Understanding Medigap Policies in Virginia

In Virginia, you can buy Medigap policies from private insurance companies, but the state regulates the plans to ensure they meet minimum requirements.

Medigap policies are standardized, meaning they're identified by letters (A, B, C, D, F, G, K, L, and M) that indicate the level of coverage.

Each lettered plan offers different combinations of benefits, with some plans covering more services than others.

Plan F, for example, is the most comprehensive plan available in Virginia, covering 100% of Medicare-approved costs.

For another approach, see: What Is Medicare Supplement F

In Virginia, you have ten different Medicare Supplement plans to choose from, each labeled with a letter from A to N. Plans F and C are no longer available for those who turned 65 after January 1, 2020.

The federal government standardizes Medigap plans, so all plans of the same type offer the same coverage, regardless of the insurance carrier. This means you can shop around for the best price without sacrificing coverage.

Take a look at this: What Is Medigap Coverage Used for

Here's a breakdown of the benefits offered by each plan:

Keep in mind that Plans F and G also offer a high-deductible option, which requires you to pay for Medicare-covered costs up to the deductible amount of $2,700 in 2023 before your policy pays anything.

The monthly premium for your Medigap plan will depend on your age, gender, tobacco use, and state of residence, in addition to the type of plan you choose.

Medigap policies in Virginia can be a bit pricey, but it's essential to understand the costs involved. The cost of a Medigap policy varies from person to person, depending on factors like age, gender, and where you live.

In 2024, Medigap premiums in Virginia range from $24 a month for a high-deductible Plan G to $415 for the highest-cost Plan D. If you turned 65 before January 1, 2020, the highest premium plan is $718/month for Plan F.

You might enjoy: Medicare Supplement Plan Chart

Your premium can also be affected by your personal factors, such as your age, gender, and whether or not you smoke. Policies tend to be more expensive if you're a man, you're older, or if you smoke.

Insurance providers price their Medigap policies in one of three different ways, which can impact your premium. Community-rated plans charge everyone the same premium, regardless of age. Issue-age-rated plans price your premium based on the age you are when you enroll, while Attained-age-rated plans base your premium on your current age.

Here's a breakdown of the most common Medigap plans in Virginia and their estimated costs:

Keep in mind that these costs are estimates and may vary depending on your insurer and how your premium is rated.

Signing up for a Medigap policy in Virginia can be a bit tricky, but understanding the enrollment process can help you make the most of it.

The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period, which starts when you turn 65 and are enrolled in Medicare Part B.

This six-month period is a golden opportunity to enroll in any plan available in Virginia without worrying about pre-existing conditions. You'll also pay premiums equivalent to those paid by a person with no pre-existing conditions for your plan.

During this period, insurance companies must accept and approve your application for the Medigap plan you choose, without using medical underwriting to decide whether to accept your application or change the price.

Once this initial period of eligibility is over, however, insurers are free to use their own risk assessment and underwriting processes to approve or deny your application for Medigap coverage based on any pre-existing conditions you may have.

There are certain situations that may give you guaranteed issue rights to purchase a Medigap policy, regardless of your health conditions or any pre-existing health conditions:

It's essential to note that insurance companies can deny your application based on your health history or charge you higher premiums outside of your Medigap Open Enrollment Period.

Intriguing read: Medigap Plan B

If you're looking for a top-notch Medigap company in Virginia, Anthem is a great choice. It's the best Medicare Supplement company for most people in the state.

Anthem's Medigap plans are often cheaper than the state average, with Plan G costing $122 per month. This is $13 cheaper than the state average.

Anthem also gets very few complaints about its Medigap plans, which means people tend to be happy with the service they get. Good customer service can make a big difference if you have a question or issue.

Medico is another option, but it's not the best choice for most people. It has about twice the number of complaints overall compared to an average company its size.

Plan G is usually the best choice if you're new to Medicare, or if Plan F costs at least $257 per year more than Plan G. Plan G has the same coverage as Plan F, except it doesn't pay your $257 Medicare Part B deductible.

Here are some average costs of Anthem Medigap plans in Virginia:

Liberty Medicare is also a resource for finding Medigap providers in Virginia, but it's more of a directory than a company itself.

In Virginia, the law allows Medicare providers to charge more than what Medicare allows, which is known as Extra Charges.

Medicare Supplement Plans in Virginia that do not include Extra Charges, such as Plan C and Plan D, are less expensive than plans that include them, like Plan F and Plan G.

You can't buy Medicare Supplement plans for people under 65 in Virginia, as the Federal Government doesn't have a constraint to force Medigap providers to sell these policies to people under 65 with Medicare due to disability, and Virginia hasn't added any additional requirements.

Some states offer additional individual Guaranteed Issue Periods, but Virginia does not have such periods.

Virginia does permit a household discount to be applied to Medicare Supplement plans, and several Medigap vendors offer this discount.

Here's a list of some Medigap vendors that offer Medicare Supplement plans in Virginia:

For example, Plan F is a popular choice in Virginia, but it's likely only a good option if you were eligible for Medicare before 2020.

If you're feeling overwhelmed by the multitude of Medigap policy options available in Virginia, getting in touch with trained, unbiased counselors can be a good first step.

The Virginia Insurance Counseling and Assistance Program (VICAP) is a great resource for seniors on or about to be on Medicare. VICAP offers free, confidential, and unbiased counseling on Medicare, Medicare Advantage plans, Medicare Part D, Medigap, and long-term care insurance.

Counselors at VICAP will also assist seniors with healthcare denials or appeals and identify subsidies for low-income individuals. Counseling is provided at the local Area Agencies on Aging.

The Virginia Bureau of Insurance website is another valuable resource for researching Medigap policies in the state. It includes information on ways that Medigap insurers can and cannot approach consumers in Virginia.

Virginia has several programs for seniors and others designed to assist with the often-high cost of prescription drugs, including the Virginia Prescription Drug Card, which provides cost savings of up to 30% on both generic and brand drugs to every resident of the state of Virginia.

Here are some key contacts and resources to keep in your back pocket: