Anthem Blue Cross and Blue Shield health insurance rates in Virginia are extremely affordable. The combination of low prices and available federal subsidies allow Va residents to purchase quality healthcare plans, either on or off the Exchange. Individual, family and small business BCBS coverage provides quality benefits at a very low cost. Senior Medicare Supplement and Advantage plans are also offered to applicants that have reached age 65. Plan D prescription drug plans can be customized to match your budget and RX needs.
Our website provides free online Virginia BCBS quotes, and helps you compare and enroll for the best offered policies. If you apply for coverage, there are no medical questions to answer, and your pre-existing conditions are covered. You also can not be denied because of any past or present conditions, and there is no waiting period, or increase in the copay, coinsurance or deductible. 10 "essential benefits" are included in each plan, and there is no maximum payout cap if you develop a chronic condition. Provided benefits include hospital inpatient, outpatient and ER, prescription drugs, office visits (pcp and specialist), radiology and lab services, maternity, newborn, and prenatal care, substance abuse, and mental disorder.
New plans and legislation are being designed, and should be available in 2018 or 2019, depending on how quickly Trump Administration changes can be implemented. Short-term plans, although non-compliant, can provide cheap medical benefits in less than 24 hours. Currently, HMO (Health Maintenance Organization) and POS (Point Of Service) policies are offered. Tiered pricing for hospitals and facilities allows you to select lower-costing treatment, while retaining the highest available quality. Network-negotiated discounts at medical facilities help reduce out-of-pocket costs.
We have listed below the most popular Anthem health insurance plans in Virginia. Your household income will determine if you are eligible for a federal subsidy, and how much the premium will reduce. In many situations, your actual deductible and out-of-pocket expenses will be less than shown (Silver-tier cost-sharing). Plans are also available for specific temporary needs. Individual deductibles are shown. Family deductibles are double the single amount on most plans. LiveHealth online office visits are available with the copay equal to the primary-care physician copay on each policy.
HealthKeepers Catastrophic 7150 -- $7,150 deductible. Must be under age 30 to qualify. Otherwise, proof of financial hardship is needed. Primary-care physician (pcp) office visits are subject to a $40 copay (three per person per year allowed and coinsurance is 0%. Maximum out-of-pocket expenses are also $7,150.
HealthKeepers Bronze 4900 For HSA -- Inexpensive HSA-eligible plan. Deductible is $4,900 with maximum out-of-pocket expenses of $6,550. Coinsurance is 35%. For persons with no medical conditions that prefer the lowest premium, this plan should be strongly considered. Medical, dental, and vision expenses can be paid with pre-tax dollars.
HealthKeepers Bronze POS 4500 -- $4,500 deductible with $7,150 maximum out-of-pocket expenses and 30% coinsurance. Pcp and specialist office visit copays are $35 and $65 respectively for the first five visits. Additional visits must meet the deductible. Tier 1 drugs have a $25 copay while Tier 2, 3, and 4 drugs are subject to 50% coinsurance.
HealthKeepers Bronze POS 5750 For HSA -- HSA-eligible plan with $5,750 deductible and maximum out-of-pocket expenses of $6,550. Coinsurance is 0%, and Tier 1 and Tier 2 drugs are subject to 20% coinsurance (Tiers 3 and 4 are 50%).
HealthKeepers Bronze 5150 -- $5,150 deductible with $7,150 maximum out-of-pocket expenses and 35% coinsurance. Pcp office visits are $45 for the first three visits. Tier 1 drugs are subject to 35% coinsurance while other tiers must meet 50% coinsurance.
HealthKeepers Bronze 5900 -- $5,900 deductible with $7,150 maximum out-of-pocket expenses and 35% coinsurance. Pcp office visits are $40 for the first two visits. Tier 1 and Tier 2 drugs are subject to 35% coinsurance while Tiers 3 and 4 must meet 50% coinsurance.
HealthKeepers Bronze 6200 For HSA -- HSA-eligible plan with $6,200 deductible and maximum out-of-pocket expenses of $6,550. Coinsurance is 25%, and Tier 1 and Tier 2 drugs are subject to 25% coinsurance (Tiers 3 and 4 are 50%).
HealthKeepers Bronze 6350 -- $6,350 deductible with $7,150 maximum out-of-pocket expenses and 40% coinsurance. Pcp office visits are $40 for the first two visits. Tier 1 and Tier 2 drugs are subject to 40% coinsurance while Tiers 3 and 4 must meet 50% coinsurance.
HealthKeepers Silver POS 2300 -- $2,300 deductible with maximum out-of-pocket expenses of $7,150 and 20% coinsurance. PCP and specialist office visits are provided with $20 and $65 copays for the first five visits (combined). Tier 1 and Tier 2 drugs must meet a $20 and $50 copay only. Tier 3 and Tier 4 drugs are subject to 50% coinsurance.
HealthKeepers Silver 1800 -- Low $1,800 deductible with maximum out-of-pocket expenses of $7,150 and 30% coinsurance. Pcp office visit copay is $35 for the first three visits, but specialist visits must meet deductible. Prescription drug benefits are identical to previous plan.
