Get the best health insurance rates for individuals in Virginia from top-rated companies, and easily and quickly enroll online for private plan or Exchange benefits. Single, family, small business, and Marketplace medical plan rates are also available so you can view and compare side-by-side options and prices, and sign up for coverage with or without a federal subsidy. Compare policies that reduce your medical costs and provide immediate benefits.
We understand that each person has different priorities and and you may need coverage for many years, or perhaps just a few months. Instantly, review customized quotes from Anthem Blue Cross Blue Shield, Cigna, Kaiser, CareFirst, and additional companies, including Senior Medicare Supplement, Part D prescription drug, and Advantage plans. A new Plan G (HD) Supplement plan is offered for newly-eligible Medicare applicants in 2021. The deductible is $2,340 and paying the Part B deductible can be applied to the total plan deductible.
Open Enrollment begins every November (under age 65) and October (age 65 and over). During this time, subsidized policies (under-65) are offered with pre-existing conditions immediately covered on your effective date. The application process now takes only 10-20 minutes. 2021 "Off-Exchange" plans are also offered for persons that don't qualify for a federal subsidy or choose different types of policies (short-term). Many policies are designed to fit your budget and also provide coverage for chronic diseases.
Temporary plans can be issued for up to 364 days. Many affordable options are available if you miss the deadline, and are offered throughout the entire year. Although temporary policies do not contain 10 "essential health benefits," they do provide affordable major medical benefits. Generally, up to $1-2 million of benefits are available, and applications for short-term coverage are often approved within 48 hours. Large provider networks are available, including UnitedHealthcare's PPO network.
Applicants that have reached age 65 also have access to guaranteed Medigap coverage from a wide selection of carriers. High-deductible plans provide 100% coverage after the deductible has been met. Also, Medicaid expansion provides more consumers with low-cost options including CHIP benefits for children. "Cover Virginia" is offered to eligible applicants with income less than $18,900 (one person), $25,524 (two persons), $32,160 (three persons), and $38,796 (four persons). Pregnant women and adults can also qualify for coverage. Generally, only five questions are asked to determine eligibility.
FAMIS also provides medical benefits for children. There are no fees or costs for qualifying families. To receive benefits, applicants must reside in Virginia, be a US citizen or lawfully-residing immigrant, under age 19, and not eligible for FAMIS Plus. Eligible families can receive the following benefits: office visits, preventative checkups, vaccinations and immunizations, prescription drugs, dental and vision, x-rays and lab tests, ER visits, and mental health coverage.
Open Enrollment For Under Age 65
You can apply for medical plan benefits after the Open Enrollment period ends (under age 65) by using a "Special Enrollment Period" exemption. This applies to many situations, including pregnancy or adoption, losing credible coverage from an employer, reaching age 26 while covered on a parent's policy, divorcing, or moving to a different service area. These "life events" provide 60 days to review and choose plans without underwriting. If Administration healthcare options eventually gain Congress-approval, we will review and rate them for you. It's possible that by 2022, additional low-cost plans may be offered that do not include all essential health benefits. Premiums on newer plans could reduce by as much as 25%-45%, and tax credits would continue to be offered.
Catastrophic plans are inexpensive, and cover office visits, hospitalization, prescription drugs and other required essential benefits. Because of the higher deductibles and copays, out-of-pocket expenses are generally higher than most other options. Often, Silver-tier plans provide the best combination of major medical benefits, copays for specialists and non-generic prescriptions, and a federal subsidy that includes "cost-sharing."
Depending on the household Federal Poverty Level, significant savings may be available. HSA, high-deductible, and comprehensive plans are offered. Copays are often available on pcp office visits, specialist visits, and ER and Urgent Care visits. Tier 1 and Tier 2 prescription drugs frequently feature lower copays. 90-day mail-order options are generally available on most drugs.
Small group benefits are offered at all times. However, the employer must meet the carrier minimum participation requirements (specific percentage of eligible employees must enroll). Part-time employees are eligible to enroll, and are counted in the participation tally. If group requirements are not met, an Open Enrollment is available from November 15th to December 15th. If the OE deadline is missed, alternative plans may be available (see below).
Non-Obamacare plans are available at any time without a qualifying life event (QLE). Although instant tax credits (federal subsidy) are not available, premiums are often low since all essential health benefits are not required. Also, pre-existing conditions are not required to be covered, and annual coverage maximums are typically between $100,000 and $2 million. Urgent Care and Teledoc copays are offered by most companies. PPO networks are offered along with indemnity plan options. Dental and vision benefits can be added to most plans.
