Virginia Medicare Part D Plans (PDP) 2018 Prescription Drug Plans for People with Medicare

Virginia seniors, your Medicare Part D plan (PDP) choices are fewer this year. Fortunately, 2018 monthly premiums are about the same, however, the maximum deductible is now $405 per year, one of the lowest annual increases we've seen.

Don't make a PDP decision on the premium and deductible alone. It's critical that you verify that your medications are covered. You find this information, and the co-payment tiers, in the formulary. On each PDP page (above) we post links to the formulary and pharmacy web pages, and the phone numbers to contact the plan.

The Medicare Part D Donut Hole is Closing, but not in 2018

As you might be aware, the Medicare Part D coverage gap, also known as the donut hole, is with us for a few more years. The new healthcare law is gradually doing away with the coverage gap. Until the donut hole is gone for good, you can save money on prescriptions that are not covered by a Virginia PDP by downloading a Pharmacy Discount Card or coupons. We recommend GoodRx.com.

The 2018 Initial Coverage Limit (ICL) is $3,750. The Coverage Gap (donut hole) starts when you reach the ICL ($3,750) and ends when you spend a total of $4,950. This year, Part D enrollees will get a 60% discount on the total cost of brand-name drugs purchased while in the donut hole. A 50% discount, paid by the brand-name drug manufacturer, applies to getting out of the donut hole. But, the additional 10% paid by your PDP does not count toward your True Out-of-Pocket (TrOOP) costs.

For instance, if you reach the donut hole and purchase a brand-name medication with a retail cost of $100, you'll pay $40 for the prescription and get a $90 credit toward meeting your total out-of-pocket spending limit.

PDP enrollees pay a 51% co-pay (maximum ) on all generic drugs purchased while in the coverage gap. For example, if you fall in the Donut Hole in 2018, and your generic medication retails for $100, you'll pay only $51. This amount counts toward your TrOOP.

Some plans offer additional gap coverage, so look for it on the plan information pages.

Medicare Part D is Included with Most Virginia Medicare Advantage Plans

There's more than one way to get prescription drug coverage with your Medicare benefits. The first way is by enrolling in one of the Part D plans above. The second way to get help paying for your prescriptions is through one of the Virginia Medicare Advantage Plans that include Part D.

Part D Plans and Medicare Supplements Work Together

Medicare does not pay for all of your hospitalization and doctor bills. Even with the new healthcare law fully in place, your Original Medicare only pays about 80 percent of your Virginia healthcare bills. We keep an up-to-date catalog of Virginia Medigap Plans, also call a Medicare Supplement, with the tools you need to find the best price and coverage. The prescription drug plans above are fully compatible with all Medicare Supplements sold in Virginia.

Medicare Part D for Dual Eligible People

In Virginia, if you are eligible for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) you will automatically be enrolled in a Virginia Medicare Prescription Drug Plan and the Social Security Extra Help program. Extra Help pays for most of the costs of your prescriptions if you meet the eligibility requirements. You may also enroll in a plan of your own choosing that better meets your needs. If you qualified for Medicaid before you were eligible for Medicare, contact the your local Medicaid office.

Related Information

• Who Qualifies For Medicare Part D Coverage?
• How Much Does Medicare Part D Cost?
• When Should I Get Medicare Part D Coverage?
• Can Changing My Medicare Part D Plan Lower My Drug Costs?