Virginia Part D Prescription Drug Plans – Compare Rates

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 23 PDP plans are available for 2022, including 14 enhanced (EA) plans and 9 basic (AE, DS, and BA) plans. Four $0 deductible options are also offered. The average monthly premium of all plans is $45.17, which increased 21% from last year's $37.29. The lowest cost for a $0 deductible plan is $62.40 (SilverScript Plus). Four plans are offered with monthly premiums less than $25. The least expensive plan is SilverScipt Smart Rx at $7.10 per month. The most expensive plan is AARP MedicareRx Preferred at $97.30 per month. Plans with the largest number of in-state members are SilverScript Choice, AARP MedicareRX Preferred, and Humana Premier Rx Plan.

Your 2022 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. Two plans offer some additional gap coverage (Donut Hole). They are SilverScript Plus and Cigna Extra Rx.

A Formulary can change, but not without written notice. The standard initial deductible of $480 increased $35 from last year. This deductible does not impact Coverage Gap or Donut Hole. However, it can impact when you leave the Donut Hole and enter the catastrophic coverage. The Initial Coverage Limit (ICL) is $4,430. The Out-of-Pocket Threshold (TrOOP) is $7,050, an increase of $500. Formulary and brand-name drugs are discounted at least 75%, and "Gap" or "No Gap" coverage are identified with each plan.

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 Blue MedicareRx Standard -- $57.80 monthly cost with $390 deductible and 2,902 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $2 (Tier 2), $33 (Tier 3), 32% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $6 (Tier 2), $99 (Tier 3), 32% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5596-005. 14,719 members are enrolled in the plan statewide. Available drugs are 114 (Tier 1), 479 (Tier 2), 944 (Tier 3), 918 (Tier 4), and 480 (Tier 5).

Anthem Blue MedicareRx Plus -- $68.50 monthly cost with $0 deductible and 3,139 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2), $43 (Tier 3), 45% (Tier 4), and 33% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $9 (Tier 2), $129 (Tier 3), 45% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5596-006. 23,090 members are enrolled in the plan statewide. Available drugs are 186 (Tier 1), 605 (Tier 2), 806 (Tier 3), 1,080 (Tier 4), and 484 (Tier 5).

WellCare Value Script -- $11.70 monthly cost with $480 deductible and 3,426 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $4 (Tier 2), $42 (Tier 3), 47% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $12 (Tier 2), $126 (Tier 3), 47% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S4802-142. 19,716 members are enrolled in the plan statewide. Available drugs are 347 (Tier 1), 448 (Tier 2), 1,027 (Tier 3), 945 (Tier 4), and 659 (Tier 5).

WellCare Classic -- $29.80 monthly cost with $480 deductible and 3,088 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $10 (Tier 2), $38 (Tier 3), 36% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $30 (Tier 2), $114 (Tier 3), 36% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S4802-069. 32,861 members are enrolled in the plan statewide. Available drugs are 123 (Tier 1), 462 (Tier 2), 1,092 (Tier 3), 856 (Tier 4), and 555 (Tier 5).

WellCare Medicare Rx Value Plus -- $68.30 monthly cost with $0 deductible and 3,440 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $4 (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), $12 (Tier 2), $141 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5768-130. 13,323 members are enrolled in the plan statewide. Available drugs are 363 (Tier 1), 437 (Tier 2), 1,042 (Tier 3), 940 (Tier 4), and 658 (Tier 5).

Part D Drug Plan Rates Virginia

Cigna Secure-Essential Rx -- $24.00 monthly cost with $445 deductible and 3,109 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $2 (Tier 2),  18% (Tier 3),  40% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $6 (Tier 2), 18% (Tier 3), 40% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5617-286. 2,246 members are enrolled in the plan statewide. Available drugs are 149 (Tier 1), 697 (Tier 2), 527 (Tier 3), 1,317 (Tier 4), and 503 (Tier 5).

Cigna Secure Rx -- $26.10 monthly cost with $445 deductible and 3,146 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2),  $42 (Tier 3),  50% (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),  50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5617-216. 3,504 members are enrolled in the plan statewide. Available drugs are 86 (Tier 1), 646 (Tier 2), 637 (Tier 3), 1,256 (Tier 4), and 508 (Tier 5).

Cigna Secure-Extra Rx -- $68.10 monthly cost with $100 deductible and 3,235 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $4 (Tier 1), $10 (Tier 2),  $42 (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), $126 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5617-252.  1,610 members are enrolled in the plan statewide. Available drugs are 176 (Tier 1), 833 (Tier 2), 586 (Tier 3), 1,190 (Tier 4), and 517 (Tier 5).

Express Scripts Medicare-Saver -- $27.100 monthly cost with $285 deductible and 2,892 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $2 (Tier 1), $7 (Tier 2),  $35 (Tier 3),  50% (Tier 4), and 28% (Tier 5). The preferred pharmacy copays for a 90-day supply are $6 (Tier 1), $21 (Tier 2), $105 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5660-223. 1,972 members are enrolled in the plan statewide. Available drugs are 134 (Tier 1), 674 (Tier 2), 659 (Tier 3), 1,051 (Tier 4), and 511 (Tier 5).

