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

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There are 69 different Virginia Medicare Advantage Prescription Drug plans (MAPD) plans in 2021.1

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 (also called Medicare Part C) plan that includes prescription drug coverage in Virginia in 2021 is $23 per month.

  • Average monthly premium cost in 2021 (weighted): $43
  • Average in-network out-of-pocket spending limit: $5,463
  • Average drug deductible in 2021 (weighted): $1771

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

You can view the average 2021 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

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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 may be able to enroll in a Medicare Advantage plan or 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

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

Top-rated Medicare Advantage Plans in Virginia 2021

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 44 top-rated 2021 Medicare Advantage Prescription Drug plans in Virginia that are rated four stars or higher. That's over 59 percent of MAPD plans offered in Virginia in 2021.

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 2021

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 to speak with a licensed insurance agent. We accept calls 24/7!

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 2021:

  • 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

Learn more about Fairfax County Medicare Advantage plans.

The chart below provides more information about MAPD plan costs and enrollment in Virginia by county in 2021.1

2021 VA Medicare Advantage by County
County Total Enrollees in County Average Premium % of Plans Rated 4 Stars or Higher Avg. Annual Drug Deductible # Plans Available
Accomack 1844 $17.91 100% $235.00 11
Albemarle 2908 $17.25 80% $272.50 8
Alexandria City 3529 $33.85 69% $168.42 26
Alleghany 986 $14.42 60% $182.78 12
Amelia 954 $16.79 71% $218.00 20
Amherst 2037 $23.00 64% $218.75 16
Appomattox 969 $22.59 62% $211.15 17
Arlington 4439 $33.08 71% $159.71 24
Augusta 3403 $13.93 60% $179.09 14
Bath 119 $17.92 57% $205.56 13
Bedford 4341 $23.47 50% $225.83 17
Bland 500 $22.63 73% $187.00 16
Botetourt 2409 $26.72 69% $195.00 18
Bristol City 2280 $23.84 82% $139.58 16
Brunswick 1048 $23.98 43% $247.50 13
Buchanan 3568 $25.20 77% $138.08 17
Buckingham 787 $17.91 75% $229.17 11
Buena Vista City 320 $13.31 75% $164.50 13
Campbell 3257 $18.80 63% $224.09 15
Caroline 1442 $16.46 50% $180.71 19
Carroll 1729 $20.38 44% $231.25 13
Charles City 552 $16.06 46% $186.25 16
Charlotte 711 $21.15 30% $214.00 13
Charlottesville City 987 $19.71 80% $262.00 7
Chesapeake City 10380 $18.84 60% $169.69 23
Chesterfield 17621 $18.15 65% $161.84 25
Clarke 468 $33.07 64% $185.45 15
Colonial Heights City 884 $14.60 72% $161.94 23
Covington City 304 $14.42 75% $182.78 12
Craig 371 $26.72 64% $170.00 18
Culpeper 1674 $16.67 100% $306.25 6
Cumberland 621 $18.93 60% $208.50 15
Danville City 3988 $18.77 53% $217.00 19
Dickenson 2649 $25.43 82% $122.73 15
Dinwiddie 1648 $16.46 71% $220.71 19
Emporia City 392 $22.26 33% $220.00 14
Essex 700 $21.11 50% $176.82 18
Fairfax 33384 $38.42 67% $163.16 26
Fairfax City 826 $34.76 65% $145.00 21
Falls Church City 354 $35.20 63% $146.94 25
Fauquier 1851 $28.09 73% $223.85 18
Floyd 1036 $28.29 69% $184.17 17
Fluvanna 960 $15.00 75% $224.29 11
Franklin 4952 $21.76 79% $201.43 18
Franklin City 486 $16.07 45% $198.89 14
