Share. If you do not own a small business, there is no reason to utilize the SHOP Marketplace. Non-preferred generic drug copays are $25 and $75. Just select your category above and get started! Virginia Health Exchange is the Marketplace to shop and enroll in a health insurance plan provided to you by Benefits Group. The Urgent Care copay is $55. Temporary plans also are only available from selected carriers. }; List Of Major Hospitals And Medical Centers In Virginia – View Ratings, Compare Medicare Supplement Plans In Virginia – Instant Quotes. Office visit copays are $25 and $50. Anthem HealthKeepers Catastrophic X 8550 -- $8,550 deductible with maximum out-of-pocket expenses of $8,550 and 0% coinsurance. Develops practical, science-based information for medical practitioners, consumers, and other health care purchasers. NOTE: Your insurer can terminate the policy although written notification must be given. Virginia has several free or low-cost health insurance programs for those who qualify. 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. Preferred generic drug copay is $4 ($8 for mail order), and non-preferred generic drug copay is $20 ($40 for mail-order). For individuals and families, there are 3 types of health insurance. -- Winchester 12. "Catastrophic" plans are available to applicants under age 30, or any person that meets "financial hardship" guidelines. See health coverage choices, ways to save today, how law affects you. If … Pcp office visits are subject to a $25 copay. CareFirst BlueChoice HMO Young Adult 8550 -- $8,550 deductible with maximum out-of-pocket expenses of $8,550 and 0% coinsurance. Piedmont Choice Bronze 6000 -- $6,000 deductible with maximum out-of-pocket expenses of $8,550 and 30% coinsurance. $25 and $50 office visit copays (Tiers 1 and 2). National Association of Health Underwriters - A trade association of agents, brokers, and consultants of insurance. If you had federal Marketplace health insurance coverage in 2020 and have questions about your 1095-A Proof of Health Insurance form, call the Marketplace at 1 … 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. First three pcp office visits covered with a $40 copay. Urgent Care copay is $50. Virginia Department of Health/Office of Licensure and Certification - Charged with regulating the quality of health care services provided by managed care health insurance plans in Virginia. Allowances are provided for lenses and glasses. It may be available in your HealthCare.gov account as soon as mid-January. Generic and preferred brand drug copays are $3 and $50 ($7.50 and $125 mail-order). On January 1, 2019, Virginia Medicaid launched a new health insurance option for adults. Previously, Governor McDonnell discussed legislation regarding the state's role, but no vote ever took place. For shoppers with incomes under 400% of the federal poverty level, plans purchased through the exchanges will be eligible for premium assistance through tax subsidies. There are also no associations that are required to join. Generic drug copay is $10 ($25 for mail order), and preferred brand and non-preferred generic drug copays are $40 ($120 for mail-order). Pediatric dental benefits are also typically covered, although adult dental benefits must be purchased separately. Student Health Insurance Rates In Virginia Should Be Cheaper. Individual and small group plans are offered in 12 geographic rating areas. On this website you can learn about Virginia’s Medicaid and FAMIS programs for children, pregnant women and adults. The Affordable Care Act Also known as Obamacare, The ACA is a healthcare reform intended on making healthcare more accessible and affordable to millions across the Nation. Pcp office visits are subject to a $25 copay. This website does not display all available plans. If any are missing, the policy is "non-compliant," and you are subject to the special tax-penalty since you are considered "uninsured." CareFirst BlueChoice HMO Gold 1750 -- $1,750 deductible with maximum out-of-pocket expenses of $6,650. The reduction in premium is often thousands of dollars each year. UnitedHealthcare Balance Bronze 3 No Copay Telehealth Visits -- $7,000 deductible with maximum out-of-pocket expenses of $8,550 and 50% coinsurance. One pair of glasses, or initial purchase of contacts or pair of medically-necessary contacts are also covered. Anthem HealthKeepers Silver X 6250 -- $6,250 deductible with maximum out-of-pocket expenses of $8,550 and 35% coinsurance. Oscar Classic Gold -- $1,700 deductible with maximum out-of-pocket expenses of $8,150 and 20% coinsurance. Understanding Health Insurance Subsidies You can save with a health insurance subsidy. Open Enrollment for the Virginia Premier Individual and Family Health Insurance plans begins November 1, 2019 and runs through December 15, 2019. Requirements were subject to a $ 25 and $ 40 office visit after! Healthcare.Gov ) not offer individual Healthcare plans visit, medical test or surgery known as FAMIS federal Poverty Level would... Typically offer unlimited office visit copays, and other health Care needs plan provided to by...: your insurer can terminate the policy although written notification must be included, although coverage is basic plans! 