Medicare Plans in Virginia

Understanding the details of Medicare can be challenging, especially for those without prior experience with this program. Knowing the ins and outs of Virginia Medicare eligibility and enrollment is essential to utilizing it successfully.

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

What Virginia Medicare Plans Are Available?

Understanding the details of Medicare can be challenging, especially for those without prior experience with this program. Knowing the ins and outs of Virginia Medicare eligibility and enrollment is essential to utilizing it successfully.  

The available Medicare plans in Virginia include several parts that speak to different healthcare needs. 

Part A: This is the hospital insurance component and does not have premiums for those who paid into Medicare taxes during traditional employment. Those who did not pay into Medicare taxes may be able to purchase a Part A plan; however, those that do purchase Part A will also need to purchase Part B. 

Part A covers in-patient hospital care, in-patient skilled nursing facility care, hospice and home health care. It also covers in-patient care in a religious health care institution. 

Part B: There are monthly premiums for this component, and they may fluctuate based on income. Those who are eligible but do not sign up incur a late enrollment penalty of 10% for every 12 months. There's an exception to the penalty for those who had other coverage or were covered by a spouse's insurance policy and needed coverage suddenly. 

Part B insurance covers physicians visits, outpatient health care, home health care, some medical equipment and preventative services

Part C: This is the Medicare Advantage Plan and is an alternative to traditional Medicare coverage. If you choose a plan under this umbrella, it kicks in and acts as a replacement of sorts for Parts A and B, providing coverage through the private Advantage Plan instead of traditional Medicare. 

The Advantage Plans are offered through private entities and have different rules. Part of what makes them different is that they might offer coverage for vision, dental and health and wellness. These plans generally include prescription medication benefits as well. 

The different Medicare Advantage plan structures include a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), Special Needs Plans (SNP), HMO Point-of-Service (HMOPOS) and a Medical Savings Account (MSA).

Part D: This is the prescription drug component and is offered to everyone that has a Medicare plan. There is a monthly premium attached to this plan and, as with Part B, premiums may fluctuate based on income. A penalty is levied for late enrollment. 

Part D coverage can be through the Medicare plan as an add on to Parts A and B or C or as part of a Part C plan.

Medigap: This is Medicare Supplement Insurance and is purchased in addition to Medicare to help cover elements that Parts A and B don't cover (such as copays or coinsurance). However, individuals have to be enrolled in the original Medicare program before adding the supplement plan.

More than 1.6 million Virginians were enrolled in the original Medicare plan in 2024 and more than 36% of individuals were enrolled in the Medicare Advantage plan in 2024. 

Medicare coverage is available in every state, though Alaska does not have the Medicare Advantage option. Also, Medicare supplement insurance has different standards in Wisconsin, Minnesota and Massachusetts. 

Who Is Eligible for Virginia Medicare?

Medicare is available for Americans who are age 65 and older. Those eligible must have been employed and paid into the system via payroll taxes or they may need to purchase the plan. The program also provides health insurance to some with disabilities (so determined by the Social Security Administration) and a few chronic/terminal conditions. 

Automatic enrollment occurs for those who are already receiving retirement benefits from the Social Security Administration in the four months prior to turning 65. 

The initial enrollment period is 3 months before a person's 65th birthday extended to 3 months after a person's 65th birthday. Enrollment outside of this period is permissible but does incur penalties. 

After the initial enrollment period, individuals may sign up for Parts A and B during general enrollment between January 1 and March 31. Coverage for these plans begins July 1. 

Special enrollment options are available for certain situations. For instance, those with a traditional Medicare plan can switch to a Medicare Advantage Plan, Medicare Cost Plan or Medicare drug plan if a 5-star rating option becomes available. This special enrollment period is only available for use one time between December 8 and November 30. 

Special enrollment also applies to those who are still working (or who are married to people who are still working) or those covered by a group health plan. These individuals can sign up for Parts A and B at any time when they lose coverage through their employer or opt out of it.

