Virginia Health Insurance

Virginia (VA)

Individual Health Insurance Regulations

When it comes to insurance, medical insurance is crucial to protect your family against sickness or injuries. An appropriate health plan can save you from huge medical bills and secure your family's health. It is advisable to assess your budget and family's health care needs, before purchasing health coverage. If you live in Virginia, you can choose from various options of health insurance. The Virginia Bureau of Insurance controls the regulations under which the Virginia health insurers can sell private health insurance to individuals and families.
Although insurance regulations in the State of Virginia provide for individual policies to be medically underwritten, Anthem Blue Cross Blue Shield of Virginia and CareFirst Blue Cross Blue Shield of Virginia do offer some individual health policies on a guarantee issue basis. Individuals applying for guarantee issue products may not be declined because of their health status. Medically underwritten policies require that the insurer be provided an opportunity to assess both past and present medical history of the applicant. By utilizing the process of medical underwriting, the carrier may opt to provide coverage per the terms of the health plan; or offer modified coverage with specific limitations and exclusions; or deny coverage based upon the applicant's health history. The State of Virginia allows the use of elimination riders which, when used, will modify coverage to eliminate or exclude coverage of specific medical conditions. At the discretion of the insurance carrier, the elimination rider may be incorporated into the policy as either a temporary or permanent exclusion of coverage. Insurance regulations also provide the carrier a 12 month look back, 12-month exclusionary period limit on pre-existing conditions. Credit for prior medical insurance is only required for persons qualified for this waiver under federal HIPAA regulations.
Search for plans and the costs associated with them using the search box above. We provide individual, family, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you can get regular doctor checkups and therefore a low-cost premium.

Virginia (VA)

Small Group Health Insurance Regulations

The State of Virginia defines a small group as a group of employees numbering from 2 - 50. Pursuant to the federal Health Insurance Portability and Accountability Act of 1996, medical coverage for groups of this size must be written on a guarantee issue basis. This prohibits insurance carriers from declining coverage to a group or individual employee based upon their past or present medical history. For those applying to a group health plan, credit for prior coverage must be given. Applicants lacking prior creditable coverage are subject to a 6 month look back, 12-month exclusionary period for pre-existing conditions by the carrier. Virginia insurance regulations allow for small group rates to be medically underwritten. Any insurance company offering small group health plans in the state must offer some standardized plans. These plans are identical in benefits, regardless of the insurance carrier, but rates can vary from one insurance company to the next by no more than 25%. For all other health plans offered by that company, the plans may be medically underwritten with no rate restrictions.

Virginia COBRA and Continuation Coverage

Virginia does not have a state mini-COBRA regulation. Federal COBRA laws apply to companies that employ more than 20 people. The federal COBRA laws require the employer to provide the option to a departing employee to remain on the group health plan for a minimum of 18 months. In special cases, some persons may be entitled to 36 months of continued COBRA coverage under federal law. Under COBRA you are entitled to the same benefits that you had under your employer's group plan and the benefits might include drug, dental, and vision care. The COBRA recipient is responsible for paying the insurance premiums that the employer was paying for the coverage along with 2%. If you lose your group coverage, you may also be able to purchase a conversion policy that is offered by the insurance company that managed your group plan. These are permanent individual health plans, but the premiums may be considerably higher than COBRA coverage or other individual health plans.