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Medical Insurance in Virginia: An Overview

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Medical Insurance in Virginia

Medical Insurance in Virginia

Introduction: The health insurance condition in Virginia is average, in comparison to rest of United States. In accordance to a survey, accomplished by The Center for Disease Control, more than 12% of the total Virginia individuals were uninsured for Virginia medical insurance for each year, between 2001 and 2003.

In the below-mentioned abstract, we have provided useful information on Virginia medical insurance regulations and Virginia medical insurance alternative options.

Regulations for Virginia Medical Insurance

There are some regulations established by the state insurance department that the Virginia medical insurance providers should strictly follow

  • All Virginia individuals who have Virginia medical insurance policy through a group or employer can not be refused or restricted obtaining medical insurance through that policy.
  • Virginia individuals looking for individual Virginia medical insurance, however, can be refused or restricted getting coverage.
  • All Virginia individuals seeking for individual Virginia medical insurance are, however, able to access coverage through CareFirst Blue Cross Blue Shield or Anthem Blue Cross Blue Shield, based on demographics.
  • All Virginia health insurance plans should have guaranteed provision for renewal. Guaranteed renewability provision lets an individual renew his or her existing medical insurance plan. However, to avail the facility, he or she should have disbursed all the premiums in time and provided no fake information.
  • Virginia medical insurance companies can not deny a HIPAA qualified individual providing coverage under individual medical insurance policy. The insurers even can not impose a pre-existing condition waiting period, on them.
  • Other than Blue Cross and Blue Shield, all Virginia medical insurance organizations can reject an application for coverage depending on age, health and other criteria.
  • Virginia medical insurance companies can implement both of pre-existing condition waiting periods and elimination riders. However, none of them are applicable on HIPAA qualified Virginia individuals.
  • Medical insurance companies can keep away medical conditions, body parts or body systems from coverage, even permanently for the entire term of a policy, through elimination riders.
  • Virginia medical insurance companies can refuse coverage for any pre-existing medical condition for no more than one year at the starting of a Virginia medical insurance policy.
  • Virginia medical insurance companies are allowed to investigate the health record of an individual dating back one year to know whether the applicant has been or should have been treated diagnosed or received medical advice for any health condition, before the commencement of a Virginia medical insurance plan. And if so, the condition would be considered as a pre-existing condition and therefore, subject to exclusion period.
  • Continual coverage from previous Virginia medical insurance plan can be credited towards new medical insurance plan for pre-existing waiting period; provided there should be no breakage in coverage for over 30 days.
  • As per state health insurance law, pregnancy may be considered as a pre-existing medical condition and thus, subject to an exclusion period.
  • All newborns and adopted children should be covered under parent's individual Virginia medical insurance policy that offers coverage for dependants. However, automatic coverage provision is available only for initial 30 days from the day of birth or adoption. The policy should be modified after that to accommodate the children, further.
  • Disabled and handicapped children should get coverage under their parent's medical insurance plan, even if they have exceeded the age limit.
  • Virginia medical insurance rates differ on the basis of health, age and other criteria. The rate of premium can be hiked at each renewal.
  • Virginia individuals between employers or medical insurance plans are able to apply for temporary Virginia medical insurance plans offered by some of the insurers.

Virginia Medical Insurance Alternative Options

To help the uninsurable or financially unable Virginia individuals to get coverage, the state of Virginia offers some Virginia medical insurance alternative programs that are discussed below:

  • Virginia Children's Medical Security Insurance Plan: This is the states' children's health insurance program that is especially designed to provide coverage to the children and teens. However, children from families, which are not qualified for Virginia Medicaid or otherwise unable to afford the cost of Virginia medical insurance, are eligible for the program.
  • Virginia Medicaid: The state program is available to the Virginia individuals who meet all the qualifying as well as income criteria.

Virginia Bureau of Insurance

BOI Main Mailing Address
P.O. Box 1157
Richmond, Virginia 23218


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