Kaiser Permanente
Avg Star Rating
4.0 ★
Plan
Premium
MOOP
Stars
Type
Compare & Enroll — Part C & Part D
Compare & Enroll in Medicare Plans in District of Columbia
With 20 Medicare Advantage options from 6 insurers, District of Columbia has limited plan options compared to most areas, suggesting a competitive market with meaningful insurer variety. Approximately 80% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 10 hospitals within 25.0 miles, most local plan networks should offer strong provider access. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.
📊 Direct from CMS
🚫 No agents or commissions
✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →
Data freshness: CMS data as of February 2026 •
ACS data as of 2023 •
Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead •
View our methodology
Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
20
Part D Plans
10
Top MA Star
4.5
Top Drug Star
3.5
Medicare Eligibility in District of Columbia
Approximately 85,783 residents (12.5% of the population) in District of Columbia are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.
The median household income in District of Columbia is $123,202 (63.9% above the National Average), which may affect eligibility for Extra Help with Part D drug costs.
Part C: Medicare Advantage Plans
Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. District of Columbia's 20 Medicare Advantage plans are a mix leaning toward PPO networks (12 PPO, 8 HMO). 16 plans offer $0 monthly premiums. The average local star rating is 3.7 out of 5, with the top plan earning 4.5 ★.
Top Medicare Advantage Plans in District of Columbia
We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in District of Columbia range from $0 to $73/month. Among rated plans, 10 plans rated 4+ stars.
Highest CMS Star Ratings
Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.
| Plan Name | Insurer | Star Rating | Premium | Type | |
|---|---|---|---|---|---|
| Aetna Medicare Premier (PPO) | Aetna Medicare | 4.5 ★ | $0.00/mo | PPO | Enroll |
| Aetna Medicare Eagle Giveback (PPO) | Aetna Medicare | 4.5 ★ | $0.00/mo | PPO | Enroll |
| Uhc Dual Choice Dc-Y2 (PPO D-SNP) | Unitedhealthcare | 4.0 ★ | $0.00/mo | PPO D-SNP | Enroll |
| Uhc Dual Choice Dc-Q001 (PPO D-SNP) | Unitedhealthcare | 4.0 ★ | $0.00/mo | PPO D-SNP | Enroll |
| Aarp Medicare Advantage From Uhc Dc-0002 (PPO) | Unitedhealthcare | 4.0 ★ | $0.00/mo | PPO | Enroll |
Lowest Monthly Premium
Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.
| Plan Name | Insurer | Monthly Premium | MOOP | Star Rating |
|---|---|---|---|---|
| Uhc Dual Choice Dc-Y2 (PPO D-SNP) | Unitedhealthcare | $0.00/mo | $9,250 | 4.0 ★ |
| Uhc Dual Choice Dc-Q001 (PPO D-SNP) | Unitedhealthcare | $0.00/mo | $9,250 | 4.0 ★ |
| Aarp Medicare Advantage From Uhc Dc-0002 (PPO) | Unitedhealthcare | $0.00/mo | $6,700 | 4.0 ★ |
| Kaiser Permanente Medicare Advantage Value Dc (HMO-POS) | Kaiser Permanente | $0.00/mo | $7,500 | 4.0 ★ |
| Uhc Dual Choice Dc-Y001 (HMO D-SNP) | Unitedhealthcare | $0.00/mo | $9,250 | 3.5 ★ |
Lowest Maximum Out-of-Pocket (MOOP)
MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.
| Plan Name | Insurer | MOOP (In-Network) | Premium | Star Rating |
|---|---|---|---|---|
| Healthspring Preferred (HMO) | Healthspring | $4,250 | $0.00/mo | 3.0 ★ |
| Kaiser Permanente Medicare Advantage High Dc (HMO-POS) | Kaiser Permanente | $5,700 | $73.00/mo | 4.0 ★ |
| Kaiser Permanente Medicare Advantage Liberty (HMO) | Kaiser Permanente | $5,900 | $0.00/mo | 4.0 ★ |
| Carefirst Bluecross Blueshield Advantage Salute (PPO) | Carefirst Bluecross Blueshield Medicare Advantage | $5,900 | $0.00/mo | 3.5 ★ |
| Healthspring True Choice Plus (PPO) | Healthspring | $6,500 | $0.00/mo | 3.0 ★ |
Plan Type Mix in District of Columbia
HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.
