If you are transitioning into Medicare soon or are already a Medicare beneficiary in Virginia, you should know that Original Medicare does not cover prescription drugs. Medicare Part D prescription drug plans can ensure you have access to the medicines you take regularly.
However, navigating Part D plans can be tricky. With the tips below, you can better navigate Medicare Part D plans in Virginia and make an informed decision.
Decide how to get your Medicare Part D in Virginia
You need to decide how you want to get your prescription drug coverage. You can stay with Original Medicare and sign up for a stand-alone Part D plan in Virginia.
Alternatively, opt for a Medicare Advantage plan that offers Part D coverage (MA-PD). With an MA-PD plan, you have a bundled solution that provides the benefits of Original Medicare in addition to prescription drug coverage.
Know the enrollment periods for Medicare Part D in Virginia
The first opportunity to enroll in Medicare Part D coverage in Virginia arises during the Initial Enrollment Period (IEP). The IEP is seven months long and consists of the 3 months before your birthday month, your birthday month, and the three months after.
From October 15 to December 7, during the Annual Enrollment Period (AEP), you can enroll in, change, switch, or drop your Part D plan. The Special Enrollment Period allows you to sign up or change your plan if you meet a qualifying condition.
Compare available Part D prescription drug plans in Virginia
Virginia has 24 stand-alone Medicare Part D prescription plans (2023), with varying monthly premiums, deductibles, coinsurance, copay, and coverage. For example, Aetna's SilverScript SmartSaver has the lowest Part D monthly premium in Virginia at $5.10 and a deductible of $505, while the highest is AARP MedicareRx Preferred (PDP) with a premium of $107.90 and a zero-dollar deductible.
When comparing plans, consider their premiums and understand their out-of-pocket costs to find one that aligns with your budget. You also want to keep costs down by ensuring your preferred pharmacies are in the plan's network.
Don't forget to confirm that the medications you currently take are covered by the plan's list of covered drugs (formulary) and are not in a high tier. Never settle on a plan unless it covers your most expensive medications at a price you can afford.
Know the cost of Medicare Part D plans in Virginia
The cost of prescription drug plans in Virginia varies depending on premium and out-of-pocket costs, the tier your medicine is on, the coverage phase you are in, whether your preferred pharmacy is in the network, and so on. If you have limited income or resources, you can apply for Medicare Part D Extra Help to help lower your prescription drug costs.
Use available resources
If you need help signing up for a Part D plan in Virginia or have questions bordering on eligibility, enrollment, and coverage, you can contact Medicare resources in Virginia such as VICAP, Virginia Bureau of Insurance, Virginia Department of Health Services, Medicare Rights Center, and Extra Help Program.
Get personalized help choosing the right Medicare Part D prescription drug plan in Virginia
As Virginia's #1 independent Medicare agent, we are all about helping residents of Virginia make the right choice about their healthcare coverage. We will discuss with you to understand your health needs and financial status, and guide you in choosing a plan that gives you access to the medications you need at a cost you can afford. Schedule an appointment today.