Virginia Health Insurance

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Health Insurance for the Well Informed

Currently in the state of Virginia, the number of uninsured non-elderly adults (age 19-64) has reached 793, 320 or 17% of the population while the cost of health insurance has risen 83.8% per year according to Families USA and Kaiser’s State Health Facts. Statistics such as these can make finding affordable health insurance nearly impossible; however, Health Plan One can help you explore your options and choose a health plan that best fits your needs.

In Virginia, individuals can either receive health insurance coverage through COBRA or HIPPA if they were recently covered by an employer health plan or through a private health insurance company. COBRA coverage is available for 18-36 months depending on qualifying events and benefits are the same as group programs. Benefits from HIPPA individual plans are based on the program selected. If individuals decide to go through a private health insurance company for coverage, plans will vary but insurers are required to offer certain benefits such as postpartum care and mammograms. Medical underwriting is allowed in Virginia without restrictions so that will determine eligibility for coverage. (www.coverageforall.org

For those individuals in Virginia unable to obtain private health insurance due to medical conditions, High risk plans are offered through Anthem Blue Cross Blue Shield and CareFirst because there is no high risk pool available. Benefits such as postpartum care and mammograms are offered under these insurers. In order to be eligible, you must not be eligible for any other insurance, including individual, group or public, you must be a Virginia resident and plan availability will depend on county residence. (www.coverageforall.org)

In Virginia, medical underwriting is allowed without restriction, except standardized plans. For standardized plans, rates may vary plus of minus 25% from the indexed rate based on the age, gender, geography, health status, and claim history of the group. There is a 6 month look back and 12 month exclusionary period limit for preexisting conditions for those without prior health coverage.

The average monthly premium for group and small business health insurance in Virginia in 2006 was $246 for single coverage but can depend on employer contribution and $645 for family coverage according to www.ahipresearch.org.

There are some factors in Virginia that determine eligibility for group and small business health insurance which include:

- Company size 2-50 employees

- Owner can count as an employee

- Proprietor-name on license must draw wages

www.coverageforall.org

Virginia offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce.

Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.

Children (ages 1-5)-133% of the Federal Poverty Level
Children (Ages 6-19)-133% of the Federal Poverty Level

Pregnant Women and Infants

Pregnant Women-133% of the Federal Poverty Level
Infants (ages 0-1)-133% of the Federal Poverty Level

Non Working Parents- 24% of the Federal Poverty Level

Working Parents- 36% of the Federal Poverty Level

Medically Needy Individual- 47% of the Federal Poverty Level

Medically Needy Couple- 42% of the Federal Poverty Level

Supplemental Security Income Recipients- 74% of the Federal

Aged, blind, and disabled- 80% of the Federal Poverty Level

Hospital care, doctor’s visits, prescriptions, mental health services, and rehabilitative services.

Co-payments vary. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

You may learn more about Virginia Medicaid at http://www.dmas.virginia.gov/rcp-medicaid_hand_book.htm.

Virginia offers the FAMIS program to children under the age of 19 whose family incomes are up to 200% of the Federal Poverty Level. The children must be residents of Virginia, U.S. citizens, without health insurance for the past 4 months and ineligible for the state employee plan or Medicaid. Please visit the FAMIS website for more detailed information at http://www.famis.org/.

Virginia also offers a program specifically for pregnant women to assist them in obtaining services. Please visit the Baby Care website for more detailed information at http://www.vahealth.org/babycare/index.asp.

Virginia Health Insurance Quotes

Virginia Health Insurance Companies

Virginia Group Health Insurance (Small Business: 1-50 employees)

Virginia COBRA Individual Health Coverage

Medicaid in Virginia

Other Virginia Health Insurance Programs