Claire Smith Last Updated On: August 11, 2023

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Your Shortcut to the Best Health Insurance in Virginia

Skimping on health insurance might save you a few bucks now, but it can cost you in the long run. You deserve access to great healthcare, and good health insurance is the way to get there.

This is why we’re about to take you through each and every important detail about health insurance in The Old Dominion. Keep reading to learn how to find cheap health insurance in Virginia!

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Table of Contents

Understanding the Type of Health Insurance You Need

While healthcare is not free, it can be made more affordable by purchasing a health insurance policy. These kinds of insurance plans help with a wide range of medical costs, keeping your bank account as minimally impacted as possible. 

The absolute first thing that you must do before purchasing health insurance is to evaluate your needs. Since there are so many different kinds of policies available for purchase, you need to have a good idea of how you want your health coverage to work. 

Ask yourself the following questions to get started:

  • What medical costs do I anticipate in the near future? What about the distant future?
  • Do I have a spouse and/or children to include in the policy? If so, what are their anticipated healthcare costs?
  • What is my income?
  • What is my monthly budget?
  • How much could I reasonably afford in copays and deductibles?
  • Which insurance providers are available in my area?

If you encounter trouble answering any of these questions, don’t sweat it! Insurance agents are more than happy to help you understand your personal insurance needs.

Where to Purchase Health Insurance in Virginia

Once you have an idea of what kind of policy you want, you can go about selecting a policy. There are four places that you can find health insurance in Virginia:

  1. The health insurance Marketplace
  2. Private insurance company
  3. Government-sponsored healthcare programs
  4. Employer-sponsored health coverage

Next, we’ll go into detail on each of these types of health insurance plans. 

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The Virginia-State Health Insurance Marketplace

Each of the 50 states has its own health insurance marketplace. The term “exchange” is used interchangeably with “marketplace.”  The marketplace is where you can go to buy health insurance plans from certain providers. Access to certain providers will depend on which county you live in because no single provider sells plans throughout the entire state.  That said, the most widely offered insurance providers on the Virginia health insurance exchange are:
  • Anthem Health Keepers
  • Optima Health Plan
You can sign up for a new plan or change your plan every year during open enrollment, which takes place from November 1 to January 15 in Virginia. 

Metal Tier System

Regardless of which company you select, you will have to choose a plan from their metal tier system. The metal tier system is a way of categorizing health insurance policies of differing prices and coverages.  Here’s a breakdown of the standard tiers that are offered:
  • Platinum Tier Plans: These have the highest premiums and lowest deductibles. They offer the most coverage on the marketplace, so they are ideal for those anticipating a great deal of medical expenses.
  • Gold Tier Plans: These have high premiums and low deductibles. They are ideal for people who anticipate many medical costs.
  • Silver Tier Plans: These are the middle-of-the-road policies. Their premiums are cheaper than gold and their deductibles are slightly higher. They are an affordable option for those anticipating a moderate amount of medical costs.
  • Bronze Tier Plans: Have low premiums and high deductibles. They are ideal for people in good health who don’t anticipate much in the way of medical costs.
  • Catastrophic Plans: Have the cheapest premiums and the highest deductibles. They are ideal for those in great health with a very limited budget. Note, these plans are not available to everyone. You typically need to be healthy and under the age of 30, or experiencing a financial hardship like homelessness.
No matter what kind of plan you end up selecting, comparing multiple insurance quotes guarantees that you’ll find affordable health insurance in Virginia. 

Health Insurance Tax Credits and Subsidies

If you purchase a health insurance policy on the Virginia health insurance exchange, you might qualify for certain tax benefits. 

Those who make less than 400% of the federal poverty level qualify for tax credits on marketplace plans, which greatly helps to reduce costs. 

Also, those who purchase a silver plan and make less than 250% of the federal poverty level can qualify for additional reductions. This makes silver plans often the most affordable option, with great coverage.

Private Insurance Companies

Sometimes it’s necessary to purchase a health insurance plan from a private insurer instead of on the marketplace. Perhaps you are not satisfied with the health insurance plans available on the exchange, or perhaps you missed the ACA enrollment period and are in need of a short-term health insurance plan. 

Be sure to do your research before committing to a policy. Private plans aren’t bound by the same ACA requirements as plans on the marketplace, so you might get less coverage for more in premiums.

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Restrictions on Short-Term Health Insurance in Virginia

Virginia has more restrictions and regulations surrounding short-term health insurance compared to the rest of the country.

