For the most part, Virginia Medicare Supplement plans follow the same guidelines the federal laws mandate. However, there are a few rules unique to only a few states, including Virginia, that we’ll cover below.

Guide to Medicare Supplement Plans in Virginia for 2020

All Medigap plans are excellent. The most important fact to understand is when Medicare pays, the Medigap plan will pay.

Medicare Supplements give you the freedom to use the doctors you know and trust. If there were an out of state emergency, your coverage will travel with you.

Across the country, including Virginia, the best Medicare Supplement plans include Plan F, Plan G, and Plan N. But, some people find the other options provide more value.

Tip: The best plan for you can be different than your friend’s policy. An agent can help you find a balance between underinsured and overinsured.

With Medigap, the policy, carrier, and zip code all play a factor in cost.

Example of Medigap Costs in Virginia

A 65-year-old woman could get a Plan G for a little over $100 a month. A 65-year-old- man would get the same policy for a little over $110 a month.

Now, if you’re older, the costs could be higher. So, a 70-year-old man could pay a little over $130 for Plan G.

Below we go over a few things that can impact Medigap premium cost and coverage.

To help understand the decision process, we’re going to introduce Pamela.

Meet Pamela

Let’s say Pamela’s doctor diagnoses her with angina. She is aware of her health risks. When looking at her options, Plan G seems sensible.

Plan G DOES NOT cover the Part B deductible; BUT, it does cost much less than Plan F. Plan G also has better benefits than Plan N.

Pamela can keep her monthly premium low by enrolling in Plan G and paying the Part B deductible herself.

Tip: While Plan G is the most beneficial for Pamela, another option could be more valuable to you.

Next, we’ll review a few guidelines that Virginia follows regarding Medicare.

Coverage Reduction

In Virginia, you have Guarantee Issue Rights when voluntarily leaving an employer plan due to coverage reduction. While some states also follow this guideline, not all states consider you eligible for these rights due to voluntary loss of coverage. With Guaranteed Issue Rights, you have the option to enroll in Medigap without underwriting.

Under 65

There are over 1 million Medicare beneficiaries in Virginia, about 15% are under 65. Plan A is the only option for those under 65, and the cost is high.

Upon turning 65, you’ll get a second OEP to enroll in Medigap. At this point, you’ll have more options available, and the cost will be significantly less.

Medicare Advantage Plans in Virginia

What happens when you can’t afford a Medigap policy? Well, it’s always better to have some sort of supplemental insurance than none.

It’s no secret that many Advantage plans have a $0 premium. However, the lower the premium, the higher the out of pocket costs will be when health issues arise.

The Kaiser Family Foundation says about 20% of eligible residents in Virginia enrolled in an Advantage plan in 2019.

Most people on Medicare under 65 are living with disability or chronic illnesses. A fantastic option is an Advantage Special Needs Plan.

Chronic Conditions Special Needs Plans

In Virginia Beach, there are two Chronic Conditions Special Needs Plans. For those eligible for Medicare and Medicaid, there are different Special Needs Plans.

The best part about a Special Needs Plan is that if you qualify, you can enroll ANYTIME! Then, when you turn 65, consider Medigap.

Let’s bring Pamela back to give a real-world example.

Hello Again Pamela

Let’s say Pamela cannot afford a Medigap plan, so she decides to enroll in an Advantage plan instead.

Pamela might choose a Preferred Provider Organization so she can see her doctors that are out of network.

The out of network costs are $50 each primary care visit. Then, the specialist costs $50 a visit. She spends $200 in doctor visit copays for the month.

So, for someone like Pamela, an Advantage plan could end up costing more in copayments than the monthly Medigap premium.

These are things to consider before buying. Once you become unhealthy, you may end up being denied a Medigap plan.

Another thing to consider is prescription drug coverage. Medigap plans do not cover prescription medications. However, some Advantage plans do. These Advantage plans are called MAPDs.

Just like the previously mentioned Advantage plans, MAPDs come with higher out of pocket costs when compared to a stand-alone Part D plan.

Stand-alone Part D policies supplement your Medigap plan to give you coverage for prescription medications.

Medicare Part D in Virginia

In Virginia, there are 29 Part D plans, and the average monthly premium is just over $40.

In Virginia Beach, the Humana Walmart Value RX Plan is less than $15 a month. But, a low premium can mean more out of pocket.

The Humana policy could benefit those with no brand name or a few brand name meds.

Let’s use our friend Pamela again to explain the Part D decision process.

Now, Pamela Needs Coverage for Her Medications

Pamela just enrolled in a Medigap plan. Now she needs to find a Part D plan to cover her medications.

Pamela takes Xarelto alongside three other brand name drugs, which is going to cost her more on the Humana plan than it’s worth.

Well, SilverScript can offer her generic drugs at $0, and her deductible is $0. Her premium is over $60 a month, BUT her savings are hundreds of dollars each month.

On the contrary, Pamela’s neighbor only takes one generic medication. The Humana plan saves her neighbor over $500 a month compared to the higher premium option.

So, the best option for Pamela is SilverScript.

Tip: Don’t judge a policy by its premium.

Medigap should be a priority for those turning 65 with health risks.

It’s estimated that by 2030 over 43% of adults in the United States will have some form of Cardiovascular Disease.

The average cost of major cardiovascular procedures in Virginia WITHOUT any complications and no need for a stent or pacemaker still cost over $40,000. Once a complication occurs, those costs can skyrocket.

FAQs About Medicare in Virginia

How to apply for Medicare in Virginia?

You apply for Medicare in all states the same way. Applying for Medicare is simple because you can do it over the phone, online, or in-person at a local office. To apply for a supplemental Medicare plan in Virginia, you’ll need to contact a licensed agent.

Who is eligible for Medicare in Virginia?

Medicare is a federal program; if you’re eligible in one state, you qualify in all states. The general rule is that you must be at least 65 years of age or older. Also, those with a permanent disability under 65 may qualify.

How many Virginia doctors will not take Medicare patients?

Physicians’ opt-outs across the united states dropped significantly in 2017. Virginia was one of the states that had a higher percentage of physicians who opted out of Medicare.

However, according to CMS data, only 1,000 doctors across the state are currently opted out of Medicare. This number is continually dropping year over year.

Get Help Deciding on Medicare Plans in Virginia

An independent agent can provide you with an unbiased rate comparison of all the Medicare options in Virginia. Our agents at MedicareFAQ work with dozens of carriers. They can guide you in the right direction. With us, you can feel confident during the decision-making process when choosing a Medicare plan.

First, we’ll make sure you’re educated on all the basics of Medicare. Then, we’ll use our resources to compare all carriers and plans available in your area. The comparison will include financial ratings, rate increases, and of course, current rates.

Get help deciding on the best Medicare plan in Virginia from a licensed MedicareFAQ agent today! Give us a call at the number above. Or, you can use our rate tool to get started now.