Virginia has one of the highest median household incomes in the country, but a significant number of its residents can’t afford health insurance. Fortunately for people 65 years and older and workers with specific disabilities, they may qualify for Medicare health insurance benefits at a much lower cost.
Virginia Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2022 Medicare trends in Virginia:
- 1,594,003 beneficiaries in Virginia are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased from $15.09 in 2022 to $12.80 in 2023.
- There are 147 Medicare Advantage plans available for Virginians for 2023.
- All Virginia residents with Medicare have access to buy a Medicare Advantage plan, including those with $0 premiums.
- In 2023, there are 24 prescription drug plans offered in Virginia.
- The lowest monthly premium for a Medicare prescription drug plan is $5.10, lowered since 2022.
Medicare Offered in Virginia
If you live in Virginia, there are two different ways that Medicare can provide the services you need. You could go the traditional route with original Medicare or choose a plan from an alternate company that will cover all of your medical expenses and more.
Medicare starts with Original Medicare, made up of Part A and Part B. Premiums are much more affordable as Part A normally doesn’t require a premium from most beneficiaries. Part B may typically require a premium.
Part A and Part B also have deductibles, copays, and coinsurance costs that beneficiaries need to take care of. In return, beneficiaries receive hospital insurance such as inpatient care from Part A. Medicare Part B covers medical insurance, such as preventive services, durable medical supplies, and outpatient care.
Also known as Medicare Part C, a Medicare Advantage Plan can offer a comprehensive Medicare package that provides the coverage of Original Medicare plus many more benefits. These additional benefits can include Medicare Part D prescription drug coverage, dental, hearing, and vision care, and supplemental healthcare services that Original Medicare doesn’t cover. Some Medicare Advantage plans even include gym memberships!
Many insurance companies offer Medicare Advantage plans, with ratings, in Virginia:
- AARP – 5/5 stars
- Aetna – 4.5/5 stars
- Anthem Blue Cross Blue Shield – 4/5 stars
- Clear Spring Health Essential (HMO)
- Optima – 4/5 stars
Medicare Supplement Plans
Some Medicare beneficiaries can buy Medicare supplemental plans for additional benefits not found in Original Medicare. The most popular program covers the cost of Medicare prescription medication, referred to as Medicare Part D. The plans can also include healthcare services not covered by Part A and Part B. Some plans can also help pay for the out-of-pocket expenses of Part A and Part B, such as deductibles, coinsurance, and copays.
The supplemental plans are available from Medicare-approved health insurance companies in Virginia. These will require a separate premium apart from the premiums required by Original Medicare.
The companies that offer supplemental coverage include:
- AARP – United Healthcare
- Colonial Penn
- Great Southern
- Mutual of Omaha
- State Farm
Virginia Medicare Enrollment
Virginians are eligible for Medicare if they are a U.S. citizen and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts October 15th
- Ends December 7th
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
Virginia Enrollment Tips & Advice
Before enrolling in Medicare and Medicare Advantage in Virginia, evaluate your options and weigh the pros and cons of price point, coverage, providers, and facilities in the plans’ networks, as well as ratings for Part C and Part D plans.
Virginia has an 9.4% poverty rate, so many Medicare beneficiaries living here cannot easily afford Medicare coverage. However, the state offers Medicare Savings Programs (MSPs) to help cover at least some of the expenses. The level of financial assistance will depend on the income and assets of the beneficiaries.
Virginia has the Virginia Insurance Counseling and Assistance Program (VICAP) to help provide free and unbiased counseling to Medicare beneficiaries. You can call VICAP at 800-552-3402.
Other resources include:
How Do I Enroll in a Medicare Plan?
Virginia residents are eligible for Medicare if they are a U.S. citizen and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis.
If you have any questions about Virginia Medicare and your eligibility for financial assistance, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.