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Get Health Insurance in Virginia

RCP reverted edits by 24.71.108.127 (talk) to revision #26287711 by MiscBot

←Older revision Revision as of 01:15, 22 December 2019
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The time to think about health insurance is before you need it. While modern health care can work miracles, even a moderately serious illness can wreak financial havoc if you don't have insurance. Traditionally, most people were covered through a plan negotiated by their employer. However, as the definition of work changes with part-time, freelance, and contract positions, more people are managing their own health insurance. You have many options in Virginia to choose from and you should be able to find a plan to suit your needs and budget.
   
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[[Category:Health Insurance]]
   
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== Steps ==
   
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===Assessing Your Health Insurance Needs===
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#Examine your options for health insurance. Depending on your situation, you may have several avenues for obtaining health coverage in Virginia. Each option has pluses and minuses, but with some research, you will likely find an option that suits your needs and budget.[[Image:Get Health Insurance in Virginia Step 1 Version 3.jpg|center]]
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#* Virginia has a federally-facilitated health insurance marketplace<ref>https://ift.tt/36QSUVs> or you can buy insurance directly from the insurance company.
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#* If you are under the age of 26, you may still be eligible to be covered on your parents' employer or private healthcare plan. The Affordable Care Act (ACA), commonly called "Obamacare" raised the age of eligibility to 26. Plans vary, but generally, you are no longer required to be in school or live in your parents' home.<ref>https://ift.tt/35HKUpz>
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#* Investigate if your employment or your spouse's job offers health insurance. Even if you are working part-time, some companies offer coverage after a certain period of employment.
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#* As of the end of 2015, Virginia has not expanded Medicaid coverage as allowed under the ACA. However, if you are low-income as defined as 143 percent of the federal poverty level, you and your children, if any, may qualify for health coverage through the Virginia Medicaid program.<ref>https://ift.tt/2Zb7eFG> Eligibility is a complicated formula, but as a general guide, if your household income is under $2,800 per month for a family of four, you may be eligible for Medicaid in Virginia.
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#Consider your medical care needs. Before the ACA, if you had a chronic illness, such as diabetes, or an old injury, such as a torn rotator cuff, you would likely be either denied coverage or your condition would be excluded. However, as of January 1, 2014, you cannot be denied coverage for any pre-existing condition.[[Image:Get Health Insurance in Virginia Step 2 Version 3.jpg|center]]
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#* When looking at the scope of coverage you may need, look at your day to day medical needs. For example, if you regularly take medication to control a health condition, then prescription drug coverage should be a priority.
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#* Another consideration is how often you may need to go to office visits, both with your regular doctor and any specialists or mental health professionals. If this is important, look at office visit co-pays.<ref>https://ift.tt/2tH4xA1> It may be more economical for you to choose a plan with a higher deductible<ref>https://ift.tt/2EGWVQn> in exchange for a lower co-pay for office visits.
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#Research medical care providers in your area. The key to most insurance plans is the provider network.<ref>https://ift.tt/2SfMafG> This is the group of doctors, healthcare providers, hospitals, and pharmacies in your area that have contracted with the insurance company. Most large insurers have searchable provider directories on the company website.[[Image:Get Health Insurance in Virginia Step 3 Version 3.jpg|center]]
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#* If any of your doctors are in another state, you will need to discuss this with your potential insurer.
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#* Most hospitals and doctors will have agreements with the large insurance companies. However, if you see an unaffiliated or non-mainstream practitioner, such as a homeopath, there may be issues. If you have any concerns, discuss insurance coverage with your doctor's office manager.
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#Understand Open Enrollment and Qualifying Events. You can't sign up for insurance any time you want. There are two circumstances when insurance companies accept new customers.[[Image:Get Health Insurance in Virginia Step 4 Version 3.jpg|center]]
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#* Open enrollment is generally between November 1st and the end of the year. Under the ACA, enrollment extends into January of the next year.<ref>https://ift.tt/2PMbPLy>
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#* A qualifying event is a significant change in your circumstances including getting a new job, moving to a different state, marriage, a new baby or adoption, or certain changes in your income.<ref>https://ift.tt/2PL14J3> When you have a qualifying event, you have 30 to 60 days to enroll in a health insurance plan.<ref>https://ift.tt/2sRtd8q>
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===Navigating the Health Insurance Exchange===
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#Create an account at the federal insurance website. Regardless of how you eventually obtain health insurance, you should review the plans that are available through the federal exchange.<ref>https://ift.tt/36QSUVs> These plans are heavily regulated and will give you a good baseline to evaluate what is available in the insurance marketplace.<ref>http://kff.org/health-reform/state-indicator/state-health-insurance-marketplace-types/</ref>[[Image:Get Health Insurance in Virginia Step 5 Version 3.jpg|center]]
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#* At the website https://ift.tt/14vwSS3, you can browse the available plans by using the search wizard. Start by entering your zip code and work your way through the questions. This will give you a useful estimate.
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#* When you are ready, register for an account and create your online profile. You will need the Social Security number for all adults and children that will be on the plan. You should also have your most recent tax return and either pay stubs or income from self-employment.<ref>https://ift.tt/34HeVV3>
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#* This is your permanent account. You must keep it updated if you move, change phone numbers, email accounts, or have a significant change in your income.
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#* The exchange has a 24-hour phone helpline if you have any problems creating an account or navigating the website. Call 1-800-318-2596 or TTY at 1-855-889-4325.<ref>https://ift.tt/2JOgY1r>
