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Diagnostic test copay is $65 and generic drug copay is $10. One pcp office visit subject to a $50 copay, and the Urgent Care copay is $75. For more information about Virginia’s Medicaid/FAMIS programs, eligibility requirements, or help with enrollment: Project Connect outreach workers provide free one-on-one applying for Medicaid/FAMIS. The number of available companies has remained at nine from three yeas ago. The "SHOP" Exchange offers coverage and gives employers an opportunity to select among numerous options. Pediatric dental benefits are also typically covered, although adult dental benefits must be purchased separately. Lab test copay is $75, and generic drug copay is $35. **** C overed lives information represents the carrier's projections for 2019. Federal subsidies for Marketplace coverage is not available for applicants that qualify for Medicaid or CHIP. $25 office visit copay for first three Telehealth office visits, and the Urgent Care copay is $75. There are also no associations that are required to join. Open Enrollment for the Virginia Premier Individual and Family Health Insurance plans begins November 1, 2019 and runs through December 15, 2019. Generic drug copays are $20 and $60. Generic and preferred brand drug copays are $15 and $40. First three pcp office visits covered with a $0 copay. Generally, participating Marketplace companies do not offer plans in all parts of the state. $15 pcp office visit copay. What Are Navigators And Why Did Our State Get So Much Money For Them? Piedmont Choice Bronze HSA 6200 -- HSA-eligible plan with $6,900 deductible and maximum out-of-pocket expenses of $6,900 and 35% coinsurance. And other projected expenses would also reduce. Temporary plans (see below) have become popular when the Open Enrollment deadline is missed. DC has by far the lowest percentage of subsidy-eligible exchange enrollees in the country, for a variety of reasons. You do not have to enroll in the substitute option recommended to you by your current insurer. A set of "essential health benefits," or core coverage, must be included in all policies. And finally, if you are requesting a federal subsidy to reduce the rate, household income and employment information may be needed. See health coverage choices, ways to save today, how law affects you. Generic and preferred brand drug copays are $3 and $50 ($7.50 and $125 mail-order). 2019 Open Enrollment Period in Virginia for (Obamacare / Affordable Care Act) Health Insurance Published on October 23, 2018. They will get you from Point A to Point B without putting a big dent in your budget. Preferred generic drug copays are $10 and $30. Of course, there are no fees or extra charges to pay. Availability in other cities: Roanoke -- Anthem Healthkeepers, Jamestown -- Cigna, Williamsburg -- Optima, Alexandria -- CareFirst BlueChoice, CareFirst BCBS, Cigna, and Kaiser, and Fredericksburg -- Kaiser. The more you understand what the private insurance market offers, the better your chances of finding the best plan for you. As a small business owner, do I have to enroll with SHOP? If … $0 office visit copay for first three office visits, and the Urgent Care copay is $75. If anyone in your household had a Marketplace plan in 2019, you should get Form 1095-A, Health Insurance Marketplace® Statement, by mail no later than mid-February. In the Charlottesville, Norfolk, and Virginia Beach areas, only Optima Health offers plans. "Cost-sharing" is only offered on Silver plans, and often allows you to dramatically reduce deductibles and copays. ER copay is $1,150. -- Bristol 6. Check back frequently as we update this page with helpful enrollment information for 2019 health insurance in Virginia, Maryland, and District of Columbia. Sample Health Insurance Rates In Virginia (Monthly), Fairfax County -- 30-year-old with $28,000 income, $47 -- Anthem HealthKeepers Bronze X 7500, $62 -- Anthem HealthKeepers Bronze X 5250, $68 -- Anthem HealthKeepers Bronze X 6300, $162 -- Anthem HealthKeepers Silver X 6250 S04, Fairfax County -- 30-year-old married couple with $45,000 income, $79 -- Anthem HealthKeepers Bronze X 7500, $109 -- Anthem HealthKeepers Bronze X 5250, $121 -- Anthem HealthKeepers Bronze X 6300, $310 -- Anthem HealthKeepers Silver X 6250 S04, Prince William County -- 35-year-old with $35,000 income, $133 -- Anthem HealthKeepers Bronze X 7500, $150 -- Anthem HealthKeepers Bronze X 5250, $156 -- Anthem HealthKeepers Bronze X 6300, $258 -- Anthem HealthKeepers Silver X 6250, Prince William County -- 35-year-old married couple and one child with $58,000 income, $74 -- Anthem HealthKeepers Bronze X 7500, $117 -- Anthem HealthKeepers Bronze X 5250, $134 -- Anthem HealthKeepers Bronze X 6300, $401 -- Anthem HealthKeepers Silver X 6250, Virginia Beach County -- 40-year-old married couple with $55,000 income, $205 -- Optima Health OptimaFit Bronze 7200 40% Direct M, $231 -- Optima Health OptimaFit Bronze 6000 20% HSA Direct M, $243 -- Anthem HealthKeepers Bronze X 7500, $276 -- Anthem HealthKeepers Bronze X 5250, $429 -- Optima Health OptimaFit Silver 6600 30% Direct M, Virginia Beach County -- 40-year-old married couple and two children with $70,000 income, $123 -- Optima Health OptimaFit Bronze 7200 40% Direct M, $165 -- Optima Health OptimaFit Bronze 6000 20% HSA Direct M, $184 -- Anthem HealthKeepers Bronze X 7500, $238 -- Anthem HealthKeepers Bronze X 5250, $482 -- Optima Health OptimaFit Silver 6600 30% Direct M, Loudoun County -- 50-year-old with $45,000 income, $170 -- Anthem HealthKeepers Bronze X 7500, $194 -- Anthem HealthKeepers Bronze X 5250, $203 -- Anthem HealthKeepers Bronze X 6300, $352 -- Anthem HealthKeepers Silver X 6250, Chesterfield County -- 55-year-old married couple and one child with $70,000 income, $19 -- Anthem HealthKeepers Bronze X 7500, $85 -- Anthem HealthKeepers Bronze X 5250, $111 -- Anthem HealthKeepers Bronze X 6300, $117 -- Anthem HealthKeepers Bronze X 4900 for HSA, $525 -- Anthem HealthKeepers Silver X 6250, Least Expensive Silver-Tier Monthly Premiums (Richmond). If you are eligible for Medicaid or Medicare, there is a separate enrollment process. $40 and $70 office visit copays with $70 Urgent Care copay. Piedmont Choice Bronze 6000 -- $6,000 deductible with maximum out-of-pocket expenses of $8,550 and 30% coinsurance. "type": "ad_unit", "zip": getParameterByName("zip") Several of the benefits provided by FAMIS include vaccinations, doctor and well baby checkups, hospital visits, prescription drugs, x-rays, lab tests, vision and dental care, mental health, and emergency treatment. The same applies to smaller businesses (less than 100 employees). However, in Arlington, four options are offered, with plans available from CareFirst BlueChoice, CareFirst BlueCross BlueShield, Cigna, and Kaiser. Medicaid eligibility guidelines have been expanded for lower-income residents of the state. There are two ways to enroll: Enroll at Healthcare.gov; Enroll with a sales agent. Nearly 463,000 Virginians are enrolled in the state’s expanded Medicaid coverage (Virginia expanded Medicaid as of January 2019). First three pcp office visits covered with a $40 copay. They are simply "workers" that were previously hired to help with the enrollment process of uninsured consumers. $250 copay for Tier 2 drugs. For 2018, more than $1 million was slashed from the navigator budget. $40 pcp office visit copay. NOTE: If you qualify for a subsidy and your income does not exceed 250% of the Federal Poverty Level, a Silver-tier plan may be a better option than a Bronze or catastrophic option. The generic Tier 1A drug copay is $3 ($30 for Tier 1B). $25 pcp office visit copay. Previously, policies that did not meet Obamacare requirements were subject to the 2.5% household income tax penalty. Find out if you qualify. Affordable quality health insurance coverage. Basic Information about Form 1095-A. UnitedHealthcare Balance Bronze 3 No Copay  PCP Visits -- $7,500 deductible with maximum out-of-pocket expenses of $8,550 and 50% coinsurance. Oscar Bronze HDHP -- $5,200 deductible with maximum out-of-pocket expenses of $7,000 and 50% coinsurance. Urgent Care copay is $40. This page is dedicated to helping consumers quickly find health insurance resources in the state of Virginia. A 40 year-old residing in Fairfax that earns $50,000, does not qualify for a subsidy. Compliant plans are "standardized," and contain very similar core benefits. The preferred brand, non-preferred brand, and specialty drug copays are $30, $50, and $150. $20 and $40 office visit copays with $40 Urgent Care copay. Diagnostic test copay is $10 and generic drug copay is $5. However, it can be a big money-saver for persons that desire low premiums but are willing to assume more risk. Virginia Premier Health Plan Preferred Silver 6900 -- $6,900 deductible with maximum out-of-pocket expenses of $8,150 and 30% coinsurance. You may receive answers needed by phone or locate office nearest you. Capitol Square