Under the Affordable Care Act, Virginia will offer 15 health insurance plans in its new insurance benefit exchange that will include four levels of coverage — bronze, silver, gold and platinum. Enrollment begins October 1, 2013 with coverage effective January 1, 2014. It runs until March 31, 2014. The new marketplace will provide essential health benefits, including maternity benefits that are optional now, as well as new taxes and fees to finance the system.

Applications can be submitted through the insurance marketplace online, by mail or in person.

Call Center: (800) 318-2596

Website:www.healthcare.gov

Medicaid Expansion in Virginia

The Affordable Care Act allows states to expand their Medicaid programs to cover individuals earning around $15,400/year and families (of four) earning around $32,000/year. During the 2013 General Assembly session, Virginia legislators determined that certain reforms to Virginia’s program need to be implemented before Medicaid will be expanded. This means that access to Medicaid coverage for low-income Virginians is unlikely to expand earlier than July 2014.

Who can participate in the Virginia Heath Benefit Exchange?

The program is open to Virginia residents buying their own coverage and to the employees of small businesses (with 1-50 employees) and their family members.

What will the plans cover?

The federal Affordable Care Act ensures health plans offer a comprehensive package of items and services including:

• Ambulatory patient services

• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care

Additional Resources

Virginia Health Care Foundation
Virginia Department of Health and Human Services
Virginia Department of Medical Assistance Services