| Plan Type | Count | Percentage | Description |
|---|---|---|---|
| PPO | 9 | 45.0% | No referrals; in and out-of-network |
| HMO-POS | 4 | 20.0% | HMO with some out-of-network options |
| HMO | 3 | 15.0% | Requires referrals; in-network only |
| PPO D-SNP | 2 | 10.0% | Medicare Advantage plan |
| HMO D-SNP | 1 | 5.0% | Medicare Advantage plan |
| PPO I-SNP | 1 | 5.0% | Medicare Advantage plan |
Choosing the Right Medicare Advantage Plan
The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:
- Provider network: Verify your doctors and hospitals in District of Columbia are in-network before enrolling
- Total cost: A $0 premium may have higher copays—calculate your annual cost
- Star Ratings: 4+ stars indicate above-average quality and member satisfaction
Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →
Medicare Advantage Insurers in District of Columbia
6 insurance companies offer Medicare Advantage plans in District of Columbia. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.
Aetna Medicare
Avg Star Rating
4.0 ★
Unitedhealthcare
Avg Star Rating
3.9 ★
Plan
Premium
MOOP
Stars
Type
Humana
Avg Star Rating
3.5 ★
Carefirst Bluecross Blueshield Medicare Advantage
Avg Star Rating
3.5 ★
Healthspring
Avg Star Rating
3.0 ★
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Part D: Prescription Drug Plans (PDP)
Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 10 standalone Part D plans in District of Columbia, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 2 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.
Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.
Top Part D Drug Plans in District of Columbia
We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in District of Columbia range from $0 to $109/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.
Highest CMS Star Ratings (Part D)
Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.
| Plan Name | Insurer | Star Rating | Premium | Deductible | |
|---|---|---|---|---|---|
| Wellcare Classic (PDP) | Wellcare | 3.5 ★ | $5.70/mo | $615 | Enroll |
| Wellcare Value Script (PDP) | Wellcare | 3.5 ★ | $5.60/mo | $615 | Enroll |
| Silverscript Choice (PDP) | Aetna Medicare | 3.0 ★ | $97.40/mo | $615 | Enroll |
| Humana Basic Rx Plan (PDP) | Humana | 3.0 ★ | $0.00/mo | $615 | Enroll |
| Humana Value Rx Plan (PDP) | Humana | 3.0 ★ | $4.30/mo | $601 | Enroll |
Lowest Monthly Premium
Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.
| Plan Name | Insurer | Monthly Premium | Drug Deductible | Star Rating |
|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | Humana | $0.00/mo | $615 | 3.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $4.30/mo | $601 | 3.0 ★ |
| Wellcare Value Script (PDP) | Wellcare | $5.60/mo | $615 | 3.5 ★ |
| Wellcare Classic (PDP) | Wellcare | $5.70/mo | $615 | 3.5 ★ |
| Healthspring Assurance Rx (PDP) | Healthspring | $32.60/mo | $615 | 2.5 ★ |
Lowest Annual Drug Deductible
The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.