In 2021, Virginia mandated that short-term health insurance plans:

  • Must not exceed three months for initial coverage period
  • Must not exceed six months for a total length of the coverage period
  • Are not available for purchase during the ACA open enrollment period

It’s also crucial to note that short-term health insurance in Virginia does not need to include the same essential health benefits that other plans do. This means that your short-term plan likely won’t include coverages for:

  • Maternity care
  • Mental health services
  • Prescription drugs

Even though there are many restrictions on short-term health insurance plans, there are also many reasons why you may need one. 

Sometimes special circumstances occur outside of the marketplace open enrollment period and you need coverage to hold you over until the next period. Maybe you added a dependent, or lost your job. Whatever the reason, a short-term health insurance policy from a private insurance provider is an option but shouldn’t be considered a long-term solution. 

Government Sponsored Healthcare Plans

There are two government-sponsored healthcare plans that Virginians might be eligible for: Medicare and Medicaid. 

Medicare

Medicare is for people who are 65 years of age or older and for those with specific disabilities such as Lou Gehrig’s Disease or End Stage Renal Disease. 

There are different parts to Medicare coverage and not all of them are essential. Here’s a breakdown:

  • Original Medicare includes Part A and Part B. Part A covers emergency care and is free of charge, while Part B covers outpatient care and has a reduced premium.
  • Medicare Advantage is also called Medicare Part C. These are Medicare plans purchased from private insurance companies offering more extensive coverage, including Parts A,B,D, and often vision and dental.
  • Medicare Part D includes prescription drug benefits and can be added to original Medicare for an extra cost.

Everyone automatically qualifies for Medicare at age 65 and there are penalties for not enrolling on time, unless you have valid health insurance from another source, like your job.

Medicaid

Medicaid is where you can turn to for low income health insurance in Virginia. Those who make up to 138% of the federal poverty level can receive Medicaid free of charge. 

Medicaid benefits typically include:

  • Vision care
  • Dental care for children
  • Hospitalization and clinic treatment
  • Laboratory and x-ray services
  • Doctor services, nursing services, medical and surgical dental services
  • Family planning and midwife services
  • Nursing facility services for people aged 21 or older
  • Home healthcare for people eligible for nursing facility services
  • Pediatric and family nurse practitioner services
  • Screening, diagnosis, and treatment services for persons under the age of 21

Medicaid helps provide healthcare coverage to those who wouldn’t otherwise be able to afford it. 

Employer-Sponsored Health Insurance

Last but not least are the employer-sponsored plans. Insurance companies often make deals where they give reduced rates to employers. They do this because an employer can sign up many employees with their company. 

If your employer has a sponsored health insurance plan, then it’s quite simple to enroll. Just speak with your employer to get started. Oftentimes, your employer will subsidize part or all of your premiums, making it an affordable option. 

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The Average Cost of Health Insurance in Virginia

We’ve nailed down the nitty-gritty details of where to find different kinds of insurance policies. Now we can talk about the cost. 

There’s no way to accurately measure exactly how much you’ll pay for health insurance coverage in Virginia. There are just so many different health insurance policies to choose from and so many factors that impact the price you’ll pay. 

The cost of health insurance is dependent on more than just the type of policy, it’s also affected by:

  • Age
  • Income
  • Health Status
  • County
  • Family size

While we cannot tell you exactly what you can expect to pay for health insurance, we can share the average price of a silver-tier marketplace policy for a 40-year-old, which lands at $382 per month. 

This is great news by the way! Virginia’s average is well below the national average of $560 a month for the same tier. Therefore, finding low-cost health insurance in Virginia will be a breeze. 

Find Health Insurance Coverage in Virginia

Everyone deserves affordable healthcare, regardless of your income or where you live. If Virginia is your home state, then you’re in luck: you’re saving on health insurance just by virtue of your zip code, compared to the rest of the U.S. 

At the end of the day, finding the best health insurance plans in Virginia is a matter of:

  • Understanding your needs
  • Comparing quotes from multiple companies
  • And seeking advice from experts.

Start by getting access to free quotes here so that you’re one step closer to getting the health insurance you need to feel your best—without breaking the bank. 

Claire Smith Claire is a creative entrepreneur with a variety of marketing and content creation skills, including blog and web copy writing, research, and strategy. She has a Masters in Cultural Studies from Queen's University and is known for thinking laterally about marketing, based on her deep knowledge of people and behavior.

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