How Much Does Medicare Cost in Virginia?
The overall cost of Medicare varies depending on a number of factors, including the selected plans and what those plans cover. Generally, you can expect your Medicare costs to come from the following sources:
- Monthly premium: A monthly premium is the dollar amount you must pay each month to maintain and keep your Medicare coverage.
- Deductible: This is the amount of money you must pay out of pocket for medical services before your insurance policy begins to cover those services. Once you meet your deductible, your insurance plan will begin to either directly cover specific medical costs or compensate you for such medical costs.
- Coinsurance: Once you have met your deductible, your insurance plan will cover a percentage of specific medical costs. The percentage you would be expected to pay is known as coinsurance.
- Co-payments: These are flat-rate payments for specific medical services or prescriptions that also activate once you have met your deductible.
- Out-of-pocket limits: These are the maximum limits you can pay in medical costs per year. Once you’ve met the out-of-pocket limit, your insurance plan will cover 100 percent of subsequent medical costs.
All of the above sources of cost can vary depending on the plan you sign up for, so it’s extremely important to weigh the pros and cons, as well as the coverage and costs, of each plan you’re considering. While you could look for a plan or combination of plans that offer you the lowest in monthly premiums, such plan(s) could come with higher deductibles or co-payments.
On the other hand, a plan with a higher monthly premium could offer more expanded medical coverage. Overall, you’ll want to strike the perfect balance between finding a plan that covers your medical needs and finding a plan that you can reliably afford.
The Cost of Original Medicare in Virginia
As mentioned previously, many aspects of Medicare, including Original Medicare, are standardized across the United States, and Virginia is no exception.
- Medicare Part A premiums cost $0 per month, although this is provided that you and your spouse have paid taxes for the past 10 years. Part A plans have a deductible of $1,484 (per hospitalization), covering the first 60 days in the hospital. Part A can also cover an additional 90 days in the hospital per stay; however, there will be a co-pay for the additional days. Part A does not have an out-of-pocket maximum.
- Medicare Part B premiums cost $148.50 per month. The only factor that can affect this monthly amount is whether your income exceeds $88,000 as an individual or $176,000 as a married couple. If this is the case, you can expect to pay slightly higher monthly premiums. In addition, the yearly deductible sits at $203, and once you’ve reached your deductible, you will be required to pay for only 20 percent of covered services.
The Cost of Medigap Plans in Virginia
Medigap plans, also known as Medicare Supplement Insurance, are supplemental insurance plans provided by private insurance companies. These can help you pay many out-of-pocket costs, such as co-payments, deductibles, and coinsurance.
Given the source of Medigap plans, the overall cost can vary. Things like the base costs for the plan, your age, your gender, where you live, or your use of tobacco can all have an impact on the cost of Medigap plans. Be sure to look at the finer details of each plan before you commit.
The Cost of Medicare Advantage in Virginia
Virginia Medicare Advantage plans at a glance:
If you are enrolled in a Medicare Advantage plan, you will still have to pay for the Part B monthly premium of $148.50. Also, depending on the Medicare Advantage plan you choose, you will have to also pay a monthly premium, though some of these premiums can be as low as $0.
Medicare Advantage plans come from approved private insurance companies and are great options compared to the less expansive coverage of Original Medicare. Medicare Advantage plans provide Part A, Part B, and sometimes Part D prescription drug coverage. It may also include other benefits like dental, vision, hearing, and wellness coverage.
Similarly, such Medicare Advantage plans can have varying deductible, co-payment, and coinsurance amounts. Consider this, and be sure to find a plan that best covers your medical needs without creating undue financial burdens.
To learn more about choosing the right Medicare Advantage plan, please read our article The Best Medicare Advantage Plans in Virginia.
The Cost of Prescription Drug Plans in Virginia
Virginia prescription drug plans at a glance:
Medicare prescription drug plans, also known as Part D, provide insurance to cover prescription medication needs. As with other aspects of Medicare that offer a variety of plan options, the overall cost can vary depending on the plan you select.
Given how varied the plans can be, it’s important to look into the finer details of each plan, especially if you know that you need specific medications on a consistent basis. Review the plan’s formulary (schedule of costs for prescriptions). Each formulary will be broken into four tiers with the first tier being the least expensive and the fourth tier being the most expensive. Ideally, the prescriptions you take regularly should be covered under Tier 1 or Tier 2.
Cost of Special Needs Plans in Virginia
Virginia Special Needs Plans at a glance:
Medicare Special Needs Plans (SNPs) have the main purpose of assisting individuals with limited income who would otherwise have a difficult time paying for general Medicare costs. Special Needs Plans have some requirements, allowing coverage for the following:
Chronic-Condition Special Needs Plans, which cover beneficiaries with certain severe or disabling chronic conditions, such as cancer, chronic health failure, or HIV/AIDS.
Institutional Special Needs Plans, which cover individuals living in an institution, such as a nursing home.
Dual-Eligible Special Needs Plans, which cover people who are “dual-eligible” for both Medicare and Medicaid benefits.