Medicare also offers a fall enrollment period. It occurs annually from October 15 through December 7, with changes taking effect as of January 1. This is the only point at which individuals who are already enrolled in a plan can choose a new Medicare Advantage or Medicare Part D plan. 

How Do I Enroll in Medicare in Virginia?

Those who are eligible to enroll may do so via the website at www.SocialSecurity.gov. Eligible citizens can also call the Social Security Administration at (800) 772-1213 Monday through Friday from 7 a.m.-7 p.m. 

Local Social Security Administration offices can also facilitate sign-up. 

HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Medicare Plans by County

Average Cost of Medicare Advantage Plans in Virginia

Average Cost of Medicare Advantage Plans in Virginia
Average Monthly Premium $42.94
Average in-network out-of-pocket spending limit $6,961.22
Average drug deductible in 2024 (weighted) $317.82
Percentage of plans rated 4 stars or higher 50.0%
Average Cost of Medicare Advantage Plans in Virginia
Average Monthly Premium
$42.94
Average in-network out-of-pocket spending limit
$6,961.22
Average drug deductible in 2021 (weighted)
$317.82
Percentage of plans rated 4 stars or higher
50.0%

Virginia Medicare Advantage Plans by County

The chart below provides more information about Medicare Advantage plan costs and enrollment in Virginia by county in 2024.

