23. April 2016 · Comments Off on Understanding Health Insurance in Virginia · Categories: Health Insurance

Health insurance remains one of the most talked about topics when it comes to products that are indispensable for residents of Virginia. With continued increase in healthcare costs, the importance of health insurance plans keeps increasing.

It goes without saying that residents of Virginia without insurance coverage are at a greater risk of experiencing financial insecurity during illness or injury. No doubt health insurance plans involve costs but affordable health policies are easily available and with the implementation of healthcare reforms, lots of options will be available to the Virginians.

Traditional indemnity insurance plans in Virginia

Traditionally, indemnity health insurance plans in Virginia offer reimbursement against the claims made by an insured person. The level of coverage provided by these plans could vary from basic to comprehensive depending upon the needs of the insured person. Accordingly, the costs of the health plans vary-premiums, deductibles, copays and coinsurance, etc.

Managed health care plans in Virginia

Unlike indemnity health plans, managed care health insurance plans involve a group of medical providers that offer comprehensive medical services. They are called preferred or participating providers.

There are basically three managed care options:

• Health Maintenance Organization or HMO

HMOs allow the insured person to select a primary care physician from the plan’s list of medical service providers. If it is necessary, the primary care physician will refer the insured person to a specialist.

• Preferred Provider Organization or PPO

PPOs allow the members to avail large medical care network. At a slightly higher cost, a PPO generally allows its members to receive care outside its network of providers

• Point of Service feature or POS

POS medical plans are special types of HMOs that allow the members to select a non-network provider at a slightly higher cost.

Impact of the Affordable Care Act of health insurance in Virginia

• Around 109,000 small businesses in Virginia will be helped with tax credit.

• Medicare beneficiaries will be mailed a check automatically to defray the costs of their prescription drugs.

• Early retirees would be provided options for reinsurance.

• $113 million federal dollars will be made available to Virginia starting July 1 to provide coverage for people with pre-existing conditions.

• With the new Act, Virginia enjoys the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status, for the very first time.

• 4.7 million people in Virginia with private insurance won’t have to worry about lifetime limits on the coverage.

• 344,000 individuals will not have to worry about to get dropped from insurance policies when they get sick.

• Children would be able to stay in their family health insurance policy till the age of 26 years.

What to look for while buying affordable health plans in Virginia

• Virginians should note what is the maximum coverage level offered in the health insurance plan. This should be the prime deciding factor.

• The second point should be the costs involved in a health plan. This could include premiums, deductibles, copays and coinsurance. Consumers can adjust these costs as per their budget.

• Virginians should make sure, if needed, that the health insurance plan offers prescription drug coverage, doctor visits and hospitalization benefits. There is no need to buy a health plan if it does not offer such coverage benefits given that consumers need them.

• A High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) is a very good option to make sure that consumers get affordable health plans. Virginians should check about this.

• Virginians, who need to see a specialist, should make sure that the health insurance plan does not require them to get referrals.

• An affordable health insurance plan should have an easy reimbursement procedure. Virginians should make sure that they do not buy from such companies whose reimbursement process is too much complicated. Such plans could actually waste a lot of money and time.

Comments closed.