Health Insurance Open Enrollment FAQ’s for Virginians

Virginia has health care plans for you and your family beginning November 1, 2020.

Due to the COVID19 pandemic, many Virginians will be accessing government sponsored health insurance for the first time. Below are all the basics for Virginia’s Open Enrollment Period beginning November 1, 2020.

1. What is the Affordable Care Act / Obamacare? The Affordable Care Act (ACA), often called “Obamacare”, allows people who do not have health insurance coverage through their job or a government program such as Medicare or Medicaid, to purchase health insurance through the government-run Marketplace. While anyone can purchase health insurance, individuals and families whose income falls below a certain level are eligible to have a portion or all of their insurance paid for by the government.

2. Will the government pay for some or all of my insurance? The amount of subsidies the government contributes depends on the household income of the buyer. Typically a single person will need to make more than $16,600 per year and a family of 3 will need to make more than $28,300. Earning lower than those amounts qualify purchasers for Medicaid. The actual amount of subsidies depend on how many family members are purchasing and which plan is selected.
It’s possible that you earn too much to qualify for subsidies. In Virginia the general cut-off is $48,000 for a single person and $100k for a family of 4; any amount higher than that usually means an individual or family does not qualify for subsidies.

3. Is Coronavirus testing covered under ACA plans? Yes. The Families First Act/CARES Act, requires public and private health insurance plans “to cover testing needed to detect or diagnose COVID-19, and the administration of that testing, without cost-sharing or medical management requirements”.

4. I’m Pregnant…Do I and my baby qualify for health insurance under the ACA? Yes, all plans cover pregnancy and childbirth provided that you qualify for subsidies. This is true even if your pregnancy begins before your coverage takes effect.

5. I’m *not* pregnant…is birth control covered? FDA approved contraceptive methods and counseling for all women, as prescribed by a health care provider is covered in network.

6. I’m Divorced…How do my kids get covered? The parent who has custody of the child is responsible for the child’s health insurance. If it’s a shared-custody situation, the parent who claims the child as a dependent must be sure the child is covered.

7. Is dental care included in Obamacare plans? Yes, basic dental care and oral health screenings are part of ACA plans for children under age 19. Orthodontics (braces) are not typically included but dental discount plans are available.

7. Can my college-age child be covered? Yes. Children age 26 and under can be covered under the ACA plan even if they are married.

9. Is there a penalty if I don’t get health insurance? There used to be but the fine no longer applies in Virginia. From healthcare.gov: “starting with the 2019 plan year (for which you’ll file taxes in April 2020), the fee no longer applies. If you don’t have coverage during 2019 or later, you don’t need an exemption in order to avoid the penalty.”

10. When is the Open Enrollment Period? When do I sign up? In Virginia, the Open Enrollment Period (OEP) is November 1, 2020 to December 7, 2020. Plans sold during OEP start January 1, 2021.

Contact us today if we can help you find and compare plans.

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