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

Kaiser Permanante Medicare Plus Standard -- $25 per month premium with office visit copays of $10 and $45 (pcp and specialist). Urgent Care and ER visit copays are $45 and $90. $6,700 maximum out-of-pocket expenses with $850 inpatient hospital copay. Outpatient group and individual therapy visit copays are $10 and $20. The ground ambulance copay is $275 and outpatient lab test and x-ray copays are $0 and $20. Prescription drug benefits are not included.

Kaiser Permanante Medicare Plus Basic -- $160 per month premium with office visit copays of $10 and $45 (pcp and specialist). Urgent Care and ER visit copays are $45 and $90. $6,700 maximum out-of-pocket expenses with $850 inpatient hospital copay. Outpatient group and individual therapy visit copays are $10 and $20. The ground ambulance copay is $275 and outpatient lab test and x-ray copays are $0 and $20. Prescription drug benefits are not included.

HumanaChoice -- $0 per month premium with office visit copays of $10 and $35 (pcp and specialist). Urgent Care and ER visit copays are $10-$35 and $120. $3,400 maximum out-of-pocket expenses with $500 inpatient hospital copay. Outpatient group and individual therapy visit copays are $35. The ground ambulance copay is $265 and outpatient lab test and x-ray copays are $0-$45 and $10-$85. Prescription drug benefits are not included.

Humana Gold Choice -- $29 per month premium with office visit copays of $15 and $45 (pcp and specialist). Urgent Care and ER visit copays are $15-$45 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 $15-$40. The ground ambulance copay is $265 and outpatient lab test and x-ray copays are $0-$45 and $15-$95. Prescription drug benefits are not included.

Erickson Advantage Senior Without Drugs -- $160 per month premium with office visit copays of $0 and $20 (pcp and specialist). Urgent Care and ER visit copays are $30 and $75. $2,900 maximum out-of-pocket expenses with $0 inpatient hospital copay. Outpatient group and individual therapy visit copays are $30. The ground ambulance copay is $150 and outpatient lab test and x-ray copays are $0-$20. Prescription drug benefits are not included.

 

Virginia Medicare Advantage Plans With Prescription Drug Coverage

Erickson Advantage Champion -- $195 deductible with with maximum out-of-pocket expenses of $3,400. inpatient hospital care copay is $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 $20. 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), $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 Freedom -- $0 deductible with with maximum out-of-pocket expenses of $3,900. The inpatient hospital copay is $200 per day for seven days. Office visit copays are $20 and $40. Diagnostic radiology services are subject to a $50 copay, while the x-rays copay is $20 and the lab services copay is $10. ER and Urgent Care copays are $75 and $30 respectively.

30-day prescription drug copays are $5 (Tier 1), $10 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $15 (Tier 1), $30 (Tier 2), and $135 (Tier 3).

 

Kaiser Permanente Medicare Plus Basic w/D (AB) Cost -- $415 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 and lab services. Outpatient x-rays have a $40 copay. ER and Urgent Care copays are $90 and $65 respectively. Most outpatient therapy copays are $35 or $40. Tier 1-6 drugs subject to 25% coinsurance.

 

Aetna Medicare Prime Plan --  $195 deductible with $6,700 maximum out-of-pocket expenses. The inpatient hospital copay is $260 per day for six days and the office visit copays are $10 and $40. The copays for in-network lab services and diagnostic tests and procedures are $40. ER and Urgent Care copays are $90 and $10-$65.

30-day prescription drug copays are $5 (Tier 1), $10 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $15 (Tier 1), $30 (Tier 2), and $135 (Tier 3).

 

UnitedHealthcare Nursing Home Plan 1 -- $415 deductible with no copays on pcp and specialist office visits. The inpatient hospital copay is $1,300. Diagnostic radiology services cost 0%-20%, depending on the type of service. ER copay is $90, and Urgent care copay is $65.  Routine hearing, dental, vision, and foot care visits are covered at 100%, subject to policy maximums. Drug coinsurance is 25% for all tiers.

 

Piedmont Select Medicare Option One -- $119 deductible with with maximum out-of-pocket expenses of $5,500. inpatient hospital care copay is $300 for the first 5 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% to 20%. The ER and Urgent Care copays are $90 and $30. Inpatient and outpatient mental health individual and group therapy visits are subject to $15 copays.

30-day prescription drug copays are $5 (Tier 1), $8 (Tier 2), and $30 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $75 (Tier 3).