HealthKeepers Silver 2800 -- $2,800 deductible with maximum out-of-pocket expenses of $7,150 and 20% coinsurance. Pcp office visit copay is $35 for the first three visits, but specialist visits must meet deductible. Prescription drug benefits are identical to previous plan, and overall benefits are also very similar.
HealthKeepers Silver 3500 -- $3,500 deductible with maximum out-of-pocket expenses of $7,150 and 15% coinsurance. Pcp office visit copay is $45, with no cap on the number of visits. Prescription drug benefits are identical to previous three plans.
HealthKeepers Silver 5000 -- $5,000 deductible with maximum out-of-pocket expenses of $6,750 and 25% coinsurance. Pcp office visit copay is $30, with no cap on the number of visits. Tier 1 and Tier 2 drugs must meet a $10 and $40 copay only. Tier 3 and Tier 4 drugs are subject to 50% coinsurance.
HealthKeepers Gold 1000 -- Low $1,000 deductible with $5,000 maximum out-of-pocket expenses and 20% coinsurance. Pcp office visit copay of $35, but specialist visits must meet deductible and coinsurance. Tier 1 and Tier 2 drug copays are $15 and $50. Tier 3 and Tier 4 drugs are subject to 50% coinsurance.
HealthKeepers Gold 1300 -- $1,300 deductible with $4,800 maximum out-of-pocket expenses. $20 and $50 office visit copays. Tier 1 and Tier 2 drug copays are $15 and $40. Tier 3 and Tier 4 drugs are subject to 50% coinsurance.
Important Note: Unless you are under age 30, you can not purchase a "catastrophic" Marketplace plan. Although financial hardship exceptions are offered, typically, prices are higher than subsidized Bronze-tier plans, so alternative policies should also be considered.
Pediatric Vision And Dental Benefits Included For All Persons Under Age 19
Diagnostic and preventative benefits have no waiting period and there is no policy maximum for covered expenses. Major services also have no waiting period. Cleanings, exams, and x-rays have 0% coinsurance and only have to meet the deductible. Fillings are subject to 40% coinsurance.Periodontics, endodontics, and oral surgery acre subject to 50% coinsurance. Cosmetic orthodontia is not included.
A $0 copay applies to all covered benefits. An annual eye exam and lenses are allowed. The lenses must be single, bifocal, trifocal, or standard progressive. Contact lenses (non-elective and elective disposable) are covered along with low vision services.
During the Open Enrollment period, there are no health-related questions asked, and acceptance is near 100% guaranteed. However, if there are immigration or citizenship issues, or you are eligible for Medicaid or Medicare, you may not be able to buy a Marketplace plan. If your income allows you to receive a federal subsidy, the policy must be an Exchange-issued plan. The amount you receive is based on your projected earnings for the year that you are applying for a policy. If you receive a federal subsidy (instant tax credit), you will need to file IRS Form 8962. Additionally, IRS Form 1095-A will be sent to you from the Department of Health and Human Services (HHS). However, the IRS will process your tax return if some of the required information is not furnished.
After Open Enrollment Ends
If you miss Open Enrollment in Virginia, many affordable options are available for both individuals and families. For example, temporary policies, which can be kept for up to 12 months, will provide very inexpensive coverage until the next period (typically in November). For 2016 effective dates, the OE period began on November 1, 2016 and ends on January 31, 2017.
Applying for temporary coverage takes about 15 minutes and many of the major carriers offer many low-cost plans. However, pre-existing conditions are not covered and short-term plans don't contain all of the required ACA benefits (such as maternity and preventive). Since subsidies are not applicable, the federal instant tax-credit is not offered.
Also, "qualifying life events," allow you to enroll at any time. These exceptions provide a 60-day window (approximately) to compare and purchase plans. Some of the most common events are divorce, birth of a child, loss of benefits from work, termination of existing coverage, and dependent turning age 26. If you voluntarily terminate a plan, you do not qualify for an SEP exemption and must wait for the next OE period to qualify for a subsidy. Regardless of plan selection, checking the Anthem provider network is recommended, so you can take advantage of substantial negotiated savings.
Anthem Individual Dental Plans In Virginia
Low-cost dental benefits are available that can be purchased separately. Three "Prime" plans (A, B and C) are offered to individuals and families. Since it is a "stand-alone" product, you do not have to purchase medical coverage to qualify. Prices are attractive throughout most of the state. For example, a 50-year old residing in Richmond would pay $20, $34, or $42 per month respectively for Plans A, B, or C. A brief outline of benefits is listed below:
Plan A -- Diagnostic and preventive services (exams, cleanings, x-rays, sealants, and fluoride treatments) covered at 100%. Basic, complex, and major services are not included in plan. A maximum of $500 per person in benefits is paid throughout the year.
Plan B -- Same diagnostic and preventive benefits as Plan A. Basic Services (Silver amalgam fillings, space maintainers, simple extractions, brush biopsy, and emergency pain treatment) covered at 80%. Some major services (root canal, periodontal services, and some oral surgery) also covered at 50%. Maximum benefit per person is $1,000.