Common "qualifying live events (QLE) are listed below:
Gaining a dependent or becoming a dependent -- Placement in foster care, birth, or adoption. Backdating of coverage is available.
Involuntary loss of qualified coverage -- Lost coverage must be minimum essential, and self-termination of the plan will not qualify as a QLE.
Permanent move -- The move must be to an area where different qualified plans are offered.
Divorce -- If qualified coverage is lost.
Marriage -- The 60-day OE period begins on the day of the wedding.
Renewal of plan outside of Open Enrollment period -- Although the renewal can be accepted, a new plan can also be chosen.
Becoming a US citizen -- This applies to Marketplace plans only.
Senior Virginia Medigap Plans
For Seniors, the month you reach age 65 and have enrolled in Medicare Part B, a six-month window begins. During this time, you can choose any available plan with no medical underwriting. If you apply for benefits after the six-month period, you may pay a higher premium because of existing health conditions. A Part B "late enrollment penalty" may be imposed in some situations, so typically, it's best to enroll in Medicare when it first becomes available. Supplement plans are standardized, which helps simplify the comparison process. The Virginia Department of Insurance approves all carriers licensed to conduct business in the state.
With our assistance, you can quickly apply for quality, but inexpensive plans from the most recognized companies. Policies are available to be kept one month or continuously renewed each year. If you qualify for the federal Obamacare subsidy, your premium could drastically reduce, potentially saving you thousands of dollars. We will calculate the amount you are eligible for, and explain which policies will maximize your personal benefits. If you are eligible for Medicare (Seniors) or Medicaid (lower household income), we will review all available options.
Medicare Advantage and Supplement plans are also offered if you have reached age 65. Prescription drug plans (Part D) are offered to eligible Seniors. Popular Part D options include AARP MedicareRx Walgreens, AARP MedicareRx Saver Plus, AARP MedicareRx Preferred, Anthem MediBlue Rx Plus, Anthem MediBlue Rx Standard, Anthem MediBlue Rx Enhanced, EnvisionRxPlus, Humana Walmart Value Rx, Humana Basic Rx, Humana Premier Rx, SilverScript Choice, WellCare Wellness Rx, WellCare Medicare Rx Select, WellCare Classic, WellCare Medicare Rx Value Plus, WellCare Medicare Rx Saver, and WellCare Value Script.
Virginia Medicare Supplement insurers are AARP/UnitedHealthcare, Aetna, American Retirement Life, Americo, Anthem BCBS, Assured Life, Atlantic Coast Life, Bankers Fidelity Life, Central States, Colonial Penn, Combined Insurance, Erie, Everence, First Care, GCU, Globe, Great Southern Life, GPM Health And Life, Guarantee Trust Life, Humana, Individual Assurance, Liberty Bankers Life, Lumico Life, Manhattan Life, Mutual Of Omaha, National Guardian Life, Order of United Commercial Travelers, Pan American Life, Pekin Life, Physician's Mutual, Renaissance Life, Reserve National, S. Utah Life, Shenandoah Life, Standard Life And Accident, State Farm, Thrivent, Union Security, United American, and USAA. Additional carriers for persons under age 65 are listed below.
Available Medicare Advantage plans include: AARP Medicare Advantage Choice, AARP Medicare Advantage Plan 1, AARP Medicare Advantage Plan 2, AARP Medicare Advantage Walgreens, AARP Medicare Advantage Patriot, Aetna Medicare Eagle, Aetna Medicare Select Plan, Aetna Better Health Of Virginia, Aetna Medicare Essential Plan, Align Connect, Align Thrive, Anthem MediBlue Plus, Anthem MediBlue Essential, Anthem MediBlue Dual Access, Anthem MediBlue Local, Clear Spring Health Essential, Erickson Advantage Liberty, Humana Honor, HumanaChoice, Humana Gold Plus, Kaiser Permanente Medicare Advantage Value VA, Magellan Complete Care Of Virginia, Optima Community Complete, Optima Medicare Prime, Optima Medicare Classic, Optima Medicare Value, UnitedHealthcare Dual Complete RP, and Virginia Premier Advantage Elite.
