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ObamaCare in Virginia


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About Obamacare in Virginia


The Affordable Care Act, widely referred to as Obamacare, has been put in place to reform the health care system and increase the affordability of health insurance across the nation. In fact, the new law states that most citizens must have health insurance by 2014 or they will be subject to a penalty that will be applied on their 2015 income taxes.



In Virginia, the Health Insurance Marketplace is available for all individuals seeking to acquire affordable health coverage. You can apply online to determine your eligibility for this program at: You may be a candidate for private health insurance or public insurance through Medicaid and the Children’s Health Insurance Program (CHIP). During the application process, you will need to provide detailed information regarding your income and household members. The veracity of the information provided is crucial, as these details will determine if you qualify for financial assistance to help you pay the insurance or if you can apply for a low-cost health plan.



Even though the enrollment period finalized on March 2014, you may still qualify for the special enrollment period; you can review the requirements at the Marketplace website. If you are interested in getting health coverage for 2015, keep in mind that open enrollment starts November 15, 2014.




Individual & Family Coverage


There are several health plans available for Virginia residents. You can use the Health Insurance Marketplace tools to search and compare plans before you decide which one better adjusts to your needs and budget. Regardless of the plan or the insurance carrier you choose, essential health benefits are guaranteed in all Marketplace health plans. This means that there is a basic set of coverage requirements that are offered by every single plan. Hospitalization, emergency room services, doctor visits, maternity care, laboratory services and prescription drugs are part of these core benefits. You will also be entitled to covered mental health treatments, rehabilitative devices, pediatric care and ambulatory services.



Marketplace health plans provide preventative services that are not subject to deductibles or other out-of-pocket expenses, such as vaccinations and blood screening. Besides these basic benefits, there are plans that will offer additional services. You may balance the costs and benefits to find a plan designed to meet your unique health needs.




Small Businesses


The Small Business Health Options Program (SHOP) Marketplace is available for VA small businesses that have fewer than 50 full-time employees. This specially designed marketplace is ideal for business owners looking for affordable health insurance for their workforce.



Amongst the advantages of using SHOP, business owners have control of the coverage they want to offer and they can decide how much they want to pay towards their employees’ insurance premiums. You can choose any of the four levels of coverage available in the Marketplace. You can purchase Bronze, Silver, Gold or Platinum plans. They all provide the same kind of benefits and service quality is guaranteed. However, each category differs on how costs are shared between the insured and the carrier. Another incentive for small business is the possibility of having health care tax credits. Companies with fewer than 25 employees may qualify for tax credits only if they purchase a Marketplace health plan.




Pre-Existing Conditions


One of the major changes introduced by Obamacare is the insurance coverage of pre-existing conditions. Insurance providers can no longer refuse treatment for these conditions. When you purchase a health plan, you are entitled to covered treatment of pre-existing conditions like diabetes, asthma, cancer and chronic pain. Medicaid and the Children’s Health Insurance Program (CHIP) are obliged by this same rule and they cannot refuse pre-exiting condition coverage either.



Only grandfathered individual health insurance plans are exempt from this reform. If you have a grandfathered plan that does not offer coverage for pre-existing conditions, you may decide to switch to a Health Insurance Marketplace plan that does. You can change plans during the open enrollment period or you may apply to determine if you are eligible for special enrollment past the enrollment deadline.

ObamaCare By State