RICHMOND — Many Virginians will soon shop for coverage during the open the enrollment period for the 2019 health insurance marketplace under the federal Affordable Care Act (ACA). The open enrollment period runs from November 1 – December 15, 2018.
Whether you are thinking about changing health insurance plans or purchasing new coverage, the State Corporation Commission’s (SCC) Bureau of Insurance encourages Virginians to review their health coverage needs and thoroughly explore all their options, especially when considering short-term, limited-duration (STLD) health insurance plans. Short-term plans may or may not meet your needs depending on the coverage provided and your personal financial and health situation. These types of policies may cost less, but they also generally cover less than an ACA-compliant marketplace plan. Recent changes to federal law allow STLD plans to extend their coverage periods from three months to 364 days and be renewable for up to 36 months.
The Bureau reminds consumers that STLD health insurance plans are not subject to ACA rules, such as the requirement to provide certain benefits including maternity care, mental health and substance use disorder services and coverage for prescription drugs. In addition, STLD health insurance plans may deny eligibility for coverage or exclude services because of pre-existing conditions and may apply daily, annual and lifetime dollar limits on the amount they will pay.
“Knowledge is your best policy when it comes to shopping for insurance,” said Virginia Insurance Commissioner Scott A. White. "When shopping for health insurance coverage, understand enrollment periods, what ACA-compliant plans must cover and where to turn for legitimate information when considering purchasing coverage. The SCC’s Bureau of Insurance has tools available that Virginians can use to determine the type of plan that best meets their needs.” he said.
The attached chart summarizes some of the key differences between ACA plans and STLD health insurance plans.
The Bureau of Insurance offers Virginians the following tips regarding the purchase of health insurance:
- Ask for details of any health insurance policy, including premiums, in writing and make sure you understand what you are purchasing.
- Check the Bureau of Insurance website at scc.virginia.gov/boi/cons/index.aspx for a list of carriers that have received approval to offer ACA health benefit plans to individuals on and off the federal marketplace in Virginia for 2019.
- The official website for the federal marketplace is www.healthcare.gov. Here you can find information regarding the ACA, qualified health plans and comparisons of marketplace plans. Be wary of other similar sounding names or websites.
- The open enrollment period for the 2019 health insurance marketplace under the ACA ends December 15, 2018. Anyone contacting you to sell individual health insurance plans through an "enrollment period" outside of the open enrollment period is not selling an ACA-compliant policy.
- No one offering ACA-compliant health care coverage will ask you if you have a pre-existing condition.
- Be wary of telemarketers from the "national enrollment center," "national healthcare center," or other official-sounding name. The federal government will not call to sell you health insurance.
- Do not provide your Social Security number, bank account details or health information to a cold caller and never agree to any request to send money over the phone.
- When purchasing insurance through an agent, make sure that person is a licensed agent and ask for the individual’s license number. If they refuse, do not do business with them. To check if a person is licensed in Virginia, visit scc.virginia.gov/boi/ConsumerInquiry
For additional information, contact the Consumer Services Section of the Virginia Bureau of Insurance’s Life and Health Division toll-free at 1-877-310-6560 or in Richmond at 804-371-9691 or visit www.scc.virginia.gov/boi.