Virginia Health Insurance Companies
When reviewing different individual, group, or ancillary policies, it's important to consider only qualified "real" insurance plans. These will typically be carriers you recognize, such as Humana, Anthem Blue Cross, Aetna, Coventry, Innovation, Health Keepers, UnitedHealthcare, Kaiser Mid-Atlantic, CareFirst Blue Cross Blue Shield, Piedmont, and Optima. These companies will stand behind their policy coverage and process claims very quickly and efficiently. We help you choose the most affordable health insurance plans in Va that offer the best benefits for the lowest cost. Note: Several of these carriers offer Group and Senior coverage, but not individual private coverage.
Qualified 2021 Marketplace plans are offered by the following carriers: Optimum Choice, CareFirst, Cigna, Group Hospitalization And Medical Services, Health Keepers (Anthem), Kaiser, Optima, Oscar, and Piedmont. Non-Obamacare plans are offered by several additional companies that feature low premiums, major medical benefits, and choice of out-of-pocket cost options. Indemnity plans offer low premiums with major medical, ER, and Urgent Care benefits. These types of plans allow you to choose any provider. CareFirst, Health Keepers, Kaiser, Optima, and Piedmont reduced their 2020 rates. Oscar is the newest carrier to offer plans (Richmond area only).
2021 Rate Changes
CareFirst -- 9.7% average decrease for 4,804 members
Cigna -- 11.66% average decrease for 63,103 members
GHMSI -- 5.2% average increase for 1,031 members
Health Keepers (Anthem) -- 7.7% average decrease for 112,190 members
Kaiser -- 13% average decrease for 30,173 members
Optima -- 7.52% average decrease for 38,077 members
Piedmont -- 3.38% average decrease for 6,000 members
Oscar -- 2.2% average rate increase for 721 members
Non-Obamacare Short-Term Plans
Short-term plans offer flexibility of benefits, easy online enrollment anytime throughout the year, and low rates. However, temporary plans are not recommended for applicants with major mental or physical pre-existing conditions. UnitedHealthcare, National General, and IHC Group offer competitive rates with several copay, coinsurance and deductible options. Maximum benefits are available from $100,000 to $2 million. Policies are offered during and outside of the Open Enrollment period.
For persons that miss the Open Enrollment deadline, need coverage between jobs, are currently uninsured, or can't afford qualified Marketplace options, temporary policies should be considered. Coverage can be approved within 24 hours without a waiting period for most benefits. However, pre-existing conditions are not covered, and many additional benefits must meet a deductible, coinsurance, or both.
Selecting lower maximum benefits ($500,000) and higher deductibles ($10,000) will substantially reduce the premium. Although urgent care and online physician visits are often covered with only a copay, specialist visits and ER visits are typically subject to a deductible. 0%, 20%, and 50% coinsurance options are usually offered.
Dental coverage is also offered through many popular carriers including Anthem Blue Cross and Blue Shield, CareFirst BlueCross BlueShield, Humana, Dominion Dental, IHC, Delta, Nationwide and UnitedHealthcare. Other ancillary coverage, such as vision, critical illness, disability, life, and long-term care, are available through additional companies. Small group and large group benefits can be offered with streamlined underwriting. COBRA benefits are extended to qualified applicants. Often, employer-provided coverage is subsidized, and therefore, less expensive.
Only basic information is needed to provide your current rates. Typically, your zip code, date of birth and possibly your county of residence are the main items of information needed. Although there are not necessarily large premium differences from one zip code to another, prices can vary. For example, rates in Richmond and Norfolk will be different than Hampton and Blacksburg. It's possible that a specific company will offer policies in Newport News, but not Roanoke. Your age will also impact the premium an insurer charges. Premiums, without a subsidy, are most expensive for persons between the ages of 61 and 64. However, households that qualify for financial help, can save thousands of dollars per year.
For short-term plans outside of the Marketplace, a high BMI will probably increase the price you pay. A normal BMI, coupled with no existing conditions, may qualify you for a "preferred" rating. During Open Enrollment, Exchange coverage requires no medical questions to be asked. If you miss the OE period, or simply forget to enroll, there are several affordable policies that can be used until the next OE period. Plans are available up to 360 days, and can be renewed with medical underwriting. National General and UnitedHealthcare offer 12 months of guaranteed coverage in many states.