| Plan Name | Insurer | Drug Deductible | Monthly Premium | Star Rating |
|---|---|---|---|---|
| Humana Premier Rx Plan (PDP) | Humana | $0 | $108.60/mo | 3.0 ★ |
| Aarp Medicare Rx Preferred From Uhc (PDP) | Unitedhealthcare | $130 | $94.50/mo | 2.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $601 | $4.30/mo | 3.0 ★ |
| Humana Basic Rx Plan (PDP) | Humana | $615 | $0.00/mo | 3.0 ★ |
| Wellcare Value Script (PDP) | Wellcare | $615 | $5.60/mo | 3.5 ★ |
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →
Choosing the Right Part D Drug Plan
The right Part D plan depends on your specific medications. Key factors to evaluate:
- Formulary: Verify your drugs are covered before enrolling
- Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
- Total annual cost: Premium + deductible + copays for your drugs
Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →
Part D Drug Plan Insurers in District of Columbia
5 insurance companies offer standalone Part D drug plans in District of Columbia. Below, we group plans by insurer.
Wellcare
Avg Star Rating
3.5 ★
Humana
Avg Star Rating
3.0 ★
Aetna Medicare
Avg Star Rating
3.0 ★
Plan
Premium
Deductible
Stars
Type
Healthspring
Avg Star Rating
2.5 ★
Unitedhealthcare
Avg Star Rating
2.0 ★
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Ready to Enroll in District of Columbia?
Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.
📋 Print our Medicare Enrollment Checklist — gather your info before you compare.
📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor
Medicare.gov is the official U.S. government site for Medicare. Available 24/7.
Pharmacy Access in District of Columbia
Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around District of Columbia.
Total Pharmacies
169
within 5.0 miles
Chain Pharmacies
79
CVS, Walgreens, etc.
Independent Pharmacies
90
locally owned
| Pharmacy | Address & Phone | Distance | Type |
|---|---|---|---|
| JOEDAT INTERNATIONAL INC | 1516 N CAPITOL ST NW WASHINGTON, DC 200023344 202-224-1491 | 0.3 mi | Independent |
| GIANT OF MARYLAND LLC | 1414 8TH ST NW WASHINGTON, DC 200013304 202-262-0577 | 0.5 mi | Chain |
| DISTRICT OF COLUMBIA CVS PHARMACY LLC | 1200 1ST ST NE WASHINGTON, DC 200023361 202-228-6499 | 0.5 mi | Chain |
| NAI SATURN EASTERN LLC | 490 L ST NW WASHINGTON, DC 200012545 202-271-2439 | 0.5 mi | Independent |
| HARRIS TEETER, LLC | 1201 FIRST STREET NE WASHINGTON, DC 200024274 202-258-0127 | 0.5 mi | Chain |
| PHARMACARE AT DC, LLC | 651 FLORIDA AVE NW WASHINGTON, DC 200011875 443-361-6500 | 0.6 mi | Independent |
| DISTRICT OF COLUMBIA CVS PHARMACY LLC | 675 K ST NW WASHINGTON, DC 200012506 202-268-0170 | 0.6 mi | Chain |
| DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C. | 2009 8TH ST NW WASHINGTON, DC 200013022 202-223-2201 | 0.7 mi | Chain |
| D.C. DEPARTMENT OF BEHAVIORAL HEALTH | 35 K ST NE WASHINGTON, DC 200024216 202-267-3206 | 0.7 mi | Independent |
| WAL-MART STORES EAST LP | 99 H ST NW WASHINGTON, DC 200011072 202-271-3720 | 0.7 mi | Chain |
Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.
Local Healthcare Access in District of Columbia
Before choosing a plan, consider the healthcare infrastructure in District of Columbia. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.
Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.
Hospitals Nearby
10
within 25.0 miles
Top-Rated Hospitals in District of Columbia
If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals in District of Columbia — click a hospital name to see its full profile and verify it's in your plan's network.
| Hospital | CMS Rating | Distance | Beds |
|---|---|---|---|
| Virginia Hospital Center | 5 ★ | 6.3 mi | 342 |
| Medstar Washington Hospital Center | 3 ★ | 1.3 mi | 818 |
| Medstar Georgetown University Hospital | 3 ★ | 3.3 mi | 535 |
| Sibley Memorial Hospital | 3 ★ | 5.4 mi | 362 |
| United Medical Center | 2 ★ | 5.4 mi | 184 |
| Howard University Hospital Corp | 1 ★ | 0.6 mi | 479 |
| George Washington Univ Hospital | 1 ★ | 2.1 mi | 371 |
| Children's National Hospital | Not Rated | 1.1 mi | 323 |
| St Elizabeths Hospital | Not Rated | 1.6 mi | 292 |
| Psychiatric Institute Of Washington | Not Rated | 1.6 mi | 104 |
View all 10 hospitals in District of Columbia to check quality before you enroll →
Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of District of Columbia.
