Category: Uncategorized

Medicare Options in District of Columbia

District of Columbia residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 98,000 Medicare beneficiaries, District of Columbia is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in District of Columbia

District of Columbia has 8 Medicare Advantage plans available, with an average star rating of 4.2 out of 5.0. The average monthly premium across all MA plans in the state is $22.40/month average premium. Medicare Advantage plans in District of Columbia typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in District of Columbia

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in District of Columbia is 4.2 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in District of Columbia

District of Columbia has 18 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for District of Columbia Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in District of Columbia

Medigap Plan G is the most popular Medicare Supplement plan in District of Columbia, with an average monthly premium of $198. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for District of Columbia

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$198/month
Plan N	Covered	Covered (with copays)	Covered	$162/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$228/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$89/month

Medicaid in District of Columbia

District of Columbia has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in District of Columbia (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$1,118/month	For seniors and disabled individuals

Medicare Savings Programs in District of Columbia

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. District of Columbia residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in District of Columbia

Social Security Disability Insurance (SSDI) recipients in District of Columbia automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in District of Columbia, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, District of Columbia residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Wyoming

Wyoming residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 120,000 Medicare beneficiaries, Wyoming is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in Wyoming

Wyoming has 4 Medicare Advantage plans available, with an average star rating of 3.5 out of 5.0. The average monthly premium across all MA plans in the state is $0/month (many $0-premium plans available). Medicare Advantage plans in Wyoming typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Wyoming

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Wyoming is 3.5 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Wyoming

Wyoming has 18 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Wyoming Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Wyoming

Medigap Plan G is the most popular Medicare Supplement plan in Wyoming, with an average monthly premium of $118. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Wyoming

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$118/month
Plan N	Covered	Covered (with copays)	Covered	$97/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$136/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$53/month

Medicaid in Wyoming

Wyoming has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 43% FPL ($11,748/year for a family of three) may qualify.

Medicaid Income Limits in Wyoming (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Wyoming

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Wyoming residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Wyoming

Social Security Disability Insurance (SSDI) recipients in Wyoming automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Wyoming, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Wyoming residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Wisconsin

Wisconsin residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,280,000 Medicare beneficiaries, Wisconsin is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Wisconsin

Wisconsin has 38 Medicare Advantage plans available, with an average star rating of 4.0 out of 5.0. The average monthly premium across all MA plans in the state is $10.20/month average premium. Medicare Advantage plans in Wisconsin typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Wisconsin

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Wisconsin is 4.0 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Wisconsin

Wisconsin has 23 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Wisconsin Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Wisconsin

Medigap Plan G is the most popular Medicare Supplement plan in Wisconsin, with an average monthly premium of $136. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Wisconsin

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$136/month
Plan N	Covered	Covered (with copays)	Covered	$112/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$156/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$61/month

Medicaid in Wisconsin

Wisconsin has partially expanded Medicaid. Adults earning up to 100% FPL may qualify, but the state has not adopted full ACA expansion to 138% FPL.

Medicaid Income Limits in Wisconsin (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Wisconsin

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Wisconsin residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Wisconsin

Social Security Disability Insurance (SSDI) recipients in Wisconsin automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Wisconsin, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Wisconsin residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in West Virginia

West Virginia residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 480,000 Medicare beneficiaries, West Virginia is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in West Virginia

West Virginia has 16 Medicare Advantage plans available, with an average star rating of 3.6 out of 5.0. The average monthly premium across all MA plans in the state is $5.80/month average premium. Medicare Advantage plans in West Virginia typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in West Virginia

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in West Virginia is 3.6 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in West Virginia

West Virginia has 21 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for West Virginia Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in West Virginia

Medigap Plan G is the most popular Medicare Supplement plan in West Virginia, with an average monthly premium of $112. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for West Virginia

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$112/month
Plan N	Covered	Covered (with copays)	Covered	$92/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$129/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$50/month

Medicaid in West Virginia

West Virginia has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in West Virginia (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in West Virginia

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. West Virginia residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in West Virginia

Social Security Disability Insurance (SSDI) recipients in West Virginia automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in West Virginia, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, West Virginia residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Washington

Washington residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,480,000 Medicare beneficiaries, Washington is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Washington

Washington has 38 Medicare Advantage plans available, with an average star rating of 4.1 out of 5.0. The average monthly premium across all MA plans in the state is $11.60/month average premium. Medicare Advantage plans in Washington typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Washington

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Washington is 4.1 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Washington

Washington has 24 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Washington Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Washington

Medigap Plan G is the most popular Medicare Supplement plan in Washington, with an average monthly premium of $152. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Washington

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$152/month
Plan N	Covered	Covered (with copays)	Covered	$125/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$175/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$68/month

Medicaid in Washington

Washington has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Washington (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$1,118/month	For seniors and disabled individuals

Medicare Savings Programs in Washington

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Washington residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Washington

Social Security Disability Insurance (SSDI) recipients in Washington automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Washington, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Washington residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Virginia

Virginia residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,680,000 Medicare beneficiaries, Virginia is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Virginia

Virginia has 44 Medicare Advantage plans available, with an average star rating of 4.0 out of 5.0. The average monthly premium across all MA plans in the state is $10.80/month average premium. Medicare Advantage plans in Virginia typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Virginia

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Virginia is 4.0 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Virginia

Virginia has 24 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Virginia Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Virginia

Medigap Plan G is the most popular Medicare Supplement plan in Virginia, with an average monthly premium of $138. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Virginia

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$138/month
Plan N	Covered	Covered (with copays)	Covered	$113/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$159/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$62/month

Medicaid in Virginia

Virginia has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Virginia (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Virginia

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Virginia residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Virginia

Social Security Disability Insurance (SSDI) recipients in Virginia automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Virginia, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Virginia residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Vermont

Vermont residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 160,000 Medicare beneficiaries, Vermont is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in Vermont

Vermont has 6 Medicare Advantage plans available, with an average star rating of 4.0 out of 5.0. The average monthly premium across all MA plans in the state is $0/month (many $0-premium plans available). Medicare Advantage plans in Vermont typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Vermont

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Vermont is 4.0 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Vermont

Vermont has 18 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Vermont Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Vermont

Medigap Plan G is the most popular Medicare Supplement plan in Vermont, with an average monthly premium of $162. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Vermont

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$162/month
Plan N	Covered	Covered (with copays)	Covered	$133/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$186/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$73/month

Medicaid in Vermont

Vermont has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Vermont (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$1,118/month	For seniors and disabled individuals

Medicare Savings Programs in Vermont

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Vermont residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Vermont

Social Security Disability Insurance (SSDI) recipients in Vermont automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Vermont, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Vermont residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Utah

Utah residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 480,000 Medicare beneficiaries, Utah is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in Utah

Utah has 22 Medicare Advantage plans available, with an average star rating of 3.9 out of 5.0. The average monthly premium across all MA plans in the state is $6.20/month average premium. Medicare Advantage plans in Utah typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Utah

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Utah is 3.9 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Utah

Utah has 22 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Utah Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Utah

Medigap Plan G is the most popular Medicare Supplement plan in Utah, with an average monthly premium of $118. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Utah

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$118/month
Plan N	Covered	Covered (with copays)	Covered	$97/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$136/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$53/month

Medicaid in Utah

Utah has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Utah (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Utah

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Utah residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Utah

Social Security Disability Insurance (SSDI) recipients in Utah automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Utah, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Utah residents may qualify for Medicaid to bridge the coverage gap.