Medicare Advantage in Virginia

Looking for Virginia Medicare Advantage Plans? Enter your ZIP below to compare affordable or $0 premium plans in your area.

Virginia state

Information about Medicare Advantage Plans in Virginia

Quick links:

There are 65 different Virginia Medicare Advantage (Medicare Part C) plans in 2019, and 20 percent of Medicare beneficiaries in Virginia were enrolled in a Medicare Advantage plan in 2019.1

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of Virginia.

You can also learn more about other types of Medicare insurance plans:

Average costs of Medicare Advantage in Virginia

The average premium for a Medicare Advantage plan in Virginia in 2019 is $43 per month.

That average is affected by the 24 available plans that feature $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $43
  • Average in-network out-of-pocket spending limit: $5,462
  • Average deductible in 2019 (weighted): $170.181

Medicare Advantage out-of-pocket spending limits, deductibles, premiums and other costs may vary depending on where you live.

You can view the average 2019 Virginia Medicare Advantage plan costs by county listed below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare Virginia Medicare Advantage plan costs

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

You may not sign up for a Medicare Advantage plan in Virginia without first enrolling in Medicare Part A and Part B, otherwise known as Original Medicare.

In order to enroll in Original Medicare, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may qualify for Medicare before you turn 65 if:

  • You receive Social Security disability benefits or Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD).

If you have ESRD, you are likely not eligible for most Medicare Advantage plans. However, you may be able to enroll in a Virginia Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a VA Medicare Advantage Plan

The first time you may be able to enroll in a Virginia Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP begins three months before your 65th birthday, includes the month of your birthday and extends for three additional months thereafter.

If you do not sign up for a Medicare Advantage plan during your IEP, you may have other opportunities to do so:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

The Medicare Advantage Open Enrollment Period lasts from January 1 to March 31 every year. During this period, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

Medicare AEP (also sometimes called the Annual Election Period) lasts from October 15 to December 7 every year. During AEP, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period (SEP).

Find a Virginia Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Virginia 2019

The Centers for Medicare & Medicaid Services (CMS) publishes annual Star Ratings that reflect how each Medicare Advantage plan performs across a range of metrics, using a system of one to five stars.2

Plans are rated every year, so the ratings can differ slightly from year to year.

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 42 top-rated 2019 Medicare Advantage plans in Virginia that are rated four stars or higher. That's over 65 percent of Medicare Advantage plans offered in Virginia in 2019.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from member surveys, information that is submitted to Medicare and Medicare’s regular monitoring activities.

List of Medicare Advantage Plans Available in Virginia in 2019

To view a list of plans offered where you live in Virginia, use our plan comparison tool.

Find a Virginia Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Virginia

Several insurance carriers may offer Medicare Advantage plans in Virginia, but the selection of plans available near you may vary.

Private insurance companies offer Medicare Advantage plans that are typically unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

The following information may help you as you compare Medicare Advantage plans in 2019:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

Virginia Medicare Advantage plans by county

The chart below provides more information MA plan costs and enrollment in Virginia by county in 2019.1

  • Buchanan County had 5 top-rated Medicare Advantage plans (4 stars or higher) in 2019, which was the most of any county in the state.

