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Virginia Health Insurance

virginia health insurance coverage

The Affordable Care Act means Virginians are seeing many new health insurance announcements and changes. Gov. Bob McDonnell announced the state would not create its own health insurance marketplace, according to a July 2013 Kaiser Family Foundation profile of state exchanges.

Virginia is one of 21 states still debating whether to expand Medicaid. 

However, the Virginia Bureau of Insurance maintains a page with useful health reform resources, and you can visit the national health insurance marketplace at HealthCare.gov in order to apply for qualified marketplace health plans.

After you register and complete the application process during open enrollment, you can research plans and determine if you qualify for financial assistance. 

Do you qualify for a Virginia health insurance subsidy?

A January 2014 Kaiser Family Foundation profile of the uninsured in Virginia says about 45 percent of formerly uninsured Virginians now qualify for some type of financial assistance. Family size and income usually determine eligibility, and people who already have access to affordable medical plans may not qualify for assistance regardless of income.

The three main ways to qualify for public assistance are through tax credits (which come in the form of subsidies), Medicaid and CHIP. Subsidies can immediately be applied to your premium if you purchase your policy on the exchange.

Here’s how Virginia residents can get help paying for health insurance:

  • Typically, eligibility for Medicaid and CHIP is determined using 2014 poverty level limits, and subsidy eligibility is based on 2013 limits.
  • The ACA offers tax credits to people with income between 100 and 400 percent of the federal poverty level. This would be a family income between $23,550 and $94,200 for a family of four or between $11,490 and $45,960 for an individual.
  • In Virginia, nondisabled adults may qualify for Medicaid if they earn less than 51 percent of the poverty level, or about $12,165 a year for a family of four.
  • Children from Virginia families with incomes below 205 percent of the poverty level, or about $48,890 a year, might qualify for CHIP.

Some Virginians who earn too much to qualify for subsidies or already have access to medical insurance may choose to purchase private plans from the marketplace anyway. Insurers must provide certain mandated benefits, such as preventive care, and cannot exclude applicants based on a pre-existing health condition.

Marketplace health insurance companies in Virginia

These Virginia health insurance companies offer qualified plans on the marketplace:

  • Aetna
  • Anthem Blue Cross and Blue Shield & Anthem Health Plans of Virginia
  • CareFirst BlueCross BlueShield & CareFirst BlueChoice
  • CoventryOne
  • Innovation Health Insurance Company
  • Kaiser Permanente
  • Optima Health

Virginia health and coverage statistics

Virginia population (2013): 8,260,405
Population 65 and older (2012): 13 percent
Life expectancy (2010): 79.0 years
Number of Medicaid beneficiaries (2012): 826,100
Number of Medicare beneficiaries (2012): 1,052,900
Estimated number of uninsured residents (2012): 1,031,900

Overall state health ranking (2014): 26

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.

Virginia health insurance resources

Federal marketplace: https://www.healthcare.gov/

Virginia Bureau of Insurance: https://www.scc.virginia.gov/boi/

Department of Medical Assistance Services (Medicaid and CHIP): http://www.dmas.virginia.gov/.

Virginia Division for the Aging: http://www.vda.virginia.gov/

Kaiser Family Foundation: http://kff.org/tag/virginia/

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