Scroll to the right to continue reading the chart
County Average Premium Average Annual Drug Deductible % of Plans Rates 4 Stars or Higher # of Plans Available
Roanoke $41 $312 51.9% 52
Virginia Beach City $38 $296 54.5% 55
Spotsylvania $51 $309 48.0% 50
Portsmouth City $38 $296 54.5% 55
Harrisonburg City $42 $333 41.2% 34
Chesapeake City $38 $296 54.5% 55
Buchanan $42 $307 48.6% 37
Nottoway $48 $338 47.5% 40
Cumberland $50 $329 50.0% 40
Tazewell $40 $315 46.2% 39
Goochland $41 $348 50.0% 56
Lee $45 $316 44.1% 34
Clarke $47 $289 54.3% 46
Smyth $45 $316 44.1% 34
Gloucester $39 $323 54.2% 48
Halifax $40 $350 47.7% 44
Buena Vista City $38 $338 47.6% 42
Staunton City $46 $338 47.6% 42
Highland $41 $320 47.4% 38
Henry $38 $338 47.7% 44
York $38 $325 56.9% 51
Northumberland $42 $308 51.1% 45
Westmoreland $45 $291 51.2% 43
Nelson $43 $336 44.4% 36
Pulaski $41 $322 52.1% 48
Newport News City $38 $315 57.4% 54
Wise $43 $323 41.0% 39
Accomack $44 $354 64.9% 37
Powhatan $41 $334 49.1% 55
Fairfax City $50 $319 52.1% 48
Madison $42 $355 45.9% 37
Martinsville City $38 $338 47.7% 44
Dinwiddie $43 $332 47.9% 48
Franklin $41 $321 50.0% 50
Galax City $41 $338 50.0% 40
King William $48 $338 45.0% 40
Lancaster $41 $324 52.4% 42
Arlington $49 $318 55.1% 49
Prince William $49 $319 52.9% 51
Mathews $39 $323 47.7% 44
Lynchburg City $40 $315 44.4% 45
James City $38 $335 54.9% 51
Jefferson $39 $337 51.2% 43
Richmond $45 $302 53.5% 43
Brunswick $39 $338 47.5% 40
Lexington City $38 $338 47.6% 42
Page $51 $272 53.5% 43
New Kent $47 $331 53.5% 43
Caroline $47 $347 47.5% 40
Washington $43 $323 41.0% 39
Henrico $41 $312 51.6% 62
Danville City $38 $353 51.1% 47
Hopewell City $44 $347 51.0% 51
Warren $48 $272 53.3% 45
Falls Church City $51 $283 52.0% 50
Giles $38 $338 48.9% 45
Northampton $42 $308 52.2% 46
Middlesex $39 $327 51.1% 45
Isle of Wight $38 $290 53.8% 52
Greene $43 $319 43.2% 37
Greensville $48 $338 48.8% 41
Winchester City $46 $272 48.8% 43
Charlottesville City $40 $338 43.6% 39
Craig $43 $318 54.3% 46
Bath $41 $320 47.4% 38
Bedford $43 $284 46.8% 47
Roanoke City $41 $312 52.8% 53
Pittsylvania $38 $340 52.1% 48
Rockbridge $38 $338 47.6% 42
Colonial Heights City $41 $333 50.0% 56
Campbell $40 $350 46.5% 43
Bland $44 $321 55.8% 43
Chesterfield $41 $312 51.6% 62
Buckingham $51 $336 48.7% 39
Fluvanna $43 $319 43.2% 37
Surry $41 $302 52.3% 44
Charles City $43 $337 51.1% 47
Amelia $41 $333 50.0% 50
Rockingham $41 $328 46.3% 41
Norton City $50 $278 41.7% 36
Culpeper $42 $350 40.5% 37
Essex $45 $302 53.5% 43
Richmond City $41 $312 50.8% 61
Poquoson City $38 $298 52.0% 50
Appomattox $47 $322 54.3% 46
Sussex $41 $314 53.5% 43
Prince George $47 $332 48.8% 43
Shenandoah $41 $328 43.6% 39
King George $48 $307 44.7% 38
Russell $45 $316 43.2% 37
Southampton $41 $291 53.3% 45
Amherst $40 $315 46.5% 43
Mecklenburg $39 $354 47.5% 40
Manassas Park City $51 $292 49.0% 51
Waynesboro City $46 $338 47.6% 42
Patrick $41 $320 48.7% 39
Radford $41 $322 53.1% 49
Stafford $51 $309 48.0% 50
Rappahannock $49 $283 52.3% 44
Franklin City $41 $278 48.9% 45
King and Queen $41 $314 52.4% 42
Alleghany $40 $337 50.0% 40
Grayson $42 $307 48.6% 37
Bristol City $43 $323 41.0% 39
Frederick $46 $272 48.8% 43
Orange $42 $350 40.5% 37
Floyd $41 $322 52.1% 48
Suffolk City $38 $303 53.7% 54
Louisa $42 $314 47.5% 40
Alexandria City $49 $309 56.0% 50
Emporia City $48 $338 48.8% 41
Norfolk City $38 $315 56.6% 53
Williamsburg City $38 $311 56.0% 50
Wythe $40 $334 47.5% 40
Montgomery $41 $307 49.0% 49
Salem $41 $298 51.0% 51
Loudoun $49 $299 51.8% 56
Hanover $41 $312 50.8% 61
Albemarle $40 $353 45.0% 40
Fairfax $49 $318 55.1% 49
Scott $45 $307 47.5% 40
Hampton City $38 $296 54.5% 55
Lunenburg $39 $355 44.7% 38
Manassas City $51 $292 49.0% 51
Carroll $41 $338 50.0% 40
Fredericksburg City $52 $296 46.9% 49
Petersburg City $41 $322 51.7% 58
Dickenson $42 $307 48.6% 37
Covington City $40 $337 50.0% 40
Fauquier $47 $304 51.1% 45
Botetourt $41 $298 51.0% 51
Prince Edward $40 $334 47.7% 44
Augusta $43 $350 51.1% 45

Local Health Insurance Resources in Virginia

For more information and assistance with Medicare, Medicaid and additional help, reach out to the Virginia Insurance Counseling & Assistance Program (VICAP): Call (800) 552-3402 or visit https://www.vda.virginia.gov/vicap.htm. Virginia also has numerous resources to help with Medicare needs, including the Virginia Drug Assistance Program.

The state also offers a Medicare Savings Program for low-income residents signed up for Medicare, which helps with deductibles and premiums.