We found the 24 best Medicare Part D Plans in Virginia. Sign-up for 2024 Medicare Part D plan notification HERE.
- The average premium is $44.89 per month, however the lowest premium is just $5.10.
- The average drug plan deductible is $389 per year, but 4 plans have a zero-dollar deductible.
- Medicare rated 0% of all plans available in Virginia 4 stars or higher.
- There are 9 basic benefit plans and 15 enhanced benefit plans.
- A total of 6 plans offer full low-income subsidy (LIS) for those who qualify.
- There are 4 plans that have additional coverage in the coverage gap phase (aka, "donut hole").
- 2024 Medicare Prescription Drug Plans (PDP) will be published in early October. Sign-up to be notified.
We also ranked the best Medicare Advantage plans with Part D in Virginia for 2024.
Virginia Medicare Part D Plans
|Plan Name||Premium||Deductible||Benefit Type||LIS||Gap
|AARP MedicareRx Preferred||$107.90||$0||Enhanced||No||Yes||Yes|
|AARP MedicareRx Saver Plus||$30.90||$505||Basic||Yes||No||No|
|AARP MedicareRx Walgreens||$28.20||$350||Enhanced||No||No||No|
|Anthem MediBlue Rx Plus||$48.40||$0||Enhanced||No||No||No|
|Anthem MediBlue Rx Standard||$61.20||$505||Basic||No||No||No|
|Cigna Extra Rx||$60.30||$100||Enhanced||No||Yes||Yes|
|Cigna Saver Rx||$12.70||$505||Enhanced||No||No||No|
|Cigna Secure Rx||$34.50||$505||Basic||Yes||No||No|
|Clear Spring Health Premier Rx||$20.00||$505||Enhanced||No||No||No|
|Clear Spring Health Value Rx||$24.80||$505||Basic||Yes||No||No|
|Humana Basic Rx Plan||$35.70||$505||Basic||Yes||No||No|
|Humana Premier Rx Plan||$79.20||$300||Enhanced||No||Yes||Yes|
|Humana Walmart Value Rx Plan||$31.00||$505||Enhanced||No||No||No|
|Mutual of Omaha Rx Essential||$19.50||$505||Enhanced||No||No||No|
|Mutual of Omaha Rx Plus||$91.10||$505||Basic||No||No||No|
|Mutual of Omaha Rx Premier||$74.90||$505||Enhanced||No||No||Yes|
|Wellcare Medicare Rx Value Plus||$71.30||$0||Enhanced||No||No||No|
|Wellcare Value Script||$9.60||$505||Enhanced||No||No||Yes|
Please note that 2024 Medicare Part D plan information for Virginia beneficiaries will not be available until early October.
Sign-Up for 2024 Medicare Part D Plan Notification
Virginia Medicare Part D Plans Have Four Phases
Medicare prescription drug plans are designed to help Medicare beneficiaries pay for their prescription drugs. Some of the cost-sharing concepts of these plans are foreign to new Medicare beneficiaries, so let's look at the four phases.
The Deductible is the First Phase
The deductible (up to $505 in 2023) is the amount that you pay before your Medicare Part D plan begins paying its share of the costs. So, if you enroll in a 2023 prescription drug plan with a $480 deductible, you'll spend $480 out-of-pocket before cost-sharing coverage begins. Most Medicare Part D plans have a deductible, but some Medicare Part D plans exclude Tier 1 drugs from the deductible, giving immediate coverage on most generic medications.
The 2nd Phase is the Initial Coverage Limit (ICL)
The Part D ICL (Initial Coverage Limit) for 2023 is $4,660. During the ICL phase, your Part D plan will cover the majority of your prescription costs. If your prescription costs exceed $4,660 you go into the coverage gap phase ("donut hole")
The Third Phase is a Coverage Gap
After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic drugs might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,400 in True Out Of Pocket Costs (TrOOP).
Some plans offer additional gap coverage, so look for it on the plan information pages.
Phase 4 is Catastrophic Coverage
Once you've spent $7,400 out-of-pocket you are out of the coverage gap phase and will receive catastrophic coverage. This happens automatically and ensures that you only pay a small amount for all covered drugs for the remainder of the year.
The out-of-pocket costs that help you get catastrophic coverage include:
- Your plan's deductible;
- What you paid during the initial coverage limit period;
- Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
- The amount paid by others, including family members, most charities, and other persons on your behalf; and
- The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.
The Lowest Premium May Not Be the Lowest Overall Cost
Choose from the available Part D Medicare plans carefully, and don't settle on a Part D plan until you know that your most expensive medications are covered at a price you can afford. This information is available in the plan's formulary. You'll find links to the formulary information, pharmacy information, and the customer service phone number on each PDP page (above).
IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health, and your finances.
Get Your Prescriptions and More with a Medicare Advantage Plan
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 Medicare prescription drug plans available in Virginia. The second way is to get prescription coverage through one of the many Virginia Medicare Advantage Plans that include Part D benefits. Most Medicare Advantage plans available in Virginia include Part D as an additional benefit.
Using Supplemental Medicare Insurance with Part D
With Original Medicare you are responsible for paying about 20 percent of all hospital and medical bills. Without additional protection, even a brief hospital stay can cost you thousands out-of-pocket. That's why we maintain a complete directory of Virginia Medicare Supplement Insurance, also known as Medigap. We make it easy to find the best rates on the coverage you want. All Medicare supplements sold in Virginia plans are 100% compatible with Medicare Part D plans.
Virginia Medicaid and Your Medicare Part D
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 your local Medicaid office.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.
Citations & References
- Medicare.gov, "How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan", Last Accessed September 28, 2022
- Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed September 1, 2022
- Medicare.gov, "Catastrophic coverage", Last Accessed June 13, 2022
- Medicare.gov, "Are prescription drugs covered in Medicare Advantage plans?", Last Accessed June 5, 2022
- SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
- CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
- CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023