Key takeaways
- Virginia residents have access to various Medicare options, including Original Medicare (parts A and B), Medicare Advantage (Part C), and Medicare Part D for prescription drug coverage.
- Medicare Advantage plans in Virginia, offered by private insurers, often include benefits beyond Original Medicare, such as vision, dental, and hearing coverage.
- For assistance with Medicare questions in Virginia, individuals can contact the Virginia Insurance Counseling & Assistance Program (VICAP) or Medicare directly.
Medicare eligibility in Virginia follows the same federal guidelines as elsewhere in the country. To be eligible, a person must be at least 65 years old or living with a qualifying disability or chronic health condition.
Medicare is made up of four parts:
- Part A (hospital insurance) and Part B (medical insurance) are known as Original Medicare.
- Part C, also known as Medicare Advantage, is an alternative to Original Medicare.
- Part D, which is prescription drug coverage.
People can also purchase a supplemental insurance plan (Medigap) to help cover the out-of-pocket costs associated with Original Medicare. Medicare Advantage beneficiaries are not eligible for Medigap.
Read on to learn more about Medicare options in Virginia and when to enroll.
Snapshot of Medicare in Virginia
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Virginia for the 2026 plan year:
- A total of 1,712,896 residents of Virginia are enrolled in Medicare.
- The average monthly Medicare Advantage plan premium changed from $10.96 in 2025 to $9.19 in 2026.
- There are 143 Medicare Advantage plans available in Virginia for 2026, compared with 142 plans in 2025.
- All Virginia residents with Medicare have access to buy a Medicare Advantage plan with a $0 premium.
- For 2026, 9 stand-alone Medicare Part D plans are available in Virginia, and the lowest monthly premium for a stand-alone Part D plan is $0.
- Roughly 21.72% of people with a stand-alone Part D plan get Extra Help.
- As in most states, 10 different Medigap plans are offered in Virginia for 2026.
In Virginia, as in other states, Medicare includes several types of coverage:
- Original Medicare: This is managed by the federal government and includes Part A (hospital insurance) and Part B (medical insurance). Original Medicare does not include prescription drug coverage.
- Medicare Advantage (Part C): These plans are offered by private insurers and include all Original Medicare benefits along with other perks such as vision, dental, and drug coverage. Some Medicare Advantage plans have limited provider networks, so beneficiaries should confirm their doctors are in-network before enrolling.
- Medicare Part D: This is a private, stand-alone plan for prescription drug coverage. People can pair Part D with Original Medicare or with a Part C plan that does not include drug benefits.
- Medigap (Medicare supplement insurance): Medigap plans are private plans that help pay for out-of-pocket costs of Original Medicare, such as copays and coinsurance. Medigap cannot be used with Medicare Advantage. A person can choose among 10 standardized plans.
Availability of private plans varies by county, and beneficiaries can check Medicare.gov for local options.
Virginia residents can qualify for Medicare at age 65 years if they are U.S. citizens or legal residents for at least 5 years. People under 65 years may also qualify through disability or by living with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
When choosing a plan, a person may consider provider networks, costs, and quality ratings. A person has the option to join a plan or modify their coverage during one of the following enrollment periods:
- Initial enrollment: Enroll 3 months before to 3 months after the month of their 65th birthday.
- Open enrollment: Join or change plans from October 15 to December 7.
- Medicare Advantage open enrollment: Switch Medicare Advantage plans or return to Original Medicare from January 1 to March 31.
- Special enrollment period: Enroll after a qualifying life change, such as losing job-based coverage.
A person eligible for Medicare due to a disability will be automatically enrolled. If they are eligible based on age, they will need to enroll.
A person may wish to choose a plan that:
- has doctors they like and facilities convenient to their location
- covers the services they need
- provides affordable coverage
- has a high star rating for quality and patient satisfaction from CMS
People in Virginia who have questions about Medicare can contact the Virginia Insurance Counseling & Assitance Program (VICAP) at 800-552-3402.
Individuals can also contact Medicare directly 24/7 at 800-633-4227 or via online chat.
More than 1.7 million Virginia residents are enrolled in Medicare. Several private insurance companies offer different Medicare Advantage and Medigap plans throughout the state.
Overall, monthly premium costs have decreased for 2026 Medicare Advantage plans in Virginia.
People who have questions about Medicare can contact the Virginia Insurance Counseling & Assistance Program (VICAP) or Medicare directly by phone or online chat.