 

Piedmont Select Medicare Option Two -- $405 deductible with with maximum out-of-pocket expenses of $5,750. inpatient hospital care copay is $325 for the first 5 days. PCP and specialist office visit copays are $0 and $45. Diagnostic tests, lab fees and x-rays are subject to coinsurance ranging from 0% to 20%. The ER and Urgent Care copays are $90 and $45. Inpatient and outpatient mental health individual and group therapy visits are subject to $30 copays.

30-day prescription drug copays are $7 (Tier 1), $12 (Tier 2), and $35 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $87.50 (Tier 3).

 

Piedmont Select Medicare Option Three -- $0 deductible with with maximum out-of-pocket expenses of $6,700. inpatient hospital care copay is $350 for the first 5 days. PCP and specialist office visit copays are $0 and $50. Diagnostic tests, lab fees and x-rays are subject to coinsurance 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 $35-$40 copays.

30-day prescription drug copays are $10 (Tier 1), $15 (Tier 2), and $40 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $0 (Tier 2), and $100 (Tier 3).

 

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.

 

Aetna Medicare Essential Plan -- $0 deductible. Inpatient hospital care copay is $279 for the first six days. PCP and specialist office copays are $15 and $45. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $25 to 20%. The ER and Urgent Care copays are $80 and $15-$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).

 

AARP MedicareComplete Plan 1 -- $95 deductible. Inpatient hospital care copay is $250 for the first five days. PCP and specialist office copays are $5 and $30. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $5 to $100. The ER and Urgent Care copays are $90 and $30-$40. Inpatient and outpatient mental health individual and group therapy visits are subject to a $15-$25 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 $135 (Tier 3).

 

AARP MedicareComplete Plan 2 -- $0 deductible. Inpatient hospital care copay is $250 for the first five days. PCP and specialist office copays are $0 and $40. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $5 to 20%. The ER and Urgent Care copays are $80 and $30-$40. Inpatient and outpatient mental health individual and group therapy visits are subject to $30-$40 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).

 

Aetna Medicare Essential Plan -- $0 deductible with maximum out-of-pocket expenses of $5,000. Inpatient hospital care copay is $279 for the first six days. PCP and specialist office copays are $15 and $45. Diagnostic tests, lab fees and x-rays are subject to a copays of $25-$45. The ER and Urgent Care copays are $80 and $15-$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).
 

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

Anthem MediBlue Local -- $0 deductible with maximum out-of-pocket expenses of $3,400. Inpatient hospital care copay is $300 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 $100 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 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 $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 $42 (Tier 3). 90-day prescription drug copays are $12 (Tier 1), $30 (Tier 2), and $126 (Tier 3).

 

Anthem MediBlue Smart Fit -- $0 deductible with maximum out-of-pocket expenses of $3,400. 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 $100 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).

 

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 $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 Plus -- $160 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 $90. The ER and Urgent Care copays are $90 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 $2 (Tier 1), $8 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $6 (Tier 1), $24 (Tier 2), and $135 (Tier 3).

 

Humana Value Plus -- $415 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $1,860. 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 $90 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 $47 (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).

 

Innovation Health Voyager Plan -- $145 deductible with maximum out-of-pocket expenses of $5,500. Inpatient hospital care copay is $295 for the first five days. PCP and specialist office visit copays are $15-$25 and $35-$50. Diagnostic tests, lab fees and x-rays are subject to copays ranging from $0 to $50 or 20%. The ER and Urgent Care copays are $80 and $15-$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 $47 (Tier 3). 90-day prescription drug copays are $0 (Tier 1), $15 (Tier 2), and $141 (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 $0 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).

 

Kaiser Permanente Medicare Plus Basic -- $415 deductible with maximum out-of-pocket expenses of $6,700. Inpatient hospital care copay is $1,340 per stay. PCP and specialist office visit copays are $35 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 $65. Inpatient and outpatient mental health individual and group therapy visits are subject to $35 copays.

30-day prescription drug copays are 25% (Tier 1), 25% (Tier 2), and 25% (Tier 3). 90-day prescription drug copays are 25% (Tier 1), 25% (Tier 2), and 25% (Tier 3).

 

Molina Medicare Options -- $210 deductible with maximum out-of-pocket expenses of $6,700.

30-day prescription drug copays are $2 (Tier 1), $8 (Tier 2), and $45 (Tier 3). 90-day prescription drug copays are $6 (Tier 1), $24 (Tier 2), and $135 (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.