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Written by David Bynon [3], Medicare Analyst since 2012.  Last updated May 1, 2025

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Medicare Advantage
 » 
Virginia
 » 
Falls Church County

Guide to Medicare Advantage Plans in Falls Church County, VA for 2025

List of Plans | Plan Overview | Benefits | How to Choose | Enrollment | FAQ

There are 32 Medicare Advantage plans available in Falls Church County, VA for the 2025 plan year, including 20 plans with $0 premiums. Most plans include prescription drug coverage. These counts exclude Special Needs Plans.

Not in Falls Church County? Enter your ZIP code to see plans in your area.

  • Top 3 Plans by Enrollment:
    1. Kaiser Permanente Medicare Advantage Standard VA (HMO-POS) — 86 enrollees
    2. Kaiser Permanente Medicare Advantage Value VA (HMO-POS) — 76 enrollees
    3. AARP Medicare Advantage from UHC VA-0015 (PPO) — 28 enrollees
  • Average Monthly Premium: $18.58
  • Average Maximum Out-of-Pocket Limit: $6,997
  • Average Prescription Drug Deductible: $343.75
  • Ratings (Plan Mix): 4+ Stars: 42% · 3 Stars: 58% · Below 3: 0%
  • Plan Type Breakdown 12 PPO · 10 HMO-POS · 6 HMO · 1 PFFS · 3 REGIONAL PPO

Falls Church County, Virginia Medicare Advantage Plans

Medicare Advantage Plans in Falls Church County, VA for 2024
Plan Name Type Premium MOOP Rx Ded. Rating
Aetna Medicare Choice* PPO $85 $6,750 $590
☆☆☆☆☆
Aetna Medicare Eagle* PPO $0 $6,750 N/A
☆☆☆☆☆
Kaiser Permanente Medicare Advantage Care Plus VA* HMO-POS $26 $5,500 $0
☆☆☆☆☆
Kaiser Permanente Medicare Advantage High VA* HMO-POS $137 $5,700 $0
☆☆☆☆☆
Kaiser Permanente Medicare Advantage Liberty* HMO $0 $5,900 N/A
☆☆☆☆☆
Kaiser Permanente Medicare Advantage Standard VA* HMO-POS $15 $5,900 $0
☆☆☆☆☆
Kaiser Permanente Medicare Advantage Value VA* HMO-POS $0 $6,500 $0
☆☆☆☆☆
AARP Medicare Advantage from UHC VA-0003 PPO $0 $6,700 $495
☆☆☆☆☆
AARP Medicare Advantage from UHC VA-0010 HMO-POS $37 $6,700 $340
☆☆☆☆☆
AARP Medicare Advantage from UHC VA-0014 HMO-POS $0 $7,900 $420
☆☆☆☆☆
AARP Medicare Advantage from UHC VA-0015 PPO $0 $7,900 $420
☆☆☆☆☆
AARP Medicare Advantage Patriot No Rx VA-MA01 PPO $0 $8,900 N/A
☆☆☆☆☆
Humana Gold Choice H8145-004 PFFS $18 $7,550 $350
☆☆☆☆☆
Aetna Medicare Select HMO-POS $0 $5,900 $250
☆☆☆☆☆
Aetna Medicare Value HMO-POS $0 $4,150 $250
☆☆☆☆☆
Anthem Extra Help HMO-POS $8 $2,900 $590
☆☆☆☆☆
Anthem Medicare Advantage 3 HMO-POS $19 $3,900 $250
☆☆☆☆☆
Humana Full Access R0110-005 Regional PPO $128 $9,350 $480
☆☆☆☆☆
Humana Gold Plus H5619-047 HMO $0 $9,350 $350
☆☆☆☆☆
Humana Gold Plus H6622-085 HMO $20 $9,350 $590
☆☆☆☆☆
Humana USAA Honor Giveback Regional PPO $0 $9,350 N/A
☆☆☆☆☆
Humana USAA Honor Giveback PPO $0 $9,350 N/A
☆☆☆☆☆
HumanaChoice Giveback H5216-308 PPO $0 $9,350 $450
☆☆☆☆☆
HumanaChoice Giveback H5216-406 PPO $0 $9,350 $450
☆☆☆☆☆
HumanaChoice H5216-027 PPO $71 $9,350 $350
☆☆☆☆☆
HumanaChoice H5216-152 PPO $0 $3,400 N/A
☆☆☆☆☆
HumanaChoice H5216-363 PPO $31 $9,350 $590
☆☆☆☆☆
HumanaChoice R0110-004 Regional PPO $0 $7,550 N/A
☆☆☆☆☆
Anthem Medicare Advantage PPO $0 $7,950 $295
☆☆☆☆☆
Sentara Medicare Salute HMO $0 $3,550 N/A
☆☆☆☆☆
Sentara Medicare Value HMO $0 $4,300 $150
☆☆☆☆☆
Johns Hopkins Advantage MD Select HMO $0 $7,500 $590
☆☆☆☆☆
**Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages.
📊 At a Glance: Medicare Advantage in Falls Church County
Average Monthly Premium
$18.58
Plans with $0 Premium
20
Average MOOP Limit
$6,997 ($9,350 max. in 2025)
Average Rx Deductible
$343.75
Plans Without Drug Coverage
4 (standalone Virginia Part D plans)
Plans with 5-Star Ratings
No 5-star plans available.
Stars  Ratings (Plan Mix)
4+ Stars: 42% · 3 Stars: 58% · Below 3: 0%
Plans Available
32 (excluding Falls Church County SNP plans)
Plan Type Breakdown
12 PPO · 10 HMO-POS · 6 HMO · 1 PFFS · 3 REGIONAL PPO
Countywide Enrollments
388 (excluding SNP plans)
Top 3 Plans by Enrollment
1. Kaiser Permanente Medicare Advantage Standard VA (HMO-POS) — 86 enrollees
2. Kaiser Permanente Medicare Advantage Value VA (HMO-POS) — 76 enrollees
3. AARP Medicare Advantage from UHC VA-0015 (PPO) — 28 enrollees

