Virginia: Health Insurance Plan Options

Residents of Virginia who find themselves in need of temporary health insurance may now purchase quality short term health insurance coverage offered by Pivot Health.

With Pivot Health’s short term health insurance plan, you receive comprehensive benefits coverage for doctor visits, hospitalizations, urgent care facility visits and much more. Other key features which benefit Virginia residents include:

Affordable coverage
with Pivot Health’s short term medical coverage, you receive many of the same benefits as provided by individual major medical plans, at rates up to 50% less.
Flexible coverage duration
do you need coverage for as little as one month? Or for the remainder of the year? Pivot Health provides you the flexibility to select the duration of coverage to meet your needs.
No network restrictions
enjoy the freedom to seek treatment from the providers and facilities you want, without worrying about whether benefits are paid at in-network or out-of-network rates.
User-friendly, online application process
Pivot Health’s easy application process takes just a short amount of time, and you’ll learn within minutes of applying if you have been approved for coverage.
Coverage when you want it
qualified applicants select the date they want their short term health insurance coverage to start, which can be as soon as 24 hours from the time of application.

Pivot Health short term medical insurance plans also include non-insurance benefits

Discounted telehealth doctor consultations
No need to book an appointment, drive to the office and sit in a waiting room. Connect directly with a doctor whenever and wherever it works for you – telehealth consultations are unlimited and available 24/7.
Savings on eyewear and eye care
Discounts range from 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses. Maintaining good eye health has never been so affordable.
Discounts on prescription drugs
You can save up to 75 percent on prescription drugs at thousands of pharmacies across the country, making it easier for you to budget prescription medications.

Virginia Residents Face Health Care Coverage Challenges

The Virginia Health Care Foundation’s 2016 Profile of Virginia’s Uninsured reported key statistics about uninsured residents of the Commonwealth. Approximately 12.5 percent of Virginians under age 65 – or 874,000 people – are uninsured, meaning, they lack any health insurance coverage and have to pay all of their medical bills out-of-pocket. This is more than three percent higher than the national uninsured rate of 9.1 percent.

Approximately 75 percent of Virginia’s uninsured residents are part of working families, with almost half of these families having at least one full-time worker, and another nearly 20 percent having at least one part-time employee.

Those Virginians who had the financial means to buy individual major medical insurance on the exchange experienced an average premium increase of 19.5 percent for 2017. Although a significant increase, this rate is lower than the national average premium increase of 25 percent. Most, but not all, enrollees on the Virginia exchange will receive a higher federal premium subsidy to help offset the rise in premium rates. The problem, some health care policy experts say, is that by increasing premium subsidies, the federal government takes on a greater financial burden.

Recently, Dr. Peter Cunningham, a health care policy professor at Virginia Commonwealth University, had this to say about the government increasing premium subsidies: “This is a longer-term concern for the Affordable Care Act. The issue is the long-term sustainability from a financial perspective.”

Despite a total of 10 insurance carriers offering exchange plans in Virginia, the reality for many Virginians is that they will receive almost no choice in selecting an insurer. Starting in 2017, only one insurance carrier will sell coverage in 28 of the state’s independent cities or counties, many of which are rural. Up until 2017, at least two insurers, if not more, offered exchange plans throughout the state. The reduced insurance carrier competition could lead to more expensive premium rates, and some insureds might find that their doctors don’t participate in their new plan’s provider network.

Rising premium rates, fewer carrier options, and employed Virginians who are still unable to afford comprehensive medical coverage point to the need for Commonwealth residents to have access to a broader range of health insurance choices.

Pivot Health offers Virginians a short term health insurance option that may meet their needs and budgets. This type of plan provides comprehensive benefits coverage, with no network restrictions, at significantly lower rates than major medical insurance plans cost.

The State of Health in Virginia

The 2017 Commonwealth Fund’s Scorecard on State Health System Performance gave Virginia an overall ranking of 25 out of 51 (the 50 states plus the District of Columbia).  This is the most recent version of the organization’s scorecard of its comparison for states in the U.S.  The Commonwealth Fund’s Scorecard rated Virginia in several areas, including:

  • Uninsured adults aged 19 to 64: 28th ranking (13 percent in Virginia, the same as the U.S. average of 13 percent)
  • Uninsured children ages 0 to 18:  26th ranking (5 percent, the same as the U.S. average of 5 percent)
  • Adults who went without care because of cost in the previous year:  21st ranking (12 percent in Virginia, compared to the U.S. average of 13 percent)
  • Individuals under age 65 with high out-of-pocket costs relative to annual household income:  20th ranking (14 percent, the same as the U.S. average of 14 percent)
  • At-risk adults who did not have a routine doctor visit in the previous two years:  10th ranking (11 percent in Virginia, compared to U.S. average of 13 percent)
  • Adults that did not visit a dentist in the previous year:  12th ranking (14 percent, compared to U.S. average of 16 percent)
  • Adults with age- and gender-appropriate cancer screenings:  12th ranking (71 percent in Virginia, compared to the U.S. average of 68 percent)
  • Hospitalized people who said the hospital staff managed pain well, were responsive to calls for help and who explained medications and their side effects:  33rd ranking (67 percent, compared to the U.S. average of 68 percent)
  • Breast cancer deaths per 100,000 females: 44th ranking (22.7 in Virginia, compared to U.S. average of 20.6)
  • Colorectal cancer deaths per 100,000 people: 22nd ranking (14 percent, compared to the U.S. average of 14.3 percent)
  • Suicide deaths per 100,000:  15th ranking (12.9 percent in Virginia, compared to U.S. average of 13 percent)
  • Adults who report fair or poor health or activity limitations: 8th ranking (22 percent, compared to the U.S. average of 26 percent)
  • Adults who smoke:  21st ranking (17 percent in Virginia, the same as the U.S. average of 17 percent)
  • Adults who are obese: 18th ranking (29 percent, the same as the U.S. average of 29 percent)
  • Children (ages 10-17) who are overweight or obese: 21st ranking (30 percent in Virginia, compared to the U.S. average of 31 percent)
  • Percent of adults who have lost 6 or more teeth due to decay or disease:  22nd ranking (10 percent, the same as the U.S. average of 10 percent)

Virginia also had positive rankings for these categories:

  • Adults with age-appropriate vaccines
  • Children with medical and dental preventive care visits in the past year
  • Medicare patients whose health provider always listens, explains, shows respect and spends enough time with them
  • Hospitalized patients are given information about what to do during their recovery at home
  • A lower-than-national-average rate of hospital admissions for children with asthma

2017 Health Insurance Plans Offered in Virginia

Virginia uses the federally-run exchange but has a health insurance marketplace plan management exchange, which means that the state is responsible for overseeing the plans that are sold on the exchange. There are 10 insurance carriers participating in the state’s exchange, including:

  • Aetna
  • CareFirst Blue Choice
  • Cigna
  • Group Hospitalization and Medical Services, Inc.
  • Health Keepers (Anthem)
  • Innovation Health Insurance Company
  • Kaiser Foundation Health Plan of the Mid-Atlantic
  • Optima Health Plan
  • Piedmont Community Healthcare (and Piedmont HMO)
  • UnitedHealthcare of the Mid-Atlantic

Virginians throughout much of the state, however, have access to only one insurance carrier option when purchasing exchange plans.

Medicaid Enrollment in Virginia

19 states have chosen not to expand Medicaid under the terms of the Affordable Care Act, including Virginia. A recent Kaiser Family Foundation study reported that there are approximately 136,000 Virginians in the Medicaid “coverage gap.” These residents have income too high to qualify for traditional Medicaid benefits, yet their income is too low to qualify for subsidies to help pay for insurance plans purchased on the Virginia state exchange.

Medicaid expansion advocates say that not expanding the Medicaid program will adversely affect the finances of Virginia hospitals, the tax burden on residents, and the premiums that Virginians pay for private insurance plan coverage. Expansion advocates also promote the fact that the federal government currently pays 100 percent of the cost for providing Medicaid benefits, although that amount will reduce over time to 90 percent.

Opponents of Medicaid expansion have raised concerns that over time as the federal funding rate for the expansion decreases, Virginia’s costs for funding Medicaid will rise dramatically. Further, they argue that the Medicaid program is badly broken and cite numerous studies showing that Medicaid patients have poorer health outcomes than patients who have no health care coverage. With health care providers receiving significantly lower compensation for services to Medicaid patients, many providers drop out of the Medicaid program.

Virginia residents caught in the Medicaid coverage gap—who can’t get Medicaid and can’t afford Obamacare—may greatly benefit from an affordable, comprehensive health care benefits plan such as Pivot Health short term medical insurance

An Affordable Health Care Coverage Option: Short Term Health Insurance

If you live in Virginia and do not have health insurance, take a closer look at Pivot Health’s short term health insurance. It provides you the comprehensive medical coverage to meet your benefit and budget needs.

Pivot Health: offering you choices and flexibility that pivot to meet your needs over time.

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