Purchasing Coverage Through The Exchange
With the creation of the Virginia Health Exchange seven years ago, underwriting guidelines changed. Since medical questions are no longer asked, all applicants (including children) qualify for a policy (assuming you meet citizenship requirements). The variable is the size of your tax subsidy, which is based on your projected earnings for next year, and how it relates to the Federal Poverty Level. Changes in projected household income can impact your subsidy, and also the cost of medical coverage.
We can quickly and accurately calculate that amount for you. Bronze and Silver Marketplace options are the cheapest available medical plans. Platinum and Gold policies are the most costly since out-of-pocket expenses and deductibles are the lowest. "Catastrophic" tier policies are inexpensive options that are offered to applicants that have not reached age 30. "Financial hardship" exceptions are available to older applicants, although often, Bronze and Silver-tier plans are more cost-effective.
Several of the cheapest 2021 health insurance plans in Virginia (Bronze and Silver Tiers) are listed below:
Anthem Healthkeepers Bronze X 8200
Anthem Healthkeepers Bronze X 5500
Anthem Healthkeepers Bronze X 5900 For HSA
Anthem Healthkeepers Silver X 6250
Anthem Healthkeepers Silver X 5800 Online Plus
CareFirst Blue Choice
Cigna Connect 7000
Cigna Connect 6750
Cigna Connect 5500
Cigna Connect 1500
KP VA Bronze 6000/55/Vision
KP VA Silver 7500/40/Vision
OptimaHealth Optima Fit Bronze 7500 40% Select RK M
Oscar Classic Bronze
Oscar Simple Bronze
UnitedHealthcare Balance Bronze 3 No Copay PCP Visits
UnitedHealthcare Balance Bronze 3 No Copay Telehealth Visits
Va family rates are typically higher than single or individual rates. An older age and/or nicotine use will also result in higher premiums. Reaching age 65 generally creates an immediate Medicare-eligibility. When that occurs, there is always an Open Enrollment window that allows you to qualify for Medicare Supplement coverage regardless of your existing medical conditions. Part D prescription drug and Advantage plans are also offered. Each company publishes a Formulary drug list (generic and brand name) that helps identify the drugs with the greatest value. Often, pharmacists, doctors, and nurse practitioners review and update the list.
Researching rates and coverage from different carriers is sometimes not easy. If you have ever tried to compare televisions in a retail store (or online), you know what we mean. We'll help you understand why certain policies will provide maximum coverage at the most affordable cost. By customizing a policy for you, you'll be less likely to pay for items you will rarely (or never) use. Additional helpful resources include the Office of Family Health Services and FAMIS (low-cost coverage for children).
Maternity And Delivery Coverage
Maternity benefits are included on all qualified plans. If you're fairly certain you will be utilizing this portion of your policy in the next few years, then a "Silver" or "Gold" plan may be your best choice because of lower available deductibles. However, your maximum "out-of-pocket expenses" must also be taken into consideration, since you are likely to meet the maximum amount if your delivery occurs. Deductibles as low as $1,000-$3,000 are available ($8,150 is the highest), although maximum out-of-pocket expenses must also be considered. A Health Savings Account (HSA) can also be utilized to help pay for expenses with tax-deductible dollars. Dental and vision expenses may also be paid from the account.
But what if you don't need maternity coverage? There may be other specific policy options you also don't need. We can focus and research the plans that don't charge you for unneeded policy provisions. That's one of the ways you'll save money by using the free quotes our website provides. And as companies change their benefits and exclusions, we'll keep you updated so your policy is always current. By personally customizing a policy to match your specific needs, you pay less. Also, as dependents eventually need their own coverage, children can easily qualify for guaranteed plans, regardless of any health issues that may be present.
Viewing and comparing your Virginia healthcare options is just one of the many free services we provide. We're confident you'll be matched with the carrier that gives you the most benefits for the least cost. And as plans, rates or laws change, we keep you up to date on the impact it has on you and how you can make the right adjustments to your policies. 12-month short-term plans have become more popular and offer a low-cost Obamacare alternative. Prices are cheap, and policies are often approved within 24 hours. Coverage is offered at all times.
Additional Information -- A private Marketplace for small business owners is being established by the Va Chamber of Commerce, who is partnering with ChamberSolutions. A "defined contribution" concept will be utilized, which will allow employees to select benefits from multiple options.
The "Virginia Benefits Market" provides types of policies, including high-deductible, comprehensive, and PPO/HMO contracts. Our website, along with licensed brokers, provides details, prices, and information regarding setting up and implementing coverage.