MoneyGeek used the Centers for Medicare & Medicaid Services' (CMS) five-star quality rating system to find the most widely available Medicare Advantage plans in Virginia.
Our summary outlines the best plans for various categories, including the plan type, whether or not it has drug coverage and the out-of-pocket cost limits.
Buyers can use our summary to select the best Medicare Advantage plans in Virginia, although our averages only reflect a generalization. To find a suitable plan for your specific needs, you will need to shop around. This also means checking the hospitals and providers in your preferred plan's network.
MoneyGeek also analyzed the best medicare supplement plans in Virginia for those focused on covering out-of-pocket expenses.
Best Medicare Advantage Plan in Virginia - Overall
The best Medicare Advantage plan in Virginia varies based on your healthcare needs. The HumanaChoice H5216-248 (PPO) plan from Humana, for instance, is the most suitable for people seeking a PPO plan with seven core benefits, a high score from the CMS and drug coverage.
A PPO plan is usually more expensive than other plans. However, it allows you to access a wider network of healthcare providers, doctors and hospitals. If you purchase the HumanaChoice H5216-248 (PPO) plan, you won’t need a referral to see a specialist outside the plan’s network.
Humana
Your best Medicare Advantage plan depends on your preferences. From our research, HumanaChoice H5216-248 (PPO) may be the best plan for those seeking to buy a PPO plan. This plan features:
- No monthly premiums
- Drug coverage
- An in-network max out-of-pocket limit of $5,900
- An overall CMS star rating of 4 out of 5
HumanaChoice H5216-248 (PPO) from Humana includes the seven most common benefits: hearing, fitness, dental, worldwide emergency, telehealth, vision and over-the-counter drugs. Frequent travelers can benefit from worldwide emergency coverage.
Best HMO Medicare Advantage Plan in Virginia
The best HMO Medicare Advantage plan in Virginia may vary based on your needs. Buyers looking for an HMO plan with 10 core benefits, drug coverage and a high CMS rating can consider Optima Medicare's Optima Medicare Value plan.
HMO plans cost less than PPO plans. They feature a smaller network of hospitals and healthcare providers except during emergencies. Buyers also need a referral to see a specialist.
Optima Medicare
You can only determine the best Medicare Advantage plan in Utah by defining your healthcare needs. MoneyGeek discovered that the best HMO plan in the state is Optima Medicare Value (HMO) from Optima Medicare. This plan includes the following features:
- No monthly premium
- Drug coverage with an annual deductible of $150
- An in-network max out-of-pocket limit of $3,400
- 4 out of 5 overall star rating from CMS
The Optima Medicare Value (HMO) plan features 10 additional core benefits. These are vision, dental, transportation, telehealth, fitness, hearing, worldwide emergency, over-the-counter drugs, emergency response devices and in-home support benefits.
Best Medicare Advantage Plan in Virginia Without Drug Coverage
If you do not need Part D prescription drug coverage, you can still consider some of the best Medicare Advantage plans in Virginia.
For example, if you need a plan with the nine most common benefits and a high CMS rating without regard for drug coverage, the Humana Gold Plus H6622-074 (HMO) plan may be the best option.
Humana
From our findings, Humana's Gold Plus H6622-074 (HMO) is the best plan for buyers looking for the best plan, regardless of whether it includes drug coverage. This plan includes:
- Monthly premium of $17
- Drug coverage with a deductible of $250
- An in-network max out-of-pocket limit of $7,550
- A 4.5 out of 5 overall star rating from CMS
This plan has a high score from CMS, Part D drug coverage and nine other benefits: vision, dental, worldwide emergency, hearing, telehealth, transportation, over-the-counter drugs, emergency response and fitness.
Best Medicare Advantage Plan in Virginia for Low Max Out-of-Pocket Costs
In Virginia, some Medicare Advantage plans have low or no premiums, but you may need to cover more costs out of pocket. To avoid this, you will need to get a plan with low out-of-pocket costs.
If you need the best Medicare Advantage Plan in Virginia with a low max out-of-pocket limit, seven core benefits, a high rating from the CMS and Part D drug coverage, HumanaChoice H5216-248 (PPO) from Humana may be the best option.
Humana
According to MoneyGeek. HumanaChoice H5216-248 (PPO) from Humana is the best for buyers looking for a plan with a low max out-of-pocket limit, whether the plan has drug coverage or not.
Purchasing HumanaChoice H5216-248 (PPO) means you will have:
- No monthly premium
- Drug Coverage
- An in-network max out-of-pocket limit of $5,900
- Overall CMS star rating of 4 out of 5
A Medicare Advantage plan with a low max out-of-pocket limit helps you save on health expenses since your insurer will cover the costs for in-network coverage once you reach your limit. However, PPO plans apply a different max out-of-pocket limit for out-of-network coverage. For the HumanaChoice H5216-248 (PPO), you will pay $10,000.
Medicare Advantage Plan in Virginia - Statistics
If you wish to purchase Medicare Advantage plans in Virginia, you can find them in 10 healthcare organizations. The following information includes statistics about common and rare components of plans, including the plan type, unique plans with a $0 premium and the core benefits.
Use this data for a better sense of widely available and less common plans in the state.
Virginia Medicare Advantage Plans are a mix of HMO, PPO and PFFS Plans with 70.2% offering drug coverage
Over 50% of the Medicare Advantage policies in Virginia are Preferred Provider Organization (PPO) plans. In Virginia, 44.2% of the total plans available on the market are Health Maintenance Organizations (HMO) plans and only 4.3% are Private Fee-for-Service (PFFS) plans. About 70.2% of the plans provide drug coverage. Most of these are HMO plans.
63% of Medicare Advantage Plans in Virginia have a $0 premium
Virginia has 46 unique plans with a $0 premium, which is 63% of the total number of Medicare Advantage Plans in the market. The remaining 37% of the plans apply a monthly premium. The average cost of these premiums is $56.70 per month.
Vision, hearing, worldwide emergency and telehealth benefits are common in Virginia, with most plans offering them
Medicare Advantage Plans in Virginia provide several common benefits. However, the most widely available are vision, hearing, worldwide emergency and telehealth, which are available from all insurers. Home safety devices and modifications and in-home support are the rarest benefits in the state.
Methodology
MoneyGeek collected data from the Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files released in October 2021. Plans in Virginia were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of Virginia based on county availability.
About Mark Fitzpatrick
