Medicare Advantage (MA) plans typically offer more robust coverage than Original Medicare. Here we describe Medicare Advantage plans in Virginia and explain how the program works to help you compare your options.
What is Medicare Advantage in Virginia?
Also known as Medicare Part C, Medicare Advantage plans must offer the same benefits you get with Original Medicare (Part A, hospital insurance, and Part B, medical insurance). They are not limited to that coverage, though. In fact, over 90% of Virginia MA plans provide additional benefits, such as prescription drug coverage and fitness programs.
Virginia Medicare Advantage plans with prescription drug coverage
You can get your Original Medicare benefits plus Part D coverage with a Medicare Advantage Prescription Drug plan (MA-PD). If you choose an MA plan that does not cover prescription medications, you need to join a standalone Medicare Part D plan.
Please note that you cannot have both an MA-PD plan and a standalone Part D plan.
Who is eligible for Medicare Advantage in Virginia?
Once you enroll in Medicare Parts A and B, you are eligible for Medicare Advantage in Virginia. American citizens and permanent legal residents age 65 and older qualify for Medicare.
You may be eligible for Medicare before turning 65 if you collect Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months.
You get Parts A and B automatically if you qualify due to a disability. If you "age" into Medicare, enrollment is only automatic if you begin collecting Social Security at least 4 months before your 65th birthday.
When can you sign up for a Medicare Advantage plan in Virginia?
There are five Medicare Advantage enrollment periods in Virginia.
- The Initial Enrollment Period (IEP) lasts for 7 months, beginning 3 months before your eligibility month. As an example, if your birthday or 25th month of disability occurs in April, your IEP lasts from January 1 through July 31.
- If you don't sign up for Part A and/or Part B during your IEP, you may do so during the General Enrollment Period from January 1 through March 31. You then have from April 1 through June 30 to join an Advantage plan.
- You can also sign up for an MA plan during Medicare Annual Enrollment, which runs from October 15 through December 7.
- The Medicare Advantage Open Enrollment Period from January 1 through March 31 allows people who are currently enrolled in Medicare Part C to either switch to a new MA plan or return to Original Medicare.
- Special Enrollment Periods let you change your Medicare Advantage plan if you experience certain life changes. The full list of qualifying circumstances is on Medicare.gov.
Types of Medicare Advantage plans in Virginia
There are four main types of Medicare Advantage plans in Virginia:
- Health maintenance organizations (HMOs)
- Preferred provider networks (PPOs)
- Private fee-for-service plans (PFFS)
- Special needs plans (SNPs)
Private insurance companies provide Medicare Advantage plans. Check the individual plan to see what it covers.
How to choose a Medicare Advantage plan in Virginia
To find the best Medicare Advantage plan for your unique situation, look at the following metrics:
- Coverage (including the drug formulary of an MA-PD plan)
Our Find a Plan tool makes it easy to compare Medicare Advantage plans in Virginia. Just enter your location information to review Medicare plans in your area.
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