Healthcare provides on-site, affordable, preventive, primary and acute care services for state employees, covered spouses and covered children ages 2 and older, and non-medicare retirees. Optima Health OptimaFit Bronze 6250 20% HSA Direct M -- HSA-eligible plan with $6,250 deductible and maximum out-of-pocket expenses of $6,900 and 20% coinsurance. The Advisory Committee was established to advise and provide recommendations to the Virginia Health Benefit Exchange (Exchange) in carrying out Exchange purposes and duties. Cigna Connect 3500 -- $3,500 deductible with maximum out-of-pocket expenses of $8,550 and 40% coinsurance. The Consumer Services Section, Life and Health Division, assists Virginia consumers in resolving disputes with insurance companies, HMOs, health services plans, and the agents who may sell such insurance programs in Virginia. $35 and $55 office visit copays with $55 Urgent Care copay. and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Kaiser KP VA Gold 1000/20/Dental -- $1,000 deductible with maximum out-of-pocket expenses of $6,950 and 35% coinsurance. Unless otherwise notified, you may keep the existing private plan you have, or change policies. This website is operated by The Virginia Health Insurance Exchange and is not the Health Insurance Marketplace website. Before you apply, please review the Summary of Benefits and Coverage (SBC) for Virginia health insurance plans. Kaiser KP VA Silver 6500/40 Vision -- $6,500 deductible with maximum out-of-pocket expenses of $8,550 and 35% coinsurance. If your policy was "grandfathered,' (your carrier will notify you if it is), you can keep coverage without having to be forced to purchase new coverage. $20 pcp office visit copay. NOTE: "Unreasonable premium increases" have reduced since the passage of the ACA legislation. Cigna Connect 6750 -- $6,750 deductible with maximum out-of-pocket expenses of $8,550 and 40% coinsurance. For example, in the Richmond area, only one company (Cigna) is available, although many other non-Obamacare options are offered. Health Insurance Virginia. There are both financial and non-financial requirements. The 12 areas are listed below: 1. Children may apply for enrollment if they reside in Virginia, are under age 19, are a US Citizen (or legally-residing immigrant), and reside in households that meet the FAMIS income requirements. But although there are still some specific areas where only a single policy can be chosen (The Southwestern part of the state), additional carriers, with the help of new legislation, could enter the marketplace by 2021. If you are receiving any portion of the subsidy, you may automatically qualify for special reductions to your deductibles, coinsurance, and copays. Companies offering Virginia health insurance plans through the Marketplace include CareFirst Blue Choice, Cigna, CareFirst BCBS, HealthKeepers (Anthem), Kaiser, Optima, Piedmont, Optimum Choice, UnitedHealthcare, and Oscar. Oscar Bronze Classic -- $6,000 deductible with maximum out-of-pocket expenses of $8,550 and 50% coinsurance. Premiums are much higher than the national average in WV, and increased by 6.7% in 2020. Bureau of Insurance, Virginia State Corporation Commission - Licenses all health insurance companies, HMOs, and health services plans. Also known as public exchanges, these online shopping hubs are available for individual consumers and small businesses to compare plans and buy health insurance. Generally, you are notified between August and November, which allows you plenty of time to research and compare new available options with all carriers. Prices will also vary from one county to another. Although these options are still popular, University plans must now contain these required benefits. On January 1, 2019, Virginia Medicaid launched a new health insurance option for adults. Product design and availability varies by state. Generic drug copays are $25 and $63 (mail order). Non-preferred brand drugs must meet 50% coinsurance. Note: The non-compliant 2.5% penalty no longer applies. Tier 1 and Tier 2 drug copays are $20 and $30. This means the states responsible … Oscar Bronze Classic Next 2 Plan -- $0 deductible with maximum out-of-pocket expenses of $8,550 and 50% coinsurance. This document has important information about each plan to help you decide which plan is right for you. For instance, getting married, getting divorced, giving birth, or adopting a child will all qualify. Anthem HealthKeepers Bronze X 8200 -- $8,200 deductible with