Advantage 65: Is the Virginia State Retiree Plan Medicare Advantage?
No. Despite the name, Advantage 65 is not a Medicare Advantage plan. It is the Commonwealth of Virginia's retiree health plan that works with Original Medicare: Medicare pays first, and Advantage 65 pays second. If you have Advantage 65, you have Original Medicare, and you can see clinicians who accept Original Medicare.
The name causes real confusion. Many retirees, and some front desks, see "Advantage" on an Anthem card and assume it is a Medicare Advantage plan. This guide explains the difference and what it means for your care.
What Advantage 65 Is
A plan that pays after Medicare. The Virginia Department of Human Resource Management (DHRM) describes Advantage 65 as a Medicare supplemental plan that pays secondary to Medicare, and states plainly that the Advantage 65 plans are not Medicare Advantage plans.
Built on Original Medicare. Retirees in the state program who are eligible for Medicare must enroll in both Part A and Part B.
Administered by Anthem Blue Cross and Blue Shield. That is why your card carries the Anthem name.
Drug coverage is separate. For plans that include it, prescription coverage runs through Express Scripts as an enhanced Medicare Part D plan.
Local government retirees covered through The Local Choice program may also have a plan called Advantage 65. It works with Original Medicare in the same way.
How It Differs From Medicare Advantage
Who pays first: with Advantage 65, Original Medicare pays first and Advantage 65 pays second. With Medicare Advantage (Part C), a private plan replaces Original Medicare for your care.
Which doctors: with Advantage 65, clinicians who accept Original Medicare. With Medicare Advantage, the plan's network.
Which card: with Advantage 65, you use your Medicare card and your Advantage 65 card. With Medicare Advantage, you use the plan's card.
One point from DHRM is worth knowing: if a state retiree enrolls in a separate Medicare Advantage plan, the state's Medicare-coordinating plans will not pay for services received through that plan.
What You Pay for Doctor Visits, Including Psychiatric Care
Part B deductible: you pay it yourself. Advantage 65 does not cover the Medicare Part B deductible ($283 in 2026).
After the deductible: Medicare pays its share of the approved amount for a covered visit, and Advantage 65 pays the Part B coinsurance for doctor's care.
Which clinicians: the plan's benefit summary says it covers Medicare participating physicians who accept Medicare's payment. Ask whether a practice participates in Medicare before you book.
For outpatient mental health care, that usually means that once you have met the deductible, Medicare and Advantage 65 together cover most or all of a covered visit. Your exact costs depend on your plan option, so confirm with Anthem using the member services number on your card.
If a Front Desk Says They Do Not Take Your Plan
Sometimes a scheduler sees the Anthem card and the word "Advantage" and turns a retiree away. If that happens:
Say that you have Original Medicare, Parts A and B, and that Advantage 65 is your supplement.
Offer your red, white, and blue Medicare card first, then your Advantage 65 card.
Ask the practice to check your Medicare eligibility directly.
Where to Get Help With Your Plan
Welmivia does not advise on choosing or changing Medicare coverage. For questions about your state retiree benefits, contact DHRM or your former employer's benefits office. For free, unbiased help with Medicare choices, contact VICAP, the Virginia Insurance Counseling and Assistance Program.
How Welmivia Works With Advantage 65
Welmivia is a participating Medicare practice. We bill Original Medicare Part B directly, and we accept Advantage 65 as a supplement. Visits are by video with Dr. Diaz for adults located in Virginia or Florida, and we check your Medicare eligibility before scheduling.
To check your coverage or ask about a first visit, call 434-623-0003 or request a Medicare appointment . For more on costs, see our guide, Does Original Medicare Cover Psychiatric Care by Video?
What to Take Away
Advantage 65 is not Medicare Advantage. It pays after Original Medicare.
You pay the Part B deductible; after that, Medicare and Advantage 65 usually cover covered doctor visits.
Show your Medicare card first, and ask practices whether they participate in Medicare.
Welmivia is not a crisis service. If someone is in danger, call 911. For a mental health crisis, call or text 988.
Sources
Virginia Department of Human Resource Management. Medicare and the State Retiree Health Benefits Program (fact sheet).
Virginia Department of Human Resource Management. 2026 memo to State Retiree Health Benefits Program enrollees eligible for Medicare.
The Local Choice. Your Advantage 65 Benefits, effective January 1, 2026.
Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B premiums and deductibles. November 2025.
This guide is general information, not insurance advice for your situation. Plan details can change each year; confirm current benefits with DHRM or Anthem.
