Medicare Advantage Plans in Arlington County, VA:
Your Complete 2025 Guide
With 34 Medicare Advantage plans available in Arlington County, Virginia for 2025, you can choose from a variety of options that go beyond Original Medicare. Many plans also include valuable extras like vision, dental, and/or fitness benefits. There may not be a plan in Arlington County that has all of these benefits in one plan.
Types of Medicare Advantage Plans in Arlington County, VA
With 34 Medicare Advantage plans available in Arlington County for 2025, you have a range of options to choose from. However, there are no 5-star plans available this year. Here’s a breakdown of your choices:
Summary of Medicare Advantage Plan Types Available in Arlington County, Virginia
- Preferred Provider Organization (PPO) Plans: These plans (16 available) offer flexibility with out-of-network care at a higher cost. The average monthly premium for these plans is $19.67.
- Health Maintenance Organization (HMO) Plans: These plans (8 available) require in-network care and generally have lower costs. The average monthly premium for these plans is $2.46.
- HMO Point-of-Service (HMO-POS) Plans: These plans (10 available) blend HMO and PPO features, allowing some out-of-network care. The average monthly premium for these plans is $24.21.
- Special Needs Plans (SNP): These highly specialized Medicare Advantage plans cater to individuals with specific healthcare needs. Learn more here: Medicare Special Needs Plans in Arlington County, VA .
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans offer flexibility by allowing you to see both in-network and out-of-network providers. These plans often have higher costs for out-of-network care but provide more options for those who want greater freedom in choosing their healthcare providers.
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| Aetna Medicare Choice | $85 | $6,750 | $590 | |
| Aetna Medicare Eagle | $0 | $6,750 | N/A | |
| AARP Medicare Advantage from UHC VA-0003 | $0 | $6,700 | $495 | |
| AARP Medicare Advantage from UHC VA-0015 | $0 | $7,900 | $420 | |
| AARP Medicare Advantage Patriot No Rx VA-MA01 | $0 | $8,900 | N/A | |
| Humana Full Access R0110-005 | $128 | $9,350 | $480 | |
| Humana USAA Honor Giveback | $0 | $9,350 | N/A | |
| Humana USAA Honor Giveback | $0 | $9,350 | N/A | |
| HumanaChoice Giveback H5216-308 | $0 | $9,350 | $450 | |
| HumanaChoice Giveback H5216-406 | $0 | $9,350 | $450 | |
| HumanaChoice H5216-027 | $71 | $9,350 | $350 | |
| HumanaChoice H5216-152 | $0 | $3,400 | N/A | |
| HumanaChoice H5216-266 | $0 | $9,350 | $350 | |
| HumanaChoice H5216-363 | $31 | $9,350 | $590 | |
| HumanaChoice H5216-408 | $0 | $9,350 | $450 | |
| HumanaChoice R0110-004 | $0 | $7,550 | N/A | |
| *Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Out-of-Network Costs: PPO plans allow you to see out-of-network providers, but this flexibility often comes with higher costs. Evaluate additional costs if you prefer providers outside the plan's network.
- Provider Network: Verify your preferred doctors and specialists are in-network to lower costs. If flexibility is important, confirm the network meets your needs.
- Premiums and Out-of-Pocket Maximums: Compare premiums and out-of-pocket maximums across plans. Higher premiums may provide more coverage, but assess if benefits justify additional cost.
- Additional Benefits: Many PPO plans include extras like dental, vision, or fitness programs. Assess which benefits align best with your healthcare priorities, keeping in mind availability varies.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans typically require you to use in-network providers for your care. These plans often have lower out-of-pocket costs and premiums, making them a cost-effective option for those who don't mind a more limited provider network.
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| Kaiser Permanente Medicare Advantage Liberty | $0 | $5,900 | N/A | |
| Humana Gold Plus H5619-047 | $0 | $9,350 | $350 | |
| Humana Gold Plus H6622-083 | $0 | $9,350 | $350 | |
| Humana Gold Plus H6622-085 | $20 | $9,350 | $590 | |
| Humana Gold Plus H6622-091 | $0 | $9,350 | $450 | |
| Sentara Medicare Salute | $0 | $3,550 | N/A | |
| Sentara Medicare Value | $0 | $4,300 | $150 | |
| Johns Hopkins Advantage MD Select | $0 | $7,500 | $590 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- In-Network Care: HMO plans generally require you to use in-network providers for all non-emergency care. Verify your preferred doctors, specialists, and hospitals are in-network before enrolling.
- Primary Care Referrals: Many HMO plans require referrals from your primary care doctor to see specialists. Be comfortable with this care coordination requirement.
- Lower Costs: HMO plans typically have lower premiums and out-of-pocket costs compared to other plan types, beneficial if cost savings are your priority.
- Additional Benefits: Some HMO plans offer extras like dental, vision, or fitness programs. Evaluate which benefits are most important, noting availability may vary.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine features of both HMO and PPO plans. You’ll have the flexibility to see out-of-network providers, but at a higher cost than in-network care. This can be a good option if you want the cost savings of an HMO but still want some freedom to go out-of-network when needed.