Plan C -- Similar to Plan B although major restorative services, and prosthetic services and repairs are also included in the plan (50% benefit). The maximum benefit per person increases to $1,250.
NOTE: Additionally, "Dental Family Value," "Dental Family," and "Dental Family Enhanced" plans are also offered. Two sets of benefits are offered (dependents age 18 and younger, and adults age 19 and over). Deductibles range from $25-$50, and maximum annual benefits (per person) range from $750-$1,000. Diagnostic and preventative benefits have no waiting period.
Temporary coverage works best when you are between jobs, waiting for relocation to a new job, just graduated from high school, college or graduate school, or simply find yourself without benefits for various reasons. Unexpected illness or injury are one of the primary purposes of purchasing this type of policy. All of the plans previously listed have no minimum number of month requirements for keeping the policy. Therefore, it is possible and permissible to purchase a policy, and terminate at any time. In Virginia, since Anthem does not offer temporary contracts, Standard Security Life, (part of the IHC Group), provides free quotes on their official websites. However, the two carriers are not affiliated with each other.
If a policy is canceled outside the Open Enrollment period, although you will have options, the number of choices will be limited. There are specific designated "short-term" contracts that allow you to apply and get approved within 12-36 hours. UnitedHealthcare is one of several carriers that provide cheap rates on policies you can keep from 1-3 months. Pre-existing conditions are not covered on this type of plan, and the benefits do not comply with ACA federal legislation. NOTE: The maximum number of months offered on a single policy changed from 12-3 months as of April of 2017.
Senior Virginia Healthcare Plan Options
Consumers that are eligible for Medicare can not purchase coverage from the Exchanges and receive a subsidy. Instead, three options are available:
Three Medicare Supplement policies in Virginia can be purchased. During the annual Open Enrollment, acceptance is guaranteed and you can not be turned down. Pre-existing conditions are also covered. Options A, N and F are available, and each policy is different from the others.
Plan A is the cheapest Medigap policy and covers the hospital coinsurance or co-payment. But it does not cover the Part A deductible or Part B copayment. Plan N offers better benefits although it does not include Part B excess charges. Plan F is the most comprehensive option, and of course, is the most expensive.
Six Advantage contracts are offered, and each policy features no or an extremely low premium. Copays and deductibles are also often waived. Current available plans are:
MediBlue Dual Advantage -- $0 and $0 office visit copays with $6,700 maximum out-of-pocket expenses. Inpatient hospital copays are Medicare-defined cost-share.
MediBlue Smart Fit -- $10 and $35 office visit copays with $5,000 maximum out-of-pocket expenses. Inpatient hospital copays are $200 for first five days and $0 for days 6-90.
MediBlue Diabetes -- $0 and $30 office visit copays with $3,400 maximum out-of-pocket expenses. Inpatient hospital copays are $250 for first five days and $0 for days 6-90.
Mediblue COPD -- $0 and $30 office visit copays with $3,400 maximum out-of-pocket expenses. Inpatient hospital copays are $200 for first five days and $0 for days 6-90.
MediBlue Local -- $0 and $30 office visit copays with $3,400 maximum out-of-pocket expenses. Inpatient hospital copays are $200 for first five days and $0 for days 6-90.
MediBlue Care To You -- $0 and $0 office visit copays with $3,400 maximum out-of-pocket expenses. Inpatient hospital copays are $200 for first five days and $0 for days 6-90.
Part D Plans
Part D provides prescription drug benefits. There are three plans that Anthem offers in Virginia and the range of monthly rates is approximately $20-$140. Blue Medicare RX Standard (PDP) is the least expensive policy and has a $310 pharmacy deductible with initial coverage of $2,850. The Preferred Brand Copay is $40.
Blue MedicareRX Plus and Blue Medicare RX Premiere are two additional policies that offer richer benefits at a higher cost. If you do not take any current prescriptions, they may not be the best option.
Anthem Blue Cross Blue Shield offers many affordable plans to individuals, families and small business owners. We make it easy for you to view and compare the best available policies and enroll as quickly as possible.
News From The Past
March 2015 -- Virginia Anthem policyholders can receive free financial protection and 24 months of credit monitoring as a result of the massive data breach earlier this year. More than three million Va customers were impacted with hackers possibly obtaining access to social security numbers, dates of birth, email addresses, and possibly additional financial data.
Attorney General Mark Herring is recommending state residents take advantage of the free offers to help protect against future identity theft and other potential fraudulent activities. Written notification has been sent to all persons affected with specific instructions how to take advantage of the free services. Special protection for children will be included if any policyholder was insuring a child.
May 2015 -- Jobs will be eliminated at the Anthem office in Henrico County. No figure was given regarding the number of employees that will lose their positions, although an announcement should provide more details within the next two months. These laid-off employees may be offered other positions with the company. Currently, about 2,700 persons work for Anthem in Richmond.
March 2017 -- How will President Trump's proposed American Health Care Act impact Virginia? It's too early to determine, since may portions of the proposed legislation will be tweaked or eliminated, and more provisions will certainly be added. The final product, if approved by Congress, should be effective in 2018 or 2019. Until that time, the Affordable Care Act is still the law of the land.