Like any other state, the ability to buy an individual health insurance policy in Virginia depends on the health status of a consumer.
However,
there are certain circumstances when consumers must be allowed to buy individual health insurance from private insurers.
Some facts that consumers should know about individual health plans in Virginia:
• Except Anthem BlueCross BlueShield and CareFirst BlueCross BlueShield, private insurers in Virginia can turn down the application of a consumer to provide individual health coverage. Based on certain questions regarding health status of the consumers, insurers can impose certain limitations on an health policy.
• CareFirst and Anthem would give individual health plans to any Virginian regardless of the health status. CareFirst serves the Northern part of Virginia while Anthem serves the rest of the state. The rates offered by these insurers does not depend upon the health status but are customized according to age, location, etc.
• HIPAA eligible individuals in Virginia can buy health plans from any company. Moreover, the plans can't have any pre-existing exclusion period, etc. however, rates for such policies are not regulated.
What is the coverage provided by individual health plans in Virginia?
The coverage provided by any individual health plans in Virginia varies. There is no law in Virginia for insurers to sell standardized policies. The health insurance plans can be customized according to the needs of an individual. However, Virginia does require all health insurance plans to cover certain benefits including mammograms and postpartum care.
Does individual health plans in Virginia cover pre-existing medical condition?
• Insurers in Virginia can impose pre-existing condition exclusion periods, which should not exceed 12 months.
• Insurers in Virginia can also impose elimination riders, which means that coverage for a health condition or even an entire body part or system is excluded.
• However, for individuals who are HIPAA eligible, no pre-existing condition exclusion periods or elimination riders can be imposed
What could be the costs of an health plans in Virginia?
• Like mentioned earlier, the charges for an insurance policy depend upon the health status. For individuals with expensive health conditions, the charges would be higher. There is no law in Virginia that prohibits Virginia health insurers from charging you more because of your health status.
• Unlike life insurance, the premium charges of a health insurance policy might increase annually depending on the age of the individuals.
Can an health policy in Virginia be cancelled?
• The law in Virginia mandates that the individual health coverage policy can't be cancelled because a consumer got sick. This law is called guaranteed renew-ability. However, the individuals have this protection if they pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area.
• In case of short-term or temporary health insurance policies, the individuals might need to renew their policies after a specific period of time.