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#Compare the offered insurance plans. Once you have created your profile, the system will show you all the plans available in your area. The system will also estimate whether you are eligible for a subsidy to help pay for your coverage.[[Image:Get Health Insurance in Virginia Step 6 Version 3.jpg|center]]
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#* If you are eligible for a subsidy, you have three choices. First, you can decline the subsidy and pay the full premium. Second, you can opt to have the subsidy paid directly to the insurer to reduce your premium costs. Finally, you can claim the credit when you file your tax return for the year. Regardless, you will have to reconcile the credit when you file your tax return. Consult with a tax professional to determine which option is the best choice for you.<ref>https://ift.tt/2MkLstX>
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#* Insurance plans are broken into four categories: bronze, silver, gold, and platinum. The breakdown is the amount that the plan pays for your medical care after you meet the deductible. Bronze plans pay 60 percent of costs, silver plans pay 70 percent, gold plans pay 80 percent, and platinum plans pay 90 percent.<ref>https://ift.tt/2M62RGW> Premiums, deductibles, co-pays, and prescription drug coverage will vary by category and plan. At this stage, take your time to review all of the plans offered. When you are logged in with your profile, you can save interesting plans to review in more detail later.
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#* Each plan will link to the insurance company summary of plan benefits. Review each potential plan carefully to get the best value for your payment. If you have any questions, contact the insurance company directly.
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#Verify the availability of medical providers under the plans. Insurance is of no use if you do not have a good choice of doctors, hospitals, and pharmacies. Check the insurance company's provider directory or contact the doctor's office and ask if they accept the plan.[[Image:Get Health Insurance in Virginia Step 7 Version 3.jpg|center]]
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#* Many of the more economical plans strictly restrict benefits to your home state. If you live in a border area or need to see specialists in another state, consider a plan with a nationwide network. It will cost more, but may be necessary for you to get the coverage you need. Contact the insurance company to verify the geographical scope of coverage.<ref>https://ift.tt/2sPC6iQ>
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#Complete your enrollment and maintain your health insurance. You can choose and enroll for a health insurance plan directly through the exchange website. The site will walk you through the process including calculating any subsidy you may be eligible for. The insurance company will confirm your registration and send you plan documents.[[Image:Get Health Insurance in Virginia Step 8.jpg|center]]
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#* Once your enrollment is complete, you will pay your premiums directly to the insurance company. Most offer a choice of auto-pay, online payments, or through the mail by check or money order.<ref>https://ift.tt/35NG0HJ>
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#* Your premium must be paid by the due date every month or your policy may be cancelled. If you are having financial difficulty, contact the insurer directly to discuss payment arrangements.
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#* Toward the end of the plan year and before open enrollment, you will have the option to keep your current insurance or you can go back to the exchange and see if there is a different plan that interests you.
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===Looking at Insurance Outside of the Exchange===
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#Talk with a local insurance agent. You are not limited to the exchange for finding health insurance. Most insurance companies offer plans that meet the requirements of the law, but are not part of the federal or state marketplace. Strongly consider working with a licensed insurance agent to help you navigate the open market and get the best deal for you and your family.[[Image:Get Health Insurance in Virginia Step 9.jpg|center]]
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#* You will not be eligible for any subsidy or other income-based premium assistance if you shop outside of the exchange.<ref>https://ift.tt/2QmszYT>
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#Consider an insurance broker. Unlike an agent who works primarily for one insurance carrier, a broker can shop with several companies in the open market and search out the best insurance deal for you and your family. A broker is like having several agents working for you at the same time. The disadvantage is that you will likely receive less customer service after the sale because the broker doesn't have as close a relationship with the carrier.<ref>http://www.bankrate.com/finance/insurance/health-insurance-sherpa-agent-or-broker-1.aspx</ref>[[Image:Get Health Insurance in Virginia Step 10.jpg|center]]
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#* As with an agent, if you end up purchasing health insurance outside the exchange, you will not receive and income-based premium assistance.
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#Contact insurance companies directly. You can browse insurance plans through the websites of the health insurers. Some will even allow you to generate an online quote. However, you should follow up with a phone call to make sure of pricing, provider availability, geographical coverage, and prescription drug benefits.[[Image:Get Health Insurance in Virginia Step 11.jpg|center]]
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#Consider temporary or short-term health insurance. If you are in a position where regular health insurance is not an option, you may want to consider short term insurance. For example, if you are attending school or an extended volunteer assignment or job outside your normal home coverage area, a bridge policy can protect you until you are ready for a regular plan.<ref>http://www.inc.com/zoe-henry/5-things-to-know-about-short-term-health-insurance-plans.html</ref>[[Image:Get Health Insurance in Virginia Step 12.jpg|center]]
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#* Short term plans are not strictly regulated by the ACA. You can be denied for a pre-existing condition.
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#* These plans tend to be geared toward major medical issues and may not have reduced co-pays for office visits and prescription drugs. 
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==Warnings==
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* The ACA requires that you obtain health insurance or face a fine in the form of a tax penalty. Consult a tax professional to determine what type of penalty you could be facing and how it would be calculated and assessed. 
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== Related wikiHows ==
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*[[Get the Most from your Health Insurance]]
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*  [[Prepare for a Health Insurance Physical]]
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*  [[Improve Your Love Life by Improving Your Health]]
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== References ==
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