expenses of $5,900. Inpatient hospital care copay is $325 for the first five days. PCP and specialist office copays are $0 and $40. Diagnostic tests, lab fees and x-rays are subject to $0-$90 copays. The ER and Urgent Care copays are $90 and $50. Inpatient and outpatient mental health individual and group therapy visits are subject to a $40 copay.

30-day prescription drug copays are $0 (Tier 1), $16 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $48 (Tier 2), and $141 (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 $0 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 $90 and $50. 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 $35 (Tier 3). 90-day prescription drug copays are $12 (Tier 1), $30 (Tier 2), and $105 (Tier 3).

 

Anthem MediBlue Smart Fit -- $0 deductible with maximum out-of-pocket expenses of $3,450. Inpatient hospital care copay is $345 for the first five days. PCP and specialist office copays are $10 and $0-$40. Diagnostic tests, lab fees and x-rays are subject to $0 copay. The ER and Urgent Care copays are $120 and $20. Inpatient and outpatient mental health individual and group therapy visits are subject to a $0-$40 copay.

30-day prescription drug copays are $5 (Tier 1), $12.50 (Tier 2), and $40 (Tier 3). 90-day prescription drug copays are $15 (Tier 1), $37.50 (Tier 2), and $120 (Tier 3).

 

Anthem MediBlue Access -- $0 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $375 for the first five days. PCP and specialist office copays are $0 and $45. Diagnostic tests, lab fees and x-rays are subject to $0-$140 copays. The ER and Urgent Care copays are $90 and $45. Inpatient and outpatient mental health individual and group therapy visits are subject to a  $30 copay.

30-day prescription drug copays are $4 (Tier 1), $13 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $12 (Tier 1), $39 (Tier 2), and $126 (Tier 3).

 

Anthem MediBlue Local -- $0 deductible with maximum out-of-pocket expenses of $3,450. Inpatient hospital care copay is $325 for the first five days. PCP and specialist office copays are $0 and $0-$35. Diagnostic tests, lab fees and x-rays are subject to $0 copay. The ER and Urgent Care copays are $120 and $20. Inpatient and outpatient mental health individual and group therapy visits are subject to a $0-$35 copay.

30-day prescription drug copays are $0 (Tier 1), $9.50 (Tier 2), and $40 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $28.50 (Tier 2), and $120 (Tier 3).

 

Humana Choice -- $50 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 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 $90 and $15-$45. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

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), $36 (Tier 2), and $141 (Tier 3).

 

Humana Gold Choice -- $160 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 $20 and $50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $110. The ER and Urgent Care copays are $90 and $20-$50. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $5 (Tier 1), $15 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $15 (Tier 1), $45 (Tier 2), and $141 (Tier 3).

 

Humana Gold Plus -- $415 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $490 for the first four days. PCP and specialist office copays are 20%. Diagnostic tests, lab fees and x-rays are subject to $0-20% copays. The ER and Urgent Care copays are $90 and 20%. Inpatient and outpatient mental health individual and group therapy visits are subject to a 20% copay.

30-day prescription drug copays are $0 (Tier 1), $15 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $45 (Tier 2), and $141 (Tier 3).

 

Humana Value Plus -- $395 deductible with maximum out-of-pocket expenses of $6,900. Inpatient hospital care copay is $1,969. PCP and specialist office copays are 20%. Diagnostic tests, lab fees and x-rays are subject to $0-20% copays. The ER and Urgent Care copays are $90 and 20%-40%. Inpatient and outpatient mental health individual and group therapy visits are subject to a 20% copay.

30-day prescription drug copays are $2 (Tier 1), $12 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $6 (Tier 1), $36 (Tier 2), and $141 (Tier 3).

 

Virginia Premier Advantage Elite -- $0 deductible. Inpatient hospital care copay is $0. PCP and specialist office copays are $0. Diagnostic tests, lab fees and x-rays are subject to $0 copays. The ER and Urgent Care copays are $0. Inpatient and outpatient mental health individual and group therapy visits are subject to a $0 copay. Virginia Premier has been serving state residents for more than 30 years. This plan is for applicants eligible for Medicare and Medicaid.

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

 

Innovation Health Aetna Medicare Connect -- $0 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $315 for the first seven days. PCP and specialist office visit copays are $0-$35 and $35-$50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $50. The ER and Urgent Care copays are $90 and $0-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $0 (Tier 1), $10 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $25 (Tier 2), and $141 (Tier 3).

