SCC Urges Virginians to Prepare for Shopping for Health Insurance
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Contact: Katha Treanor
Phone: 804-371-9141
Email: Katha.Treanor@scc.virginia.gov
RICHMOND – Many consumers will soon shop for health care coverage during the open enrollment period for the 2021 health insurance marketplace through HealthCare.gov. This open enrollment period for plans under the federal Affordable Care Act (ACA) runs from November 1 through December 15, 2020. After this date, consumers may only buy an ACA-compliant health insurance plan if special enrollment conditions apply to them.
Special enrollment periods (SEP) are available for people who may have recently lost their employer-sponsored health insurance coverage or have had a qualifying life event such as a household change. To learn more, visit HealthCare.gov's SEP page.
“For 2021 and again in 2022, enrollment and eligibility by Virginians will continue on HealthCare.gov, the federal health insurance platform. Virginia’s transition to a state-based system – the Virginia Health Benefit Exchange – will be ready by plan year 2023,” said Victoria Savoy, director of the Virginia Health Benefit Exchange.
The Virginia Exchange was created by the 2020 Virginia General Assembly to be operated as a new division within the State Corporation Commission (SCC). It will be an online marketplace where qualified individuals can shop for, compare and enroll in health insurance coverage. Additionally, the Virginia Exchange will create a small employer program where eligible employees of qualified small employers will be able to enroll in coverage.
Whether you are thinking about changing plans or purchasing a new health insurance plan, the SCC encourages Virginians to review their coverage needs and thoroughly explore all their options. “Not all health plans are created alike, and some are not insurance,” said Virginia Insurance Commissioner Scott A. White. He encourages Virginians to fully understand the coverage, costs and protections before they sign up for any health plan. “Understand enrollment periods, what ACA-compliant plans must cover and where to turn for legitimate information. If you have questions, the Bureau of Insurance can help.”
Consumer protection laws govern some types of health coverage, such as plans purchased through an employer or through the health insurance marketplace. Other types of plans such as health care sharing ministries and discount plans might be less expensive than health insurance plans subject to the ACA, but they are not insurance and do not offer the same protections as ACA-compliant plans.
Short-term, limited-duration health insurance plans are not available through the health insurance marketplace, but they are regulated health insurance plans. While they may, in some cases, be less expensive than plans offered through the health insurance marketplace, they often cover less than ACA-compliant marketplace plans; may deny eligibility for coverage or exclude services because of pre-existing conditions, and may apply dollar limits on the amount they will pay.
Whether shopping for health insurance on or off the exchange, the Bureau of Insurance and the Virginia Health Benefit Exchange encourage Virginians to carefully consider what health care services you and your family will need before you sign up for any health insurance plan. Ask yourself:
- Are anticipated services covered and are there any limits on coverage under each health care coverage option being considered?
- Are doctors and medications my family needs covered by the plan being considered?
- What are the monthly premiums and costs that coincide with using health services such as co-pays, co-insurance and deductibles?
Especially during open enrollment, keep the following in mind:
- In Virginia, HealthCare.gov is the official website to enroll in ACA plans.
- For free help understanding your options, find an application assister (navigator and certified application counselor) at Coverva.org/assistance/.
- Ask for details of any health plan in writing – including cost and coverage – and make sure you understand what you are purchasing.
- Look for a disclosure indicating whether the health plan complies with the ACA.
- The open enrollment period for the 2021 health insurance marketplace ends December 15, 2020. Anyone who contacts you to sell individual health insurance plans through an "enrollment period" outside of that is not selling an ACA-compliant policy.
- Do not provide personal information or send money in response to unsolicited calls or emails.
- To verify that an insurance agent, agency or company is licensed in Virginia, visit the Bureau’s website at scc.virginia.gov/boi/ConsumerInquiry/default.aspx.
- Be wary of telemarketers from the "national enrollment center," "national healthcare center," or other official-sounding name. The marketplace will not call to sell you health insurance.
For more information, contact the Virginia Bureau of Insurance toll-free at 1-877-310-6560 or visit its website at scc.virginia.gov/pages/Insurance. Use the online comparison tool to compare plans. To learn more about the new Virginia Exchange, visit scc.virginia.gov/pages/Health-Benefit-Exchange-(6).
Free translation services are available. Call the Exchange hotline at 1-833-740-1364 or the Healthcare.gov hotline at 1-800-318-2596 for assistance.
