Medicare Part D in Virginia

Looking for Virginia prescription drug benefits? Enter your ZIP below to compare Medicare Advantage plans in your area that may offer prescription drug coverage.

Virginia state

Medicare beneficiaries in the state of Virginia may wish to know more about prescription drug coverage. After all, approximately 90 percent of people over the age of 65 take at least one drug every week, yet Original Medicare (Medicare Part A and Part B) does not provide coverage for most prescription medications.1 

Medicare beneficiaries have two primary options for obtaining coverage for prescription drugs. The first is enrolling a Medicare Advantage plan that provides such a benefit. The second option is enrolling in a standalone Medicare Part D plan.

Part D plans are used in conjunction with Original Medicare (and Medicare Advantage plans that don’t provide prescription drug benefits) to provide coverage exclusively for prescription drugs. Because these plans are sold by private insurers, each plan will include its own criteria concerning:

  • Premiums
  • Deductibles
  • Copayments or coinsurance
  • Drug formulary (the list of drugs covered by the plan)

Virginia Medicare Part D plans by the numbers

There were 914,191 people in the state of Virginia enrolled in a Medicare Part D plan as of early 2018.2

There are 24 Medicare Part D plans available in Virginia in 2018, which is three more than were offered in 2017. Each plan is unique in terms of its cost and coverage, so it’s important to find a plan that fits your needs.

The chart below highlights some details about the cost of Part D plans in Virginia. 

Average plan premium

$51.66 ($0.57 lower than the national average of $52.23)

Lowest premium


Highest premium


Average deductible


No. of plans with a premium under $25


No. of plans with a $0 deductible


Eligibility and EnrollmentData reflects Medicare Part D enrollment in the state of Virginia as of 2018, as obtained from the Centers of Medicare and Medicaid Services,

If you are enrolled in both Medicare Part A and Part B, you are eligible to enroll in a Part D plan or to enroll in a Medicare Advantage plan with prescription drug coverage. Remember that not all plans are available in each state, so you may only enroll in a plan that is sold in the state in which you reside.

There are only certain times of the year in which you may sign up for a Medicare Part D plan or a Medicare Advantage plan, which are outlined below.

Initial Enrollment Period (IEP)

Your seven-month Initial Enrollment Period (IEP) begins three months before your 65th birthday, includes the month of your birthday and continues for three months after you turn 65. It typically runs concurrently with your Medicare Part B Initial Enrollment Period.

It’s important to consider that there is a Medicare Part D late enrollment penalty. You may incur this penalty if you go at least 63 continuous days without a Part D plan, a Medicare Advantage plan that offers prescription drug coverage or other creditable prescription drug coverage.

Annual Election Period

The Annual Election Period occurs from October 15 to December 7 each year. During this time, you may enroll or disenroll in a Medicare Part D plan or switch from one plan to another.

During this period, you can also enroll in a Medicare Advantage plan with prescription drug coverage, disenroll from a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

Medicare Advantage Disenrollment Period

The Medicare Advantage Disenrollment Period lasts from January 1 to February 14 each year. During this time, you may disenroll from a Medicare Advantage plan and enroll in a Part D plan.

Special Enrollment Period

A Special Enrollment Period may be granted under certain circumstances under which you can enroll in a Medicare Part D plan or in a Medicare Advantage plan. These specific circumstances can include but are not limited to: moving out of your current plan’s service area, losing your current coverage or moving into a long-term care facility.

5-Star Special Enrollment Period

There is also a 5-Star Special Enrollment Period, which runs from December 8 to November 30 each year. If you are enrolled in a Part D plan or a Medicare Advantage plan that does not have a 5-star rating, you can use this time to switch to one that does, as long as one is available in your area.4

Virginia Insurance Counseling and Assistance Program (VICAP)

The Virginia Insurance Counseling and Assistance Program provides free, unbiased and confidential information to the state’s Medicare beneficiaries about their Medicare coverage, costs and rights. The certified counselors are also available to answer questions about Medicare Advantage, Medicare Supplement Insurance and other related programs. The program may be reached at 800-552-3402.      

You can also explore more information about the insurance industry in Virginia by visiting the state’s Bureau of Insurance website.


1 Ruscin, Mark and Linnebur, Sunny. Aging and Drugs. Merck Manual. Retrieved from
2 Cubanski, Juliette; Damico, Anthony and Neuman, Tricia. Medicare Part D in 2018: The Latest on Enrollment, Premiums and Cost Sharing. May 17, 2018. Kaiser Family Foundation. Retrieved from
3’s internal analysis of CMS 2018 Prescription Drug Plan (PDP) Landscape Source Files. May 2018.
4 Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

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