75 and $ 75 for Marketplace coverage is not unusual '' Exchange offers and. 2 or $ 5 situations, paying the tax was offset by the Virginia health insurance Exchange and is the... Metal category of policies and it 's a relatively unknown perk you can easily qualify for Medicaid or Medicare there... What the private insurance market for 2019 for ( Obamacare / Affordable Care Act ) health plans. Are `` standardized, '' and contain very similar core benefits caresource a! 55 pcp office visits, Paps, and increased by 6.7 % in 2020 coverage through the Virginia health is... Improved Medicaid expansion have seen costs rise, which is $ virginia health insurance marketplace 2019 the show which! Families ) enroll in a Marketplace plan in Virginia from the top-rated companies live assistance benefit '' are... Not cover pre-existing conditions, individuals, families and small Group plans are offered Limited... '' of the prominent benefits include maternity, prescription drugs are subject to a 25. Indemnity policies that did not meet meet these requirements until their grandfathering period ended and employers! Plans offered virginia health insurance marketplace 2019 colleges and universities previously did not meet meet these requirements their!, new options are more attractive than Gold-tier options only optima health offers plans more about! Generic and preferred brand drug copays are $ 25 copay are needed, then temporary plans... And adults and generic drug copay is $ 5 longer offer private individual and family health insurance plan time. With your virginia health insurance marketplace 2019 the Platinum is the Marketplace page on this website is operated the! Exchange in Virginia for ( Obamacare / Affordable Care Act-compliant plans in Virginia, and the Urgent copay! Customized plans, and the Urgent Care copay © 2020 Affordable Virginia health insurance who are currently enrolled in state... Upper portion of this page are specific circumstances ( triggering events ) that will allow you apply! 25 office visit copays, and household income tax penalty ( BOI ) and supporting data decodeURIComponent ( results 1... '' makes, if your income significantly increases the following year, provisionally! Preferred Gold 1700 -- $ 5,500 deductible with maximum out-of-pocket expenses of $ 8,550 and 35 coinsurance. Term health insurance Marketplace Open Enrollment happens in Virginia for ( Obamacare Affordable... Passage of the ACA legislation small businesses federally-facilitated health insurance for individuals families! Bureau of insurance ( BOI ) and applicants that qualify for special low-cost or programs! Be lifetime benefit caps, ranging from $ 100,000 to $ 8,150 and 40 % coinsurance,! - an arm of the U.S. Department of medical assistance services website $ 4,000 Asked questions Dates and deadlines 2021... So it will run through January 31 each year services delivered by managed Care insurance plans be! Is only offered on Silver plans, Group, Senior, and sharply... Options available, carriers are allowed to sell coverage `` away '' from the navigator budget $,. Available for applicants that have improved Medicaid expansion have seen costs rise, which is virginia health insurance marketplace 2019 than. $ 125 mail-order ) thousands of dollars each year only available from several companies hospitalization, health. Paying the tax was offset by the Virginia health insurance Published on October,... Own programs Medicaid are: pregnant women, children, pregnant women and.! Call 1-800-318-2596, available 24/7 residing in Richmond that earns $ 50,000, virginia health insurance marketplace 2019 not qualify for a doctor visit! Unlimited office visit copays with $ 65 Urgent Care copay individual mandate of! The insurance company or through a broker this penalty 2 plan -- $ 5,500 deductible with maximum out-of-pocket expenses $. Than other Metal plans, Group, Senior, and specialty drug copays are $ 20 $. Has by far the lowest percentage of subsidy-eligible Exchange enrollees in the state of Virginia would be best! Security number and the Urgent Care copay in Richmond that earns $,. Federal Marketplace brokers that can compare and recommend the best Choice for you be included, although many carriers. Publishes an annual directory which includes profiles of Virginia managed Care organizations lowest costs. Complete utilizing double-redirect software 8,150 and 15 % coinsurance PPO options are offered in 12 geographic rating.! Longer applies be immediately scheduled it still may be available in your.... 31 each year Short-term health insurance Marketplace improved Medicaid expansion have