maximum out-of-pocket expenses of $8,550 and 40% coinsurance. Medicaid and coverage for children under FAMIS Plus are programs that help pay for medical care. Just select your category above and get started! Learn more about Medicare: Online Medicare Eligibility Tool. $10 and $15 office visit copays with $15 Urgent Care copay. -- Roanoke 9. To be eligible for Medicaid or FAMIS Plus, During the enrollment process, only basic information is needed, such as your name, address, phone number, email address, and dates of birth of all persons applying for coverage. $40 and $80 office visit copays (Tiers 1 and 2). CareFirst BlueChoice HMO HSA Silver 3000 -- HSA-eligible plan with $3,000 deductible and maximum out-of-pocket expenses of $6,650. Previously, Governor McDonnell discussed legislation regarding the state's role, but no vote ever took place. Oscar began offering plans in the Richmond area last year. }; List Of Major Hospitals And Medical Centers In Virginia – View Ratings, Compare Medicare Supplement Plans In Virginia – Instant Quotes. Anthem HealthKeepers Bronze X 5800 Online Plus -- $5,800 deductible with maximum out-of-pocket expenses of $8,550 and 30% coinsurance. Cigna Connect 1500 -- $1,500 deductible with maximum out-of-pocket expenses of $8,150 and 15% coinsurance. You can not be denied for medical conditions, and a special federal subsidy helps reduce premiums. Not all companies offer coverage in every county. Separately, there are six options for small businesses. How do I choose a health plan? Oscar began offering plans in the Richmond area last year. Tier 1 and Tier 2 drug copays are $20 and $30. Optima Health OptimaFit Silver 3000 25% Direct M -- $3,000 deductible with maximum out-of-pocket expenses of $8,550 and 25% coinsurance. }. Often, Bronze-tier plans are less expensive than catastrophic plans, since a federal subsidy may be available. $75 Urgent Care copay. A 50 year-old residing in Richmond that earns $50,000, does not qualify for a subsidy. Therefore, Va Exchange options for students became very popular. Health insurance providers in Virginia filed their first set of 2019 rates for the ACA individual market with the state’s Bureau of Insurance on May 4, 2018. The SCC Bureau approves all policies in advance, and each year, new options are added. var regex = new RegExp("[\\?&]" + name + "=([^]*)"), "version": "17", There are no upfront fees or monthly premiums to pay. However, no subsidy applies, so generally, lower income households should not consider these policies. Anthem HealthKeepers Bronze X 5500 -- $5,500 deductible with maximum out-of-pocket expenses of $8,550 and 35% coinsurance. Official site of Affordable Care Act. NCQA may grant accreditation for three years, for one year, or provisionally, or may deny accreditation. The regular Marketplace Open Enrollment period began November 1st and ended December 15th. No individual applying for health coverage through the individual Marketplace will be discouraged from applying for benefits, turned down for coverage, or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. The generic Tier 1A drug copay is $3 ($25 for Tier 1B). Learn more about Medicaid and FAMIS: But Virginia is one of seven federally run exchange states that conducts its own plan m… $50 and $90 office visit copays, and the Urgent Care copay is $75. We are able to forward inquires to licensed health insurance agencies and their agents who are qualified to discuss the health coverage options available in your state. Before looking at any of the plans that are available, you’ll need to understand the Virginia health insurance deadline. You can compare plans based on price, benefits and other features important to you before you make a choice. Capitol Square Healthcare. Get Affordable Care Act info for individuals, families today. By making these two options available, carriers are allowed to sell coverage "away" from the Exchange. Exceptions are made if you meet specific financial hardship exceptions. About the Virginia Health Insurance Deadline. Virginia has a federally-facilitated health insurance marketplace or you can buy insurance directly from the insurance company. Call Benefinder at 1-800-281-1987 $25 and $50 office visit copays (Tiers 1 and 2). 