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The 2019 Medicare Advantage Plans in Fairfax County VA.

2018 Medicare Advantage Plans in Fairfax County Virginia

There are 19 Medicare Advantage Plans available in Fairfax County VA from 7 different health insurance providers. 6 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6700. The highest rated plan available in Fairfax County received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars. Fairfax County Virginia residents can also pick from 10 Medicare Special Needs Plans.

(Click the Plan Name for More Details)

Name Premium
Part D
 Gap  MOOP Overall Rating Formulary Sign Up
Aetna Medicare Choice Plan (PPO)
$80.00 $95.00 Yes $6,700 FormularyEnroll
Aetna Medicare Prime Plan (HMO)
$29.00 $195.00 Yes $6,700 FormularyEnroll
Anthem MediBlue Plus (HMO)
$22.00 $325.00 No $6,700 Formulary
HumanaChoice R1390-001 (Regional PPO)
$0.00 $5,500 Enroll
HumanaChoice R1390-002 (Regional PPO)
$79.00 $390.00 No $6,700 FormularyEnroll
Innovation Health Medicare Connection Plan (HMO)
$0.00 $95.00 Yes $6,700 Formulary
Innovation Health Medicare Voyager Plan (PPO)
$71.00 $125.00 Yes $5,500 Formulary
Kaiser Permanente Medicare Plus Basic w/D (AB) (Cost)
$37.00 $405.00 No $6,700 Formulary
Kaiser Permanente Medicare Plus Basic w/o D (AB) (Cost)
$5.00 $6,700
Kaiser Permanente Medicare Plus High w/o D (AB) (Cost)
$98.00 $4,500
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost)
$142.00 $0.00 Yes $4,500 Formulary
Kaiser Permanente Medicare Plus Std w/o D (AB) (Cost)
$20.00 $6,000
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost)
$30.00 $300.00 Yes $6,000 Formulary
Spartan Plan VA (HMO)
$59.00 $0.00 No $5,700 Formulary
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* Plan Type does not offer Medicare Part D drug coverage.

2018 Medicare Special Needs Plans in Fairfax county Virginia

Plan Name Monthly
Premium C+D
Part D
 Gap  Special Needs
Overall Rating
Aetna Better Health, Inc. (VA) (HMO SNP)
(H1610- 001)
   25.1 405  No Dual-Eligible
Anthem MediBlue Dual Advantage (HMO SNP)
(H3447- 011)
   30.1 405  Yes Dual-Eligible
Spartan Plan VA C-SNP (HMO SNP)
(H7802- 002)
   69 0  No Chronic or Disabling Condition
Spartan Plan VA I-SNP (HMO SNP)
(H7802- 001)
   30 0  No Institutional

Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard


In 2018 once you and your plan provider have spent $3750 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 35% of the plans cost for covered brand-name prescription drugs and 44% on generic drugs unless your plan offers additional coverage.

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable

Source: CMS.

Data as of September 5, 2017.

Plans are subject to change as contracts are finalized.

Includes 2018 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2018, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.

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