Many older Virginia residents enroll in Medicare to help pay for their hospital, prescription drug, and other healthcare costs. However, the Medicare enrollment process can be complicated, and it’s important to make informed decisions when choosing a plan. Fortunately, the state and private organizations offer assistance and guidance to seniors and their caregivers throughout the process. The Office of Aging, Area Agencies on Aging, and state and local public health agencies all provide a variety of resources.
Most people become eligible for Medicare Medicare Eligibility in Virginia at age 65, although you can also qualify before then if you’re a U.S. citizen or permanent resident who’s disabled for 24 months and drawing SSDI, or have end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Once you become eligible for Medicare, you can choose to keep your Original Medicare with a stand-alone prescription drug policy or go with a Medicare Advantage plan. The latter option combines Parts A and B, as well as additional benefits like fitness programs and transportation for medical visits into one bundled plan. Medicare Advantage plans are offered by private insurance companies and are regulated by the federal government.
As of 2022, there are 132 Medicare Advantage plans available in the state, and many Medicare beneficiaries opt for this type of coverage due to its convenience. These plans typically have a regional network of providers and offer additional benefits like dental, vision, and hearing coverage. However, premiums vary by plan and you may need to meet income requirements to be able to purchase one of these plans.
For those who need to stick with Original Medicare, there are 23 stand-alone Part D plans available in the state. In 2022, all new Medicare beneficiaries will be enrolled in a default Part D plan, so if you want to change your default plan, you can do so during your one-time open enrollment period from October 15 through December 7. Whether you’re switching between Medicare Advantage and Original Medicare or adding a standalone Part D to your existing coverage, a licensed GoHealth insurance agent is ready to assist you.
Medicare beneficiaries with limited assets can also benefit from Medicare Extra Help. This program can reduce the cost of Medicare prescription drug plans and Advantage plans, but eligibility is limited by your income. You can learn more about the benefits of this program by visiting the official Medicare website or speaking with a licensed insurance agent.
If you’re a dual eligible beneficiary and meet the income limits, you can sign up for both Medicare and Medicaid through a “dual special needs” plan. These plans bundle the coverages together and offer enhanced provider networks, drug formularies, and, in some cases, additional benefits like fitness programs or non-emergency transportation. To find out if you’re eligible for these plans, check with your local Area Agency on Aging.