Virginia Part D Prescription Drug Plans – Compare Rates

Medicare Part D coverage in Virginia provides comprehensive prescription drug benefits. You can choose among 27 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 30 PDP plans are available, including 19 enhanced (EA) plans and 11 basic (AE, DS, and BA) plans. Four $0 deductible options are also offered. The average monthly premium of all plans is $37.29, which increased 4% from last year's $35.74. The lowest cost for a $0 deductible plan is $55.80 (Anthem MediBlue Rx Plus). Eleven plans are offered with monthly premiums less than $25. The least expensive plan is SilverScipt Smart Rx at $7.30 per month. The most expensive plan is Mutual Of Omaha Rx Plus at $85.50 per month. The average cost of all plans is $37.29.

Your 2021 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.

A Formulary can change, but not without written notice. The standard initial deductible of $435 increased $20 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 $4,020. The Out-of-Pocket Threshold (TrOOP) is $6,350.

The CMS Standard Plan pays up to $5,019 in prescription drug costs (generic and brand-name). 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 -- $56.10 monthly cost with $375 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.

Anthem Blue MedicareRx Plus -- $55.80 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.

Anthem Blue MedicareRx Enhanced -- $23.70 monthly cost with $330 deductible and 3,122 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $2 (Tier 2), 20% (Tier 3), 39% (Tier 4), and 26% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $6 (Tier 2), 20% (Tier 3), 39% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 4.0. Plan ID is S5596-068.

WellCare Value Script -- $16.30 monthly cost with $445 deductible and 3,463 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $8 (Tier 2), $43 (Tier 3), 47% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $24 (Tier 2), $129 (Tier 3), 47% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 4.0. Plan ID is S4802-142.

WellCare Classic -- $24.50 monthly cost with $445 deductible and 3,088 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $3 (Tier 2), $30 (Tier 3), 34% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $9 (Tier 2), $90 (Tier 3), 34% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 4.0. Plan ID is S4802-069.

WellCare Medicare Rx Select -- $20.10 monthly cost with $445 deductible and 3,463 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $3 (Tier 2), $47 (Tier 3), 42% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $9 (Tier 2), $141 (Tier 3), 42% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5810-281.

WellCare Medicare Rx Saver -- $34.50 monthly cost with $445 deductible and 3,088 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $5 (Tier 2), $37 (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), $111 (Tier 3), 42% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5810-041.

WellCare Wellness Rx Value Plus -- $74.60 monthly cost with $0 deductible and 3,473 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), $47 (Tier 3), 49% (Tier 4), and 33% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2), $141 (Tier 3), 49% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5768-130.

WellCare Wellness Rx -- $14.80 monthly cost with $445 deductible and 3,463 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $7 (Tier 2), $40 (Tier 3), 46% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $21 (Tier 2), $120 (Tier 3), 46% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 4.0. Plan ID is S4802-176.

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.

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.

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.

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.

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.

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.

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.

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.

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.

AARP MedicareRx Walgreens -- $34.20 monthly cost with $435 deductible and 3,013 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $5 (Tier 2), $40 (Tier 3), 32% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $15 (Tier 2), $120 (Tier 3), 32% (Tier 4), and 25% (Tier 5). Summary Star Rating is 3.5. Plan ID is S5921-389.

AARP MedicareRx Preferred -- $75.20 monthly cost with $0 deductible and 3,500 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 33% (Tier 5). Summary Star Rating is 3.5. Plan ID is S5820-006.

Humana Premier Rx Plan -- $54.50 monthly cost with $435 deductible and 3,197 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2),  $42 (Tier 3),  44% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $12 (Tier 2),  $126 (Tier 3), 44% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.0. Plan ID is S5884-153.

Humana Basic Rx Plan -- $27.60 monthly cost with $435 deductible and 3,030 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $1 (Tier 2),  $25 (Tier 3), 38% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $3 (Tier 2), 25% (Tier 3), 38% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.0. Plan ID is S5884-132.

Humana Walmart Value Rx Plan -- $13.20 monthly cost with $435 deductible and 3,114 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $4 (Tier 2), $47 (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), $141 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Summary Star Rating is 3.0. Plan ID is S5884-186.

Magellan Rx Medicare Basic -- $30.50 monthly cost with $435 deductible and 2,956 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $2 (Tier 2), $27 (Tier 3), 43% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $2 (Tier 1), $5 (Tier 2), $67.50 (Tier 3), 43% (Tier 4), and n/a (Tier 5). Summary Star Rating is 2.5. Plan ID is S4607-009.

SilverScript Choice -- $24.70 monthly cost with $415 deductible and 2,999 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $1 (Tier 2),  $47 (Tier 3),  38% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $3 (Tier 2), $141 (Tier 3), 38% (Tier 4), and n/a (Tier 5). Plan ID is S5601-014.

SilverScript Plus -- $65.20 monthly cost with $0 deductible and 3,044 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), $6 (Tier 2), $141 (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan ID is S5601-015.

EnvisionRxPlus -- $14.20 monthly cost with $435 deductible and 3,093 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $7 (Tier 2), $35 (Tier 3), 39% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $21 (Tier 2), $105 (Tier 3), 29% (Tier 4), and n/a (Tier 5).

Clear Spring Health Value Rx -- $27.50 monthly cost with $435 deductible and 3,123 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2), $45 (Tier 3), 36% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $3 (Tier 1), $9 (Tier 2), $135 (Tier 3), 36% (Tier 4), and 25% (Tier 5).

Clear Spring Health Premier Rx -- $15.80 monthly cost with $435 deductible and 3,148 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (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), $9 (Tier 2), $120 (Tier 3), 40% (Tier 4), and 25% (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.