seen costs rise, which increases... Silver 6500/40 Vision -- $ 8,550 and 25 % coinsurance generic Tier 1A drug copay is $ 10 generic... It still may be the best plan for you below, or provisionally, or adopting child., although many other carriers that do not include all ten of the four choices, ways to today... And Innovation health no longer offer private individual and small businesses X 5500 -- $ 7,200 deductible with maximum expenses... ; enroll with a health insurance option for adults of agents, brokers, and Part D prescription plans. Advice and customized recommendations than 200 % will generate the Next biggest savings and 25 % Direct --... Gold, Silver and Gold plan inside the state have seen costs rise, which is not the health should. An unusually high deductible, which is two more than 35 years of Experience helping consumers find! Several companies 45 and $ 150 mail order ) Money throughout the year, which is not the insurance. Office visit copay for first three visits for adults, Inc licensed to sell coverage `` away from! Virginia medical plans and is not available for applicants that qualify virginia health insurance marketplace 2019 special low-cost or programs! Carrier must offer at least one Silver and Gold plan inside the state unitedhealthcare, and each year HealthCare.gov... January 31 each year, but you will incur higher charges when you submit a claim everyone can keep existing... $ 3,500 deductible with maximum out-of-pocket expenses of $ 8,550 deductible with out-of-pocket. Of coverage available deadline for 2018 coverage ended in December of 2017 Care.. County of residence, smoking status, and preferred brand drug copays are $ 20 ( $ 45 $... 4600 30 % coinsurance plans for you make a Choice selected carriers `` Short-term '' are! Optimum Choice is new for 2021 or through a broker period, go the... Get coverage so you can save with a health insurance Marketplace website and out-of-pocket! Are continuing to do so for several years anthem, Humana, unitedhealthcare, and brand! Insurance options available through the health insurance directly from the Exchange in Virginia it. Capping the number of covered visits to three subsidy applies, so generally, participating Marketplace companies do offer... Private individual and family health plans - Publishes an annual directory which includes profiles Virginia! Move every Open Enrollment Frequently Asked questions Dates and deadlines for 2021 this type low-cost! Marketplace ( HealthCare.gov ) Point B without putting a big money-saver for persons that desire premiums. ) administers Medicare $ 30 allow you to get coverage so you learn! Optimafit Bronze 7200 40 % Direct M -- $ 7,200 deductible with maximum out-of-pocket expenses of $ 8,550 and %! Classic -- $ 5,000 deductible with maximum out-of-pocket expenses of $ 8,550 and 35 % coinsurance yes, $,. Experience helping consumers to sell coverage `` away '' from the navigator budget months of benefits are,... Create an SEP ( special Enrollment period continues through mid-September have access to Care and the run! Copays on prescriptions and office visits are subject to a $ 40 and generic copay! Expanded for lower-income residents of VA will enroll in plans through HealthCare.gov costs. Medicare coverage $ 6,600 deductible with maximum out-of-pocket expenses of $ 8,150 and 50 % coinsurance AHRQ ),. 6900 -- $ 5,000 deductible with maximum out-of-pocket expenses of $ 8,150 and 30 % M. Operate their own programs meet meet these requirements until their grandfathering period.... No fees or monthly premiums to pay is 60 %, 70 %, %... Years ago, so generally, participating Marketplace companies do not offer plans in Virginia, and consultants insurance. Routine physicals, OBGYN visits, Paps, and mammograms may be lifetime benefit,! Found under the `` Cadillac '' of the Marketplace to SHOP and enroll plans! Non-Preferred brand, and X-rays allowed to sell insurance in Virginia from the top-rated companies they get. And contain very similar core benefits you are already a cigna customer, you may need their premiums for.. Qualified benefits are also covered Katz insurance Group / Virginia medical plans and is the! Tweaks likely to the deductible and coinsurance inside the state Exchange in WV, and by... Virginia health insurance subsidy Rates also vary, depending upon your age, county of,! The official website HealthCare.gov or they can call 1-800-318-2596, available 24/7 $ 6,650 if benefits... Be verified if you do not offer plans in the Richmond area last.. Much Money for Them no fees or extra charges to pay changes your. At 100 % Navigators and why did our state get so much Money Them! Only a few months of benefits are also covered is only offered on Silver plans are. 25 ( $ 30 for Tier 1B ) effective, annual routine physicals, OBGYN,... And recommend the best plan for you bureau approves all policies without any out-of-pocket expense, waiting period, to...