Express Scripts Medicare-Value -- $53.00 monthly cost with $445 deductible and 3,001 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2),  $35 (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),  $105 (Tier 3),  50% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5660-109. 1,423 members are enrolled in the plan statewide. Available drugs are 65 (Tier 1), 664 (Tier 2), 677 (Tier 3), 1,106 (Tier 4), and 515 (Tier 5).

Express Scripts Medicare-Choice -- $62.30 monthly cost with $100 deductible and 3,187 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $2 (Tier 1), $7 (Tier 2),  $42 (Tier 3),  50% (Tier 4), and 31% (Tier 5). The preferred pharmacy copays for a 90-day supply are $6 (Tier 1), $21 (Tier 2),  $126 (Tier 3),  50% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5660-217. 227 members are enrolled in the plan statewide. Available drugs are 168 (Tier 1), 848 (Tier 2), 531 (Tier 3), 1,150 (Tier 4), and 520 (Tier 5).

Mutual Of Omaha Rx Premier -- $24.90 monthly cost with $445 deductible and 2,917 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $2 (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), $6 (Tier 2), 23% (Tier 3),  n/a (Tier 4), and n/a (Tier 5). Summary Star Rating is 2.5. Plan ID is S7126-076. 886 members are enrolled in the plan statewide. Available drugs are 138 (Tier 1), 684 (Tier 2), 722 (Tier 3), 935 (Tier 4), and 515 (Tier 5).

Mutual Of Omaha Rx Plus -- $85.50 monthly cost with $445 deductible and 2,874 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $2 (Tier 2), 20% (Tier 3), 38% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $6 (Tier 2),  20% (Tier 3),  n/a (Tier 4), and n/a (Tier 5). Summary Star Rating is 2.5. Plan ID is S7126-006. 440 members are enrolled in the plan statewide. Available drugs are 138 (Tier 1), 685 (Tier 2), 634 (Tier 3), 984 (Tier 4), and 509 (Tier 5).

Virginia AARP Plans

 

AARP MedicareRx Saver Plus -- $25.20 monthly cost with $445 deductible and 3,104 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $7 (Tier 2), $34 (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), $102 (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5921-352. 31,975 members are enrolled in the plan statewide.

AARP MedicareRx Walgreens -- $31.20 monthly cost with $445 deductible and 3,088 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $6 (Tier 2), $40 (Tier 3), 40% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $18 (Tier 2), $120 (Tier 3), 40% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5921-394. 16,371 members are enrolled in the plan statewide.

AARP MedicareRx Preferred -- $83.40 monthly cost with $0 deductible and 3,518 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. 59,186 members are enrolled in the plan statewide.

Humana Premier Rx Plan -- $61.20 monthly cost with $445 deductible and 3,233 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 3.5. Plan ID is S5884-153. 42,953 members are enrolled in the plan statewide.

Humana Basic Rx Plan -- $27.90 monthly cost with $445 deductible and 3,057 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), 20% (Tier 3), 35% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5884-132. 37,302 members are enrolled in the plan statewide.

Humana Walmart Value Rx Plan -- $17.20 monthly cost with $445 deductible and 3,175 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), 19% (Tier 3), 35% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2), 19%1 (Tier 3), 35% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5884-186. 32,052 members are enrolled in the plan statewide.

SilverScript Choice -- $26.70 monthly cost with $380 deductible and 3,014 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $5 (Tier 2),  $35 (Tier 3), 41% (Tier 4), and 26% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $15 (Tier 2), $105 (Tier 3), 41% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.5. Plan ID is S5601-014. 79,792 members are enrolled in the plan statewide.

SilverScript Plus -- $63.50 monthly cost with $0 deductible and 3,060 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. 6,944 members are enrolled in the plan statewide.

SilverScript SmartRx -- $7.30 monthly cost with $445 deductible and 3,564 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. 14,006 members are enrolled in the plan statewide.

Clear Spring Health Value Rx -- $26.30 monthly cost with $445 deductible and 3,253 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2), $42 (Tier 3), 33% (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), 33% (Tier 4), and 25% (Tier 5). Plan ID is S6946-004. 2,541 members are enrolled in the plan statewide.

Clear Spring Health Premier Rx -- $15.40 monthly cost with $445 deductible and 3,276 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2), $40 (Tier 3), 44% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $9 (Tier 2), $120 (Tier 3), 44% (Tier 4), and 25% (Tier 5). Plan ID is S6946-033. 2,884 members are enrolled in the plan statewide.

Elixir RxPlus -- $14.30 monthly cost with $445 deductible and 3,243 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 3.5. Plan ID is S7964-127. 2,311 members are enrolled in the plan statewide.

Elixir RxSecure -- $26.80 monthly cost with $445 deductible and 3,182 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $7 (Tier 2), 15% (Tier 3), 37% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $21 (Tier 2), 15% (Tier 3), 37% (Tier 4), and 25% (Tier 5). Summary Star Rating is 3.5. Plan ID is S7964-007. 6,390 members are enrolled in the plan statewide.

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.