 

Innovation Aetna Medicare Voyager -- $200 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $315 for the first seven days. PCP and specialist office visit copays are $0-$25 and $35-$50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $50. The ER and Urgent Care copays are $90 and $0-$65. Inpatient and outpatient mental health individual and group therapy visits are subject to $40 copays.

30-day prescription drug copays are $0 (Tier 1), $10 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $25 (Tier 2), and $141 (Tier 3).

 

Innovation Aetna Medicare Premier -- $150 deductible with maximum out-of-pocket expenses of $7,550. Inpatient hospital care copay is $225 for the first seven days. PCP and specialist office visit copays are $0-$25 and $35-$50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $25. The ER and Urgent Care copays are $90 and $0-$45. Inpatient and outpatient mental health individual and group therapy visits are subject to $20 copays.

30-day prescription drug copays are $0 (Tier 1), $5 (Tier 2), and $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $10 (Tier 2), and $141 (Tier 3).

 

Mary Washington Medicare Advantage Rewards -- $0 deductible with maximum out-of-pocket expenses of $5,600. Inpatient hospital care copay is $315 for the first seven days. PCP and specialist office visit copays are $5 and $45. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to 20%. The ER and Urgent Care copays are $90 and $35. Inpatient and outpatient mental health individual and group therapy visits are subject to $35 copays.

30-day prescription drug copays are $2 (Tier 1), $7 (Tier 2), and $42 (Tier 3). 90-day prescription drug copays are $6 (Tier 1), $21 (Tier 2), and $126 (Tier 3).

 

Mary Washington Medicare Advantage Complete -- $0 deductible with maximum out-of-pocket expenses of $3,400. Inpatient hospital care copay is $275 for the first six days. PCP and specialist office visit copays are $5 and $35. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $50. The ER and Urgent Care copays are $120 and $35. Inpatient and outpatient mental health individual and group therapy visits are subject to $30-$35 copays.

30-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $39 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $117 (Tier 3).

 

Clear Spring Health Essential (HMO)- $0 deductible with maximum out-of-pocket expenses of $3,250. Inpatient hospital care copay is $250 for the first six days. PCP and specialist office visit copays are $0 and $25. Diagnostic tests, lab fees and x-rays are subject to $0 copays. The ER and Urgent Care copays are $120 and $30. Inpatient and outpatient mental health individual and group therapy visits are subject to $25 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).

 

Clear Spring Health Essential (PPO)- $0 deductible with maximum out-of-pocket expenses of $5,000. Inpatient hospital care copay is $304 for the first six days. PCP and specialist office visit copays are $0 and $45. Diagnostic tests, lab fees and x-rays are subject to $25-$45copays. The ER and Urgent Care copays are $90 and $40. 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).

 

Virginia  Medicare Advantage Special Needs (SNP)  Plans

Align Connect (HMO C-SNP) -- $0 monthly premium with $445 deductible. Preferred generic, generic, and preferred brand drug copays are $2, $15, and $45.

Align Thrive (HMO I-SNP) -- $0 monthly premium with $445 deductible. Preferred generic, generic, and preferred brand drug copays are $2, $15, and $45.

American Health Advantage Plus Of VA (HMO I-SNP) -- $115 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $0, $15, and $45.

Anthem MediBlue Care To You (HMO I-SNP) -- $7 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $0, $7.50, and $40.

Anthem MediBlue Care On Site (HMO I-SNP) -- $0 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $0, $7.50, and $40.

Anthem MediBlue COPD (HMO C-SNP) -- $0 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $0, $9.50, and $40.

Anthem MediBlue Diabetes (HMO C-SNP) -- $0 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $0, $7.50, and $40.

Erickson Advantage Champion (HMO-POS C-SNP) -- $199 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $5, $15, and $45.

Erickson Advantage Guardian (HMO-POS I-SNP) -- $28.80 monthly premium with $0 deductible. Preferred generic, generic, and preferred brand drug copays are $0, $0, and $28.

Humana Gold Plus -- Diabetes And Heart (HMO-POS C-SNP) -- $0 monthly premium with $150 deductible. Preferred generic, generic, and preferred brand drug copays are $4, $12, and $47.

 

Virginia Medicare Advantage Plans With The Highest Enrollment

UnitedHealthcare Dual Complete RP R1548-001

UnitedHealthcare Dual Complete H7464-001

HumanaChoice R1390-002

Humana Honor R1390-003

Anthem MediBlue Full Dual Advantage H3447-011

Kaiser Permanente Medicare Advantage Standard VA H2172-009

AARP Medicare Advantage H5253-089

Virginia Premier Advantage Elite H9877-001

 

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.