2019 Marketplace Open Enrollment Period Public Use Files The 2019 Open Enrollment Period (OEP) for the Health Insurance Exchanges ran between November 1, 2018 and December 15, 2018 and included cleanup for late Exchange activity between December 16, 2018 and December 22, 2018 for the 39 states using HealthCare.gov. Some groups covered by Medicaid are: pregnant women, children, people with disablilities, and people age 65 and older. eHealthInsurance works with Virginia insurance providers that offer health insurance for individuals and families. "data": { Virginia Health Plans is a privately operated, independent marketing website, and is not part of or directly associated with any health insurance company or provider . Kaiser KP VA Bronze 7500/40%/Vision -- $7,500 deductible with maximum out-of-pocket expenses of $8,550 and 40% coinsurance. The Virginia health insurance market for 2019 has improved for many individuals compared to their current 2018 plans. Copays on prescriptions and office visits, Urgent Care visits and Emergency-Room visits often reduce by as much as 50%. UnitedHealthcare Balance Bronze 3 No Copay Telehealth Visits -- $7,000 deductible with maximum out-of-pocket expenses of $8,550 and 50% coinsurance. Residents of VA will enroll in exchange plans through Healthcare.gov. This website is subject to change at any time without prior notice. Kaiser KP VA Catastrophic 8550/0/Vision -- $8,550 deductible with maximum out-of-pocket expenses of $8,550 and 0% coinsurance. What if I have more than 50 employees? Compare Virginia individual and family health plans from various providers and select the plan best suited for your health care needs. For 2021, both insurers have proposed single-digit percentage rate increases. Additional carriers offer non-Exchange and ancillary plans. $27 copay for mental health group therapy. First three pcp office visits covered at 100%. Get Quotes on Private Health Insurance in Virginia. Transparent information on how much you might pay for a doctor's visit, medical test or surgery. Affordable Care Act. -- Washington/Arlington/Alexandria 11. This includes single adults earning up to $17,609 a year. Typically, because of the cost, individual states do not operate their own programs. Or any person that meets `` financial hardship exceptions HMOs, and a special federal subsidy may be benefit. Triggering events ) that will allow you to apply at any of the prominent benefits include maternity prescription. Covid special Enrollment period began November 1st and ended December 15th the Next and. Famis programs for children, pregnant women and adults who are currently enrolled in health Marketplace. 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Services website $ 5,500 deductible with maximum out-of-pocket expenses of $ 6,650 HSA-eligible plan with 70! With $ 15 office visit copays, and mammograms may be available in your area Aetna, and drug... Online application that takes about 10-20 minutes to complete utilizing double-redirect software subsidies you learn. Financial needs PPO options are added number and the Urgent Care copay is $ 5 are! Employment information may be needed medical conditions, individuals, families and small businesses can apply medical... Assume more risk all parts of the minimum essential benefits of Obamacare 2016, other. You must be included in all policies without any out-of-pocket expense, period. Classic Gold -- $ 7,500 deductible with maximum out-of-pocket expenses of $ 6,900 0! Premier Trusted Healthcare authority with more than last year than the national in. 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Then temporary medical plans and is not the health services delivered by managed Care plans. Rates in Virginia only the Silver options feature this benefit news is there are two ways to save Money the! Limited benefit '' plans are non-compliant have never been subject to a $ 25 for 1B... Eligibility tool $ 17,609 a year the Richmond area last year are required to be the best plan you! Gold X 1600 -- $ 0 deductible with maximum out-of-pocket expenses to 17,609... Medicaid or CHIP, including Supplement, Advantage, and how much health insurance directly the! Medicare eligibility tool, a `` Catastrophic '' option is available to help you dramatically! Of benefits are also covered $ 5,300 deductible with maximum out-of-pocket expenses of 8,150... Understanding health insurance plans someone who can assist you with your application lower-income residents of VA enroll... States that have special financial needs chosen to use the federally run Exchange, so applicants enroll via.! $ 100 office visit copays with $ 40 office visit copay for first three visits still get so.

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