VICAP - Medicare / Prescriptions  Find a Plan/File for Benefits  Prevent Fraud  Find Help/Volunteer  Medicare Extra Help  Wellness Benefits  Medicare & COVID

The Virginia Insurance Counseling and Assistance Program (VICAP) is part of a national network of programs that offers FREE, unbiased, confidential counseling and assistance for people with Medicare.

Counseling Topics - ALL counseling is provided at your local Area Agency on Aging

• Medicare
• Medicare Part D
• Medicare Advantage Plans
• Medigap
• Commonwealth Coordinated Care Plus (CCC Plus)
• Long-term care insurance

Counselors can also help with health care appeals, denials and identifying those eligible for low-income subsidies. VICAP counselors are not licensed to sell insurance. Counselors are trained and certified to help you understand and compare benefits, assist with filing for benefits based on income and resources, and inform you of your rights.

VICAP Can Help

Your local VICAP Program can provide you with FREE, unbiased, confidential and personal assistance. You will speak to a trained counselor who will walk you through the steps to maximize your benefits. To get in touch with a VICAP counselor in your area, contact your local Area Agency on Aging (AAA). View a map of Virginia to locate the Area Agency on Aging (AAA) that serves your community.

Find the Plan for You

VICAP counselors can help all Medicare beneficiaries, including those with disabilities and younger than 65, explore options that best meet their needs. Counselors will help you compare the quality of care and services given by health and prescription drug plans available in your area.

File for Medical Benefits

VICAP counselors can help you file for medical benefits, low-income subsidies, health care appeals and grievances. Working with you, counselors are able to help you resolve health care issues and assist you in understanding complex medical bills.

Prevent Health Care Fraud

Working collaboratively with the Senior Medicare Patrol, VICAP counselors will help educate and empower beneficiaries to take an active role in detecting and preventing health care fraud and abuse.

Virginia Senior Medicare Patrol (Virginia SMP) educates Medicare beneficiaries, their families, and caregivers to prevent, detect, and report healthcare fraud, errors, and abuse. Using a team of trained volunteers, Virginia SMP provides outreach, counseling and education. Call 1-800-938-8885 to report suspected Medicare fraud or to receive fraud prevention materials.

Watch and share this short SMP video to learn more and help others: https://youtu.be/LlqtkiyAoxs

Volunteer with VICAP

The COMPASS team is a volunteer program that helps VICAP educate, counsel and assist Virginia's Medicare beneficiaries. Your experience can have a meaningful impact on your community.

To learn more about this opportunity and become a part of the team, call 1-800 552-3402.

Get EXTRA HELP with your Medicare Costs

There are programs in Virginia that can save you money: the Extra Help Program and the Medicare Savings Programs. You may qualify to get help paying for the Part D premium and/or your Part B premium.

If you can answer “YES” to these questions, you should apply for help paying your Medicare costs:

1. Is your monthly income (for 2023) at or below $1,843 for a single person or $2,485 for a married couple?
2. Are your resources (for 2023) at or below $16,660 for a single person or $33,240 for a married couple? Resources don’t include your home, car, household items, burial plot or life insurance policies.

If you answered “YES” to these questions, please call your local Area Agency on Aging to speak to a VICAP counselor for assistance filling out the application to receive help paying your Medicare costs. The only way to know for sure if you qualify is to apply.

Stay Healthy with better Medicare benefits

The following PREVENTIVE SERVICES are available to all Medicare beneficiaries:

• Abdominal Aortic Aneurysm Screening
• Alcohol Misuse Screening and Counseling
• Bone Mass Measurement
• Cardiovascular Disease Screenings
• Cardiovascular Disease (Behavioral Therapy)
• Cervical and Vaginal Cancer Screening
• Colorectal Cancer Screenings (certain alternative tests you still pay for)
• Counseling to Prevent Tobacco Use and Tobacco Caused Disease
• COVID Vaccine
• Depression Screening
• Diabetes Prevention Program
• Diabetes Screening
• Diabetes Self Management Training
• Flu Shots
• Glaucoma Tests
• Hepatitis B Shots
• Hepatitis B Virus infection screening
• Hepatitis C Screening Test
• HIV Screening
• Lung Cancer Screening
• Mammograms
• Medical Nutrition Therapy
• Obesity Screening and Counseling
• Pneumococcal Shot
• Prostate Cancer Screening
• Sexually Transmitted Infection Screening and Counseling
• Welcome to Medicare Preventive Visit
• Yearly Wellness Visit

Yearly Wellness Visit

If you’ve had Medicare Part B for longer than 12 months, you can get a yearly “Wellness” visit to develop or update your personalized plan to prevent disease or disability based on your current health and risk factors. The yearly “Wellness” visit isn’t a physical exam. Medicare covers this visit once every 12 months.

Your provider will ask you to fill out a Health Risk Assessment as part of this visit. This will help you and your provider develop a personalized prevention plan to help you stay health and get the most out of your visit. Your visit may include: routine measurements, health advice, a review of your medical and family history, your current prescriptions, advance care planning and more.

Your provider will also perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances, and making decisions about your everyday life. If your provider thinks you may have cognitive impairment, Medicare covers a separate visit to do a more thorough review of our cognitive function and check for conditions like dementia, depression, anxiety, or delirium and design a care plan.

Your provider will also evaluate your potential risk factors for a substance use disorder and refer you for treatment, if needed. If you use opioid medication, your provider will review your treatment plan, share information about non-opioid treatment options, and refer you to a specialist, as appropriate.

Your first yearly “Wellness” visit can’t take place within 12 months of your Part B enrollment or your “Welcome to Medicare” preventive visit. However, you don’t need to have had a “Welcome to Medicare” preventive visit to qualify for a yearly “Wellness” visit.

You pay nothing for the yearly “Wellness” visit if the doctor or other qualified health care provider accepts assignment.

If your doctor or other health care provider performs additional tests or services during the same visit that Medicare doesn’t cover under this preventive benefit, you may have to pay a coinsurance, and the Part B deductible may apply. If Medicare doesn’t cover the additional tests or services (like a routine physical exam), you may have to pay the full amount.

Medicare & COVID-19

Medicare Part B covers the following items and services related to COVID-19
Note: Coverage could change when the public health emergency ends

Vaccines:

• FDA-approved and FDA-authorized vaccines help reduce the risk of illness from COVID-19 by working with the body’s natural defenses to safely develop protection (immunity) to the virus
• You pay nothing for the vaccine, booster shot, or additional dose (if immunocompromised) Take your red, white, and blue Medicare card with you, even if you have a Medicare Advantage Plan or other Medicare health plan

Diagnostic tests:

• These FDA-authorized tests check to see if you have COVID-19
• You pay nothing for this test during the COVID-19 public health emergency when you get it from a laboratory, pharmacy, doctor, or hospital, and when Medicare covers this test in your local area

Antibody tests:

• These FDA-authorized tests help see if you’ve developed an immune response and may not be at immediate risk of COVID-19 reinfection
• You pay nothing for the test during the COVID-19 public health emergency

Monoclonal antibody treatments:

• These FDA-authorized treatments can help fight the disease and keep you out of the hospital, if you test positive for COVID-19 and have mild to moderate symptoms
• You pay nothing for this treatment during the COVID-19 public health emergency when you get the treatment from a Medicare provider or supplier. You must meet certain conditions to qualify