Telehealth in District of Columbia: Is Your Internet Ready?
Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in District of Columbia. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.
Check Internet Providers at Your Address
Telehealth works best with reliable internet. Use this tool (provided free by ISP Reports) to see what's available at your address.
Opens ISP Reports in a new tab. This is not a paid relationship. Special thank you to ISP Reports for allowing free use of their address tool.
Internet Coverage in District of Columbia
Fiber Available
85.5%
of households
Cable/DSL Available
96.5%
of households
Top Provider
XFINITY
96.4% coverage
No Broadband
2.9%
of households
Internet coverage data from ISP Reports. View full internet report for District of Columbia.
Medicare-Relevant Demographics in District of Columbia
Understanding District of Columbia's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.
Total Population
686,329
Population 65+
85,783
12.5% of total
Median Age
36
1.7 years younger than the national average
Median Income
$123,202
63.9% above the National Average
On Medicare
69,116
10.1% of residents
On Medicaid
137,846
20.1% of residents
Uninsured
22,474
3.3% of residents
Social Security Recipients
122,946
17.9% of population
Demographic data from U.S. Census Bureau American Community Survey (2023). View full District of Columbia demographics (BestNeighborhood.org).
Local Medicare FAQ: District of Columbia
Common decision points based on District of Columbia's specific plan market and local healthcare landscape.
How does District of Columbia's Medicare Advantage market compare?
District of Columbia has 20 Medicare Advantage plans from 6 insurers. This is below the national average of approximately 57 plans. In areas with fewer competing plans, it's especially important to compare the available options carefully. The local mix includes 8 HMO and 12 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).
Should I choose an HMO or PPO Medicare Advantage plan in District of Columbia?
With 10 hospitals within 25.0 miles, District of Columbia has strong provider density. HMO plans (8 available) typically have lower premiums but require referrals and in-network care. PPO plans (12 available) offer more flexibility to see out-of-network providers at higher cost. In District of Columbia, PPO plans are more common, giving you more flexibility options to compare. Always verify your doctors are in-network before enrolling in any plan.
What's the real cost of $0 premium plans in District of Columbia?
16 plans (80% of available options) in District of Columbia charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In District of Columbia, maximum out-of-pocket limits range from $4,250 to an average of $7,145. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.
How does the 2026 $2,000 drug cap affect District of Columbia beneficiaries?
The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 10 standalone Part D plans in District of Columbia.
What this means locally:
- Cost predictability — No matter which of the 10 Part D plans you choose, your drug costs are capped at $2,000/year
- $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
- Low-income options — 2 plans meet the regional benchmark for Extra Help/LIS eligibility
While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.
See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions
About the Data & Editorial Team
Wes Ward
Founder & Data Lead
Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.
With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.
Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.
Transparency & Disclosures
InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.
TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.
Sources
- CMS Medicare Plan Finder Data (Part C & D): cms.gov
- CMS Provider Directory: Hospital and pharmacy data from data.cms.gov
- American Community Survey: Demographic data from census.gov
- FCC Broadband Map: Internet availability data from broadbandmap.fcc.gov
- ISP Reports: Internet provider coverage for District of Columbia from ispreports.org
- Telehealth.HHS.gov: Official telehealth guidance from U.S. Dept. of Health & Human Services
- BestNeighborhood.org: Community demographic profiles for District of Columbia from bestneighborhood.org
All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.