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List of Medicare Advantage Plans in Virginia 2019

The state of Virginia had 65 different Medicare Advantage plans available for sale in 2019.1

Plan selection may vary from one county or zip code to another. You can call to speak with a licensed insurance agent who can help you determine your eligibility to enroll and compare the Medicare Advantage plans that are available in your area of Virginia. 

Find Medicare Advantage plans in your area

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

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Types of Virginia Medicare Advantage plans

There are several different types of Medicare Advantage plans that may be available in Virginia, though not each type of plan may be available where you live.

The 2019 breakdown of Medicare Advantage plan enrollment in Virginia is illustrated in the chart below.1

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

Virginia Health Maintenance Organization (HMO) plans

Health Maintenance Organization (HMO) plans feature a network of participating doctors, pharmacies and other health care providers.

With a Medicare HMO plan, you typically choose a primary care physician (PCP) who coordinates your health care. If you need to see a specialist, you typically need to get a referral from your PCP for a specialist within your HMO plan network. 

Only care that is received within the plan network of participating providers will typically be covered by an HMO plan.

In 2019, 89.8% of Medicare Advantage beneficiaries in Virginia are enrolled in HMO plans.

Virginia Preferred Provider Organization (PPO) plans

Preferred Provider Organization (PPO) plans typically include a network of participating providers, but you may be able to go outside of the network for some covered care.

If you receive medical services outside of your Medicare PPO plan network, you will typically pay higher out-of-pocket costs than you would if you visited an in-network provider.

You typically aren't required to get a referral from a physician in order to visit a specialist when you have a PPO plan, but individual restrictions may vary.

In 2019, 10.1% of Virginia Medicare Advantage plan beneficiaries are enrolled in Local PPO plans.

Virginia Private Fee-For-Service (PFFS) plans

Private Fee-For-Service (PFFS) plans allow members to receive care from any provider that accepts the plan’s coverage, agrees to the terms and conditions of the plan and accepts Medicare.

You typically aren't required to get a referral to see a specialist when you have a PFFS plan.

Less than 1% of Virginia Medicare Advantage plan beneficiaries in 2019 are enrolled in a PFFS plan.

Special Needs Plans (SNPs)

Medicare Advantage Special Needs Plans (SNPs) feature benefits that are designed for people with certain medical conditions or who are dual eligible for Medicare and Medicaid.

Medicare SNPs aren’t available in all areas. Depending on where you live and what type of special needs you may have, a licensed insurance agent can help you find a Medicare SNP that may fit your needs, if one is available.

You can also learn more about additional Medicare plans in Virginia, such as:

Medicare Advantage plans in Virginia

One out of every five Medicare beneficiaries (20 percent) in the state of Virginia was enrolled in a Medicare Advantage plan in 2019, which totaled up to more than 326,000 beneficiaries in all.1

  • Medicare Advantage enrollment density was highest in Scott County, where 51 percent of all Medicare beneficiaries belonged to a Medicare Advantage plan.

    The counties of Bristol City (42 percent), Dickenson (46 percent), Lee (44 percent), Buchanan (43 percent) and Wise (42 percent) all had Medicare Advantage enrollment rates that were at least twice the state average.

  • Buchanan and Arlington counties each had 7 Medicare Advantage plans available in 2019, which were the most for any county in the state. 

  • 41 percent of Virginia Medicare Advantage plan beneficiaries were enrolled in plans that featured $0 premiums in 2019.

    $0 premium plans may not be available in all areas, so be sure to check with a licensed insurance agent who can help you find any $0 premium plans in your area.

  • The weighted average deductible for a Medicare Advantage plan in Virginia was $170 per year in 2019.

Individual plan costs and premiums may vary.

42 plans in Virginia were rated four stars or higher by the Centers for Medicare and Medicaid Services (CMS) in 2019.2 A plan that has four or more stars is considered a highly rated Medicare Advantage plan.

Virginia Medicare Advantage plans at a glance

  • Number of unique plans: 65
  • Number of $0 premium plans: 24
  • Number of plans rated four stars or higher: 42
  • Average weighted monthly premium: $43
  • Average weighted annual deductible: $170.18
  • Percentage of Medicare beneficiaries enrolled in a Medicare Advantage plan: 20
  • Number of people enrolled in a Medicare Advantage plan: 326,231

How to enroll in a Medicare Advantage plan in Virginia

Call today to speak with a licensed insurance agent who can help you determine your eligibility to enroll and compare Medicare Advantage plans where you live. A licensed agent may also be able to:

Connect with a licensed insurance agent today to explore your Virginia Medicare Advantage plan options. 

 

Find Medicare Advantage plans in your area

Compare Plans

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

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.

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 and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.