Medicare Part D in Virginia

If you’re looking for help with your prescription drug costs, Medicare’s Part D plan may be for you. If you’re a Virginia resident, you may choose from 25 Part D plans provided by 13 separate health care companies operating under the supervision of the federal government’s Medicare program. To take advantage of Medicare Part D you’ll first need to make sure you’re enrolled in Original Medicare Part A and Part B. Once that’s done, you can fill out an application for the Part D plan of your choice, either on the provider’s website or in person via a traditional paper application.

Don’t delay, as you may be subject to late penalties, higher monthly premium costs, and even health audits if you don’t enroll in Part D by Medicare’s various deadlines.

Medicare Part D vs. Medicare Advantage

Medicare Advantage is another option for prescription drug coverage, though it may not offer the same benefits at the same cost as a Part D plan. Advantage plans (sometimes called Medicare Part C) were originally designed to replace Original Medicare Part A and Part B, so most of their coverage options are focused on inpatient and outpatient care. However, some Advantage plans do feature additional prescription drug coverage.

Some Advantage plans are incompatible with Part D, though. In some cases, enrolling in a Part D plan while also being an Advantage member will invalidate the Advantage plan and revert the patient back to Original Medicare Part A and Part B. Be sure to consult with your doctors or a health care professional, preferably one with knowledge of the Advantage and Part D plans you are considering. Do not make any changes to your existing health coverage without first consulting with your plan administrator.

When to sign up

Medicare offers three chances for you to sign up for a Part D prescription drug plan. The Initial Enrollment Period begins three months prior to your Original Medicare eligibility date, which is a function of your birth month and your 65th birthday. The Initial Enrollment Period ends four months after this date, which means that you have a seven-month window in which to enroll.

If you miss this window, you can still apply during the Annual Election Period that runs from October 15th to December 7th of each calendar year. If you miss that window as well, you’ll have to hope for one of Medicare’s Special Election Periods which are offered infrequently at various times throughout the year. These periods are typically reserved for people which hardships (such as the unexpected loss of previous insurance), so enrolling during one of these periods may subject you to health audits, late fees, and higher monthly premium costs for the duration of your insurance plan.

What are my choices?

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The Medicare Part D services listed in the preceding table are provided in all Virginia counties. Your county of residence may provide additional plans and services. Contact your local Medicare office for additional details.

Source: CMS.gov

Plans are subject to change as contracts are finalized.

Includes contracts/plans as of April 22, 2016. The data does not reflect information for employer-sponsored plans, Part B-only plans, or plans not offering a Part D drug benefit.

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