Frederick 3187 $29.23 75% $216.25 16
Fredericksburg City 844 $34.36 56% $160.00 24
Galax City 254 $18.93 50% $205.56 14
Giles 1217 $13.77 57% $211.25 13
Gloucester 1827 $19.87 47% $199.23 20
Goochland 1399 $19.73 67% $182.65 23
Grayson 1115 $25.43 82% $122.73 15
Greene 636 $9.09 60% $205.71 11
Greensville 751 $22.26 30% $220.00 14
Halifax 2053 $24.07 25% $191.67 15
Hampton City 8248 $18.41 60% $169.69 23
Hanover 6030 $18.15 65% $161.84 25
Harrisonburg City 869 $16.31 56% $168.50 13
Henrico 18331 $18.15 65% $161.84 25
Henry 5381 $13.85 89% $210.45 15
Highland 60 $17.92 57% $205.56 13
Hopewell City 1355 $14.60 72% $161.94 23
Isle of Wight 2090 $18.84 50% $171.56 23
James City 3649 $15.27 65% $184.64 20
King and Queen 389 $15.50 60% $183.50 16
King George 577 $19.69 63% $159.09 16
King William 737 $17.69 60% $219.55 15
Lancaster 702 $21.07 57% $192.22 15
Lee 3514 $25.43 82% $122.73 15
Lexington City 160 $13.31 75% $164.50 13
Loudoun 8646 $38.30 69% $162.27 30
Louisa 2027 $15.36 67% $233.33 14
Lunenburg 668 $17.62 50% $216.50 14
Lynchburg City 3809 $19.42 70% $242.50 16
Madison 588 $9.09 60% $205.71 11
Manassas City 1082 $33.08 79% $146.18 24
Manassas Park City 376 $33.08 79% $146.18 24
Martinsville City 1347 $12.79 86% $187.00 14
Mathews 546 $14.34 43% $196.82 16
Mecklenburg 2198 $22.18 36% $211.36 15
Middlesex 646 $20.44 55% $211.36 17
Montgomery 3321 $21.76 69% $201.43 18
Nelson 820 $13.75 60% $196.25 12
New Kent 993 $17.06 67% $192.31 18
Newport News City 9426 $18.41 60% $169.69 23
Norfolk City 11121 $18.84 61% $169.69 23
Northampton 904 $23.76 88% $234.50 15
Northumberland 800 $21.65 73% $211.67 19
Norton City 505 $23.31 100% $90.50 14
Nottoway 836 $23.79 40% $220.45 16
Orange 1485 $9.43 50% $174.44 14
Page 1109 $35.63 56% $209.09 16
Patrick 1526 $20.85 44% $218.75 13
Petersburg City 2623 $18.15 65% $161.84 25
Pittsylvania 5498 $22.14 50% $213.44 20
Poquoson City 365 $14.54 61% $170.33 21
Portsmouth City 6073 $18.84 61% $169.69 23
Powhatan 1441 $19.73 67% $182.65 23
Prince Edward 1078 $25.36 44% $218.75 16
Prince George 1029 $17.37 67% $240.00 18
Prince William 12018 $33.08 74% $159.71 24
Pulaski 2162 $24.88 64% $187.92 17
Radford City 447 $25.32 64% $181.07 19
Rappahannock 225 $22.50 71% $194.44 14
Richmond 437 $23.13 63% $194.44 15
Richmond City 13797 $18.15 65% $161.84 25
Roanoke 6627 $25.49 71% $198.67 20
Roanoke City 7775 $25.49 69% $198.67 20
Rockbridge 1285 $12.36 75% $179.09 14
Rockingham 2910 $17.19 60% $193.64 14
Russell 3693 $23.84 82% $112.50 16
Salem City 1519 $25.32 56% $181.07 19
Scott 3961 $21.76 100% $82.27 15
Shenandoah 2022 $26.39 100% $224.58 17
Smyth 2977 $25.43 82% $122.73 15
Southampton 796 $20.81 50% $195.00 16
Spotsylvania 4194 $37.49 56% $158.06 22
Stafford 2934 $32.95 56% $158.10 27
Staunton City 1232 $13.93 60% $179.09 14
Suffolk City 4600 $18.84 61% $169.69 23
Surry 455 $15.18 46% $180.45 17
Sussex 710 $17.31 45% $205.00 13
Tazewell 4745 $24.12 85% $163.08 17
Virginia Beach City 16771 $18.84 61% $169.69 23
Warren 1269 $34.29 60% $159.50 14
Washington 6349 $22.78 85% $151.43 18
Waynesboro City 1006 $13.93 60% $179.09 14
Westmoreland 865 $21.75 75% $194.50 16
Williamsburg City 499 $19.25 58% $183.00 22
Winchester City 980 $29.27 70% $195.45 15
Wise 5707 $22.78 85% $151.43 18
Wythe 2450 $24.69 79% $160.00 18
York 2046 $19.25 58% $183.00 22

VA Medicare Advantage plans by plan type

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 2021 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.

 

1 MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

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