Health Insurance with Federal Financial Help

Open Enrollment for the Health Insurance Marketplace is now closed.

To see if you are eligible for a Special Enrollment period, click here.

Health insurance helps you pay for medical care and prescription medicines when you are sick or hurt. It also pays for preventive care, like check-ups and vaccines to keep you healthy. Click here for more information on why everyone needs health insurance.

There is a lot of talk in the news these days about health insurance in the federal Marketplace. It is confusing and hard to follow! Here are the facts:

  • You must have health insurance or qualify for an exemption. You may have heard this referred to as the “individual mandate,” and it is still in effect. If someone doesn’t have insurance and is not exempt, they will have to pay a fee of $695 or more, depending on the number of uninsured people in their household.
  • Health insurance is available in all Virginia localities. Click here for a map showing health insurance companies in each city or county. While there will be only one health insurance provider offering coverage in 2018 in most Virginia cities and counties, you will still have choices.
  • You can get financial help when you buy health insurance on the Marketplace. Most Virginians who bought health insurance through the Marketplace for 2017 got financial assistance in the form of “premium tax credits” to help pay their premiums (82%) or special “Cost Sharing Reduction” Silver Plans with lower out-of-pocket costs (59% of Virginians). Here is more information about financial help available to buy health insurance on the Marketplace  or see if you might be eligible for a discount.

Premium tax credits reduced the average monthly health care premium to $97 per person in 2017. Those who get financial help are protected from large rate increases. As the cost of    insurance goes up, so does the amount of financial assistance.

You may also be eligible for Cost Sharing Reductions, or CSRs, that lower out-of-pocket costs, like co-pays and deductibles. If your income is below 250% of the federal poverty level ($30,150/year for an individual; $51,050/year for a family of 3), you may be eligible.

Some Marketplace “Silver Plans” are special plans with CSRs for people who are eligible. All insurance companies are required to offer Silver Plans with CSRs to people who qualify. These plans will be available in 2018.

Click here to learn What You Need to Know about Health Insurance or here for FAQs from Enroll Virginia.