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| Kaiser Permanente Medicare Advantage Care Plus VA | $26 | $5,500 | $0 | |
| Kaiser Permanente Medicare Advantage High VA | $137 | $5,700 | $0 | |
| Kaiser Permanente Medicare Advantage Standard VA | $15 | $5,900 | $0 | |
| Kaiser Permanente Medicare Advantage Value VA | $0 | $6,500 | $0 | |
| AARP Medicare Advantage from UHC VA-0010 | $37 | $6,700 | $340 | |
| AARP Medicare Advantage from UHC VA-0014 | $0 | $7,900 | $420 | |
| Aetna Medicare Select | $0 | $5,900 | $250 | |
| Aetna Medicare Value | $0 | $4,150 | $250 | |
| Anthem Extra Help | $8 | $2,900 | $590 | |
| Anthem Medicare Advantage 3 | $19 | $3,900 | $250 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Out-of-Network Costs: HMO-POS plans allow out-of-network providers, but at higher costs. Evaluate potential extra costs for out-of-network care.
- In-Network vs. Out-of-Network Care: Compare coverage options between in-network and out-of-network care. Decide if flexibility justifies additional expenses.
- Referral Requirements: Many HMO-POS plans require a referral from your primary care doctor for specialist visits. Confirm you're comfortable with this requirement.
- Additional Benefits: Many HMO-POS plans include extras like dental, vision, or fitness programs. Determine which benefits best match your healthcare needs, acknowledging that not all benefits may be available in every plan.
Choosing a Medicare Advantage Plan in Arlington County requires knowing the right time to enroll. Whether it’s your first time enrolling in Medicare or you’re switching plans, understanding the different enrollment periods will help you get the right coverage for your health needs.
When to Enroll
- Initial Enrollment Period (IEP): Enroll in Medicare during this period, which starts three months before your 65th birthday and ends three months after. This is your first opportunity to select a Medicare Advantage plan. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, you can switch your current Medicare Advantage plan to a new one or return to Original Medicare if your current plan no longer suits you. Learn more
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, this period allows you to adjust your Medicare coverage for the upcoming year. Learn more
- Special Enrollment Periods (SEPs): If certain life events, such as moving or losing coverage, apply to you, you may qualify for a Special Enrollment Period to make changes to your plan. Learn more
How to Enroll
- Talk to a Licensed Agent: Speak with a licensed health insurance agent from HealthCompare 1-833-748-3201 (TTY 711) (Mon-Fri 5am-6pm, Sat 6am-5pm PST) for personalized guidance.
- Enroll Directly with the Plan Provider: Contact your chosen plan provider online or by phone to complete your enrollment.
- Visit Medicare.gov: Compare plans and enroll through the official Medicare website at Medicare.gov.
What is Medicare Advantage, and how does it work?
Medicare Advantage (Part C) is an alternative to Original Medicare that bundles Medicare Part A (hospital insurance) and Part B (medical insurance) into one plan. These plans are offered by private insurance companies and often include additional benefits like dental, vision, and prescription drug coverage.
What are the benefits of choosing a Medicare Advantage plan?
Medicare Advantage plans often provide extra benefits not covered by Original Medicare, such as dental, vision, and hearing services. Additionally, these plans may include prescription drug coverage and have lower out-of-pocket costs compared to Original Medicare.
Can I switch between Medicare Advantage and Original Medicare?
Yes, you can switch between Medicare Advantage and Original Medicare during certain enrollment periods, such as the Annual Enrollment Period (AEP) or the Medicare Advantage Open Enrollment Period (MA OEP). Special Enrollment Periods (SEPs) may also allow changes under specific circumstances.
What happens if I’m already enrolled in a Medicare Advantage plan and want to switch?
If you want to switch your Medicare Advantage plan, you can do so during the Annual Enrollment Period (AEP) from October 15 to December 7, or during the Medicare Advantage Open Enrollment Period (MA OEP) from January 1 to March 31. Special Enrollment Periods (SEPs) may also apply in certain circumstances.
Can I enroll in a Medicare Advantage plan if I have pre-existing conditions?
Yes, you can enroll in a Medicare Advantage plan even if you have pre-existing conditions. Medicare Advantage plans cannot deny you coverage or charge you more based on your health status.
How do I qualify for a Special Enrollment Period?
You may qualify for a Special Enrollment Period (SEP) if you experience certain life events, such as moving to a new area, losing other health coverage, or becoming eligible for Medicaid. SEPs allow you to make changes to your Medicare Advantage plan outside of the standard enrollment periods.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Arlington, and all other areas of Arlington County, Virginia.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
CMS Plan IDs Presented
The Medicare Advantage plan pages listed in the tables above include localization to assist beneficiaries with plans available in their service area. However, most Part C plans are available in more than one service area, which can lead to confusion. The following list of CMS IDs links to our master plan pages without localization.
- CMS.gov, "Medicare Advantage Plan Fact Sheet", Last Accessed 25 May, 2025
- Medicare.gov, "Your coverage options", Last Accessed 25 May, 2025
- Medicare.gov, "Joining a plan", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed March 15, 2025