Data Sources: CY2025 Landscape, PBP Benefits, Star Ratings Data, Monthly Enrollment by CPSC, and SimpleMaps U.S. Counties. Enrollment data last updated April 7, 2025. County demographic data last updated April 5, 2025.

Understanding Your Medicare Advantage Options

Medicare Advantage Plans, also known as Medicare Part C, are private health plans that provide all-in-one coverage, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). On top of the core benefits, many of the plans in Falls Church County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Falls Church County looking for something more than Original Medicare.

🏥 Health Maintenance Organization (HMO) Plans

HMO plan members must use the plan's network of doctors and hospitals in Falls Church County, and typically need a referral to see a specialist. Some Medicare Advantage HMO Plans may have lower costs but offer less flexibility in choosing healthcare providers. There are 12 residents enrolled in HMO plans in this county. The most popular plan is Humana Gold Plus H5619-047 .

🔓 Preferred Provider Organization (PPO)

A PPO allows more flexibility in choosing healthcare providers, with the option to see specialists without referrals, though often at a higher cost. Medicare Advantage PPOs usually have higher premiums and out-of-pocket expenses. There are 104 Falls Church County residents enrolled in PPO plans. The most popular of these plans by enrollments is AARP Medicare Advantage from UHC VA-0015 .

🪟 Private Fee-for-Service (PFFS)

Allows members to visit any Medicare-approved doctor or hospital in their area that accepts the plan's payment terms. Medicare PFFS plans offer more flexibility but may result in higher costs. There are 0 Falls Church County residents enrolled in PFFS plans. The most popular of these plans by enrollments is {top_enrolled_PFFS}.

🔀 Health Maintenance Organization Point of Sale (HMO-POS)

Medicare HMO-POS plans are a type of HMO that offers a little more flexibility. Like a regular HMO, you typically use the plan's network of doctors and hospitals for care, usually requiring a referral to see specialists. However, an HMO-POS plan lets you receive certain healthcare services outside of the network at a higher cost. There are 272 residents enrolled in HMO-POS plans in this Falls Church County. The most popular plan by enrollments is Kaiser Permanente Medicare Advantage Standard VA .

If you qualify for Original Medicare or Medicare Advantage in Falls Church County but don't know where to begin, we have licensed insurance agents[1] at 1-855-728-0510 (TTY 711) who can answer your questions (Mon-Fri 5am-6pm, Sat 6am-5pm PST) and help you get enrolled. There's no obligation.

Advantages of Enrolling in Medicare Advantage

Many Medicare Advantage Plans offer extra benefits that go beyond Original Medicare, making them an attractive option for some people. These plans provide comprehensive coverage, often including additional services like prescription drug coverage, dental, vision, and wellness programs, all bundled into one plan. By choosing a Medicare Advantage Plan, you can simplify your healthcare and potentially save on costs.

Take a look at the main benefits provided by Medicare Advantage Plans in Falls Church County:

🧑‍⚕️Coordinated Care

Plans often include care coordination services, which help you manage your healthcare across different providers and services.

💸 Cost Savings

Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.

🧾 Comprehensive Coverage

Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.

🧘 Wellness Programs

Many Yavapai County plans offer free gym memberships, wellness programs, and preventive care services. You need to stay healthy, right?

Tips for Selecting a Medicare Advantage Plan

Choosing the right Medicare Advantage Plan out of the 32 plans available in Falls Church County requires careful consideration of several key factors:

🏥1. Provider Network

Verify that your current doctors and preferred hospitals are included in the plan's network. Access to your healthcare providers can significantly impact your care experience.