  • 99 percent of MA enrollees in Chesterfield County were enrolled in a $0 premium plan.
2019 VA Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Average Monthly Premium Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Accomack 1554 16% $34 3 1 40%
Albemarle 2495 11% $26 2 1 40%
Alexandria City 3001 15% $64 0 0 11%
Alleghany 760 16% $28 4 2 43%
Amelia 784 24% $26 5 2 45%
Amherst 1591 19% $41 3 1 60%
Appomattox 726 17% $32 0 0 67%
Arlington 3630 13% $64 7 1 9%
Augusta 2780 14% $34 0 0 33%
Bath 107 8% $44 0 0 25%
Bedford 3675 18% $34 2 0 66%
Bland 466 5% $33 0 0 33%
Botetourt 2135 24% $38 2 0 31%
Bristol City 2096 23% $38 0 0 36%
Brunswick 847 42% $38 1 0 22%
Buchanan 3335 20% $35 7 2 38%
Buckingham 605 43% $32 0 0 25%
Buena Vista City 293 16% $31 0 0 40%
Campbell 2505 18% $35 0 0 65%
Caroline 1132 18% $26 0 0 44%
Carroll 1385 18% $44 0 0 14%
Charles City 452 16% $26 0 0 43%
Charlotte 589 22% $38 0 0 62%
Charlottesville City 777 16% $26 0 0 40%
Chesapeake City 8677 11% $22 1 1 74%
Chesterfield 15365 21% $0 5 2 99%
Clarke 422 24% $37 0 0 29%
Colonial Heights City 738 12% $8 0 0 81%
Covington City 254 16% $31 0 0 40%
Craig 375 14% $38 0 0 31%
Culpeper 1432 26% $40 0 0 50%
Cumberland 528 14% $26 0 0 43%
Danville City 3100 22% $22 0 0 57%
Dickenson 2335 26% $38 0 0 36%
Dinwiddie 1317 46% $22 0 0 45%
Emporia City 268 21% $34 0 0 25%
Essex 626 20% $30 2 1 36%
Fairfax 27740 20% $58 4 1 17%
Fairfax City 746 17% $55 1 0 23%
Falls Church City 320 15% $72 0 0 10%
Fauquier 1458 13% $28 0 0 50%
Floyd 873 11% $41 0 0 27%
Fluvanna 835 20% $25 0 0 50%
Franklin 4293 13% $36 0 0 45%
Franklin City 371 28% $26 0 0 43%
Frederick 2407 17% $31 1 1 43%
Fredericksburg City 537 13% $10 0 0 84%
Galax City 195 11% $41 0 0 20%
Giles 1051 9% $32 0 0 25%
Gloucester 1523 22% $29 1 0 36%
Goochland 1277 17% $6 0 0 87%
Grayson 945 20% $38 0 0 36%
Greene 524 19% $25 0 0 50%
Greensville 754 13% $38 0 0 22%
Halifax 1662 28% $23 0 0 75%
Hampton City 6942 17% $20 0 0 72%
Hanover 5358 25% $4 0 0 91%
Harrisonburg City 673 24% $47 0 0 17%
Henrico 16047 11% $0 1 1 99%
Henry 4465 26% $22 2 1 57%
Highland 78 28% $44 0 0 25%
Hopewell City 1108 9% $6 0 0 85%
Isle of Wight 1830 22% $27 1 1 42%
James City 3059 21% $11 2 1 84%
King and Queen 333 14% $25 0 0 44%
King George 402 17% $41 0 0 33%
King William 583 9% $26 0 0 43%
Lancaster 610 16% $39 0 0 20%
Lee 2981 13% $38 0 0 36%
Lexington City 165 44% $31 0 0 40%
Loudoun 6877 9% $60 0 0 14%
Louisa 1633 17% $22 0 0 44%
Lunenburg 487 19% $26 0 0 40%
Lynchburg City 2854 15% $39 2 1 61%
Madison 462 17% $25 0 0 50%
Manassas City 933 14% $64 0 0 16%
Manassas Park City 335 17% $62 0 0 19%
Martinsville City 1059 21% $22 0 0 57%
Mathews 494 23% $29 1 0 38%
Mecklenburg 1897 16% $39 0 0 25%
Middlesex 588 20% $29 0 0 33%
Montgomery 2830 15% $37 0 0 36%
Nelson 699 19% $25 0 0 50%
New Kent 881 14% $26 0 0 44%
Newport News City 8069 18% $15 0 0 79%
Norfolk City 9222 26% $23 0 0 73%
Northampton 706 26% $41 0 0 33%
Northumberland 690 18% $38 0 0 29%
Norton City 438 14% $36 0 0 33%
Nottoway 656 32% $32 0 0 29%
Orange 1225 16% $32 0 0 25%
Page 942 13% $41 0 0 33%
Patrick 1267 14% $44 0 0 14%
Petersburg City 2035 23% $8 0 0 81%
Pittsylvania 4620 25% $25 0 0 74%
Poquoson City 325 27% $25 2 1 50%
Portsmouth City 5008 12% $20 0 0 75%
Powhatan 1324 25% $3 0 0 93%
Prince Edward 814 20% $19 1 0 82%
Prince George 856 16% $26 0 0 43%
Prince William 9744 13% $60 0 0 13%
Pulaski 1989 18% $42 0 0 30%
Radford City 394 21% $38 0 0 31%
Rappahannock 211 17% $41 0 0 33%
Richmond 417 10% $38 0 0 29%
Richmond City 12038 19% $0 0 0 99%
Roanoke 5893 31% $37 0 0 38%
Roanoke City 6405 23% $37 0 0 38%
Rockbridge 994 28% $31 0 0 40%
Rockingham 2575 15% $47 0 0 17%
Russell 3301 14% $38 0 0 36%
Salem City 1335 39% $37 0 0 38%
Scott 3592 19% $36 0 0 33%
Shenandoah 1591 51% $21 0 0 60%
Smyth 2551 14% $38 0 0 36%
Southampton 699 28% $31 0 0 33%
Spotsylvania 2899 16% $8 1 1 88%
Stafford 2039 13% $9 0 0 87%
Staunton City 932 10% $34 0 0 33%
Suffolk City 3743 13% $7 0 0 90%
Surry 374 21% $26 0 0 43%
Sussex 567 21% $26 0 0 43%
Tazewell 4311 21% $38 0 0 36%
Virginia Beach City 14128 34% $24 1 1 72%
Warren 985 18% $40 0 0 29%
Washington 5766 12% $38 0 0 36%
Waynesboro City 750 36% $34 0 0 33%
Westmoreland 653 14% $41 0 0 33%
Williamsburg City 454 12% $28 0 0 44%
Winchester City 766 14% $31 0 0 43%
Wise 4745 13% $38 0 0 36%
Wythe 2023 42% $36 0 0 33%
York 1768 25% $27 0 0 43%

VA Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Virginia Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of Virginia enrollees (2019)
HMO 89.8%
Local PPO 10.1%
Regional PPO <1%
PPFS <1%
Other Plans <1%

The major types of Medicare Advantage plans include:

  • HMO
    Health Maintenance Organization (HMO) typically requires you to designate a primary care physician (PCP). You usually need to get a referral from your PCP before you can visit a specialist.

    With most HMO plans, you are required to see doctors and other health care providers that are in your plan network, except for in cases of an emergency.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are typically allowed to visit any provider who accepts Medicare, whether or not they are in the plan network.

    You will typically pay less out of pocket, however, if you seek medical services from providers within your plan’s network.

    PPO plans typically do not require patients to get a referral before visiting with a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers and how much the beneficiary will pay when care is received.

    With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts Medicare as well as your plan terms. Not all providers will accept these terms, however.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.

    Most SNPs will typically require you to seek services from providers within your SNP network. All Medicare SNPs are required to provider prescription drug coverage.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Virginia Medicare Advantage plans that are available where you live.

Local health insurance resources in Virginia

  • 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.

  • Virginia Prescription Drug Assistance Programs
    The state of Virginia has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, accessed May 2019. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

Includes 2019 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown.

2 Every year, Medicare evaluates plans based on a 5-star rating system.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.

Medicare has neither reviewed nor endorsed this information.

Last Updated: 6/25/2019