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Tips for Navigating the Health Insurance Marketplace in Virginia

Like most things related to health care, the Virginia Health Insurance Marketplace can be difficult to understand at times. To make the health care system easier to digest, you can break it up into sections. There are Medicaid and CHIP users, Medicare users, and commercial fully insured and commercial self-insured users currently in the Virginia system. Depending on your designation, you will be allowed to choose and access different health plans and coverage levels. The following sections provide a quick overview of the coverage levels available in Virginia to help you decide which coverage is best for you.

Coverage Levels

Your coverage level should be chosen based on your household’s medical needs and its total income. You want to pick a coverage level that covers all of your medical needs, but is still affordable enough that you do not struggle to pay your premium each month. Also, keep in mind that even if you pay a low monthly premium, you will still need to worry about the price of your deductible. Carefully consider all the options below before making your decision.

  • Bronze – The Bronze coverage level has the lowest monthly premiums, but the highest deductible. This coverage level offers minimal health care coverage and is best suited for those who rarely require medical care beyond basic or emergency treatment. You will also need to pay out of pocket for most routine visits.
  • Silver – If you qualify for “extra savings,” you must select Silver coverage or above in order to benefit from this deal. Silver coverage has a moderate deductible and moderate monthly premiums. It covers more costs from routine care visits than Bronze level coverage and is a good option if you only need basic and infrequent medical care.
  • Gold – Gold level coverage has slightly higher premiums and lower deductibles than Silver level coverage. This coverage level covers more routine care and is best suited for those who need to frequently attend doctor’s visits, as it covers more medical expenses.
  • Platinum – If you or one of your family members has a chronic ailment, needs constant care or requires multiple visits to doctors and specialists, you will most likely need Platinum level coverage. This coverage level has the highest premiums, but the lowest deductibles. It provides near-complete coverage for all medical expenses and is usually well worth the money you invest in it if you need constant medical care.
  • Catastrophic – Catastrophic coverage is only available to individuals under the age of 30 who cannot afford Bronze coverage. This coverage level only covers the bare minimum and will require most of your medical expenses to be paid out of pocket.