💊 2. Prescription Drug Coverage

Make sure the plan covers your medications, particularly if you have specific prescriptions you rely on regularly.

💰 3. Costs

Examine the plan's premiums, copayments, and out-of-pocket limits. Compare these costs against your budget to avoid unexpected expenses.

🎁 4. Additional Benefits

Consider what extra services, such as dental, vision, or wellness programs, are important to you, and check if the plan offers them.

⭐ 5. Plan Ratings

Look into the plan's star ratings, which provide insight into the plan's overall quality and member satisfaction.

Learn more about the basics of comparing Medicare Advantage Plans.

Medicare Advantage Enrollment Periods

Making sense of Medicare Advantage enrollment periods can seem overwhelming, but it's worth the effort for better health coverage. Missing these key dates could delay your coverage or limit your plan choices for 2025 in Falls Church County.

📅 Initial Enrollment Period (IEP)

This initial enrollment window starts three months before and ends three months after your 65th birthday, offering a total of seven months to enroll in a Medicare Advantage Plan.

🗓️ Annual Enrollment Period (AEP)

Every year from October 15 to December 7, you have the option to change, enroll, or disenroll from a Medicare Advantage Plan.

🔁 Open Enrollment Period (OEP)

Running from January 1 to March 31, this period allows changes to your Medicare Advantage Plan if you’re already enrolled or lets you switch back to Original Medicare.

For comprehensive details on how to enroll, visit our detailed guide on Medicare Enrollment.

Are you ready to enroll? Do you still have questions? Our licensed insurance agents are ready to help with no obligation. Call 1-855-728-0510 (TTY 711) for assistance, Mon-Fri 5am-6pm, Sat 6am-5pm PST.

Frequently Asked Questions

What are the most popular Medicare Advantage plan types in Falls Church County?

Based on the 2025 plan data, PPO plans are the most common in Falls Church County. The full breakdown of plan types is: 12 PPO · 10 HMO-POS · 6 HMO · 1 PFFS · 3 REGIONAL PPO.

How much can I expect to pay out of pocket for Medicare Advantage plans?

The average maximum out-of-pocket limit (MOOP) in Falls Church County is $6,997 for 2025.

Do any Medicare Advantage plans in Falls Church County have 5-star ratings?

No 5-star rated Medicare Advantage plans are available in Falls Church County for the 2025 plan year. However, 42% of plans have a rating of 4 stars or higher.

What is the average monthly premium for Medicare Advantage plans in Falls Church County?

The average monthly premium for Medicare Advantage plans in Falls Church County is $18.58. A total of 20 offer $0 premiums, though costs vary by plan type and benefits.

More About These Plans

Carrier Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

Master Plan Pages by Plan ID

The plan pages listed in the table above have been modified for localization to help consumers identify plans available in their area. Most plans are available in multiple areas. The following list of plan IDs link to each plan's master page.

H5521 027, H5521 322, H2172 013, H2172 008, H2172 005, H2172 009, H2172 010, H2001 095, H5253 089, H5253 120, H2406 122, H2001 099, H8145 004, H3931 143, H3931 162, H3447 028, H3447 051, R0110 005, H5619 047, H6622 085, R0110 006, H5216 310, H5216 308, H5216 406, H5216 027, H5216 152, H5216 363, R0110 004, H4909 014, H2563 014, H2563 008, H1339 001

Plan Availability

The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Falls Church, and all other areas of Falls Church County, Virginia, including the following zip codes: 22040, 22042, 22043, 22044, 22046.

Citations & References
  • Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 19 March, 2025
  • CMS.gov, "Special Needs Plans (SNP)", Last Accessed 24 May, 2024
  • Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed 19 March, 2025
  • Plan and enrollment data provided by the Centers for Medicare & Medicaid Services (CMS)
  • Data processed and interpreted by MedicareWire.com editorial team.
  • Read our methodology and sourcing policy.

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  • Plan Overview
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[3]About the Author

David Bynon is a Medicare analyst, published author, and U.S. Navy veteran with over 40 years of experience in cryptology, cybersecurity, and healthcare systems. Since founding MedicareWire in 2012, he has provided unbiased, data-driven Medicare plan research to assist seniors in making informed decisions.

Previously, David served as Vice President of Global Systems at Sony Pictures Entertainment and Director of Systems and Networks at HealthNet, focusing on secure HMO and Medicare infrastructures. His military career includes serving as Command Chief at TACRON-11, earning multiple Navy Commendation Medals and other commendations.

Connect with David on LinkedIn or view his Amazon Author Profile. His latest book, Why Medicare Advantage Plans Are Bad, is available on Amazon.

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