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 4.0. Plan ID is S5596-005. 14,201 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 -- $43.40 monthly cost with $480 deductible and 3,134 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $0 (Tier 1), $6 (Tier 2), 18% (Tier 3), 50% (Tier 4), and 25% (Tier 5). The preferred pharmacy copays for a 90-day supply are $0 (Tier 1), $18 (Tier 2), 18% (Tier 3), 50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5617-286. 5,928 members are enrolled in the plan statewide. Available drugs are 149 (Tier 1), 596 (Tier 2), 523 (Tier 3), 1,407 (Tier 4), and 459 (Tier 5).

Cigna Secure Rx -- $34.80 monthly cost with $480 deductible and 3,143 available formulary drugs. Preferred pharmacy copays for a 30-day supply are $1 (Tier 1), $3 (Tier 2),  $47 (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), $141 (Tier 3),  50% (Tier 4), and n/a (Tier 5). Plan Summary Star Rating is 3.5. Plan ID is S5617-216. 5,685 members are enrolled in the plan statewide. Available drugs are 83 (Tier 1), 557 (Tier 2), 655 (Tier 3), 1,287 (Tier 4), and 461 (Tier 5).

Cigna Secure-Extra Rx -- $67.10 monthly cost with $100 deductible and 3,231 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.  3,504 members are enrolled in the plan statewide. Available drugs are 179 (Tier 1), 671 (Tier 2), 726 (Tier 3), 1,157 (Tier 4), and 472 (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).

Virginia AARP Plans

 

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.