Virginia Health Insurance

Virginia has fewer health insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes important Virginia health insurance policy regulations.

  • Lists rules Virginia health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. Virginia health insurance companies and policyholders alike must abide by established insurance laws.

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Virginia health insurance policy provisions

Some of the most important Virginia health insurance laws are the ones that influence the health insurance policy specifically.

For instance, in Virginia, health insurance companies can impose a pre-existing condition exclusion period of no more than 12 months. According to Virginia health insurance regulations, medical conditions are considered to be pre-existing if you obtained medical care for or were diagnosed with 12 months prior to the beginning of the plan.

During the exclusion period, your health insurance company is not responsible for covering any medical costs related to the pre-existing condition.

If you fulfill a pre-existing condition exclusion period under one Virginia health insurance policy and then decide to change health insurance plans, your old plan can credit your new plan's pre-existing condition exclusion period.

Also, Virginia health insurance companies are permitted to exclude coverage for a pre-existing condition permanently by attaching an elimination rider to your policy.

Finally, all Virginia health insurance policies must contain a guaranteed renewability provision. This provision guarantees that at the end of your policy's term, you can renew it if you choose to do so.

Regulating Virginia health insurance companies

Understanding the laws limiting Virginia health insurance companies is especially important in making sure your health insurance company continues to honor your original contract. Virginia health insurance companies and the cost of health insurance is not too strictly limited.

For instance, the cost of your Virginia health insurance is not controlled. Your Virginia health insurance company generally charges you the same amount as others with a similar health status but they can choose to charge you more.

Also, in deciding the price of your Virginia health insurance policy and whether or not to offer you a policy, Virginia health insurance companies can base their decision on your health status.

However, once you purchase a health insurance policy, your Virginia health insurance company cannot refuse to renew your policy on the grounds of illness.

Finally, any Virginia health insurance company, except for Blue Cross Blue Shield, is free to refuse you coverage.

Temporary Virginia health insurance

Temporary health insurance is recommended during times when you have breaks in your health insurance coverage. A list of Virginia health insurance companies that sell these policies is available from the Virginia Department of Insurance.

Although temporary health insurance policies are offered, an better alternative to is a conversion policiy. These are available to individuals who have recently left a group health insurance policy.

The premiums for these policies can be more than your former Virginia health insurance premiums, but they are limited enough by state laws that they will still be affordable.

Two advantages of these plans are that they cannot be canceled because you become ill and they do not required to meet a new pre-existing condition exclusion period.

More VA health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to Virginia small business health insurance.

To find out more about VA health insurance laws and regulations, visit the official website of the Virginia Bureau of Insurance.