Health Insurance Knowledge Base
Frequently Asked Questions
Affordable Care Act
Virginia’s Insurance Marketplace is the state’s official platform for individuals and families to shop for, compare, and enroll in quality health insurance plans if they do not receive coverage through an employer. It replaced HealthCare.gov for Virginia residents starting in November 2023.
The Marketplace is designed for:
Individuals and families without employer-provided insurance
Self-employed Virginians
Those who are unemployed or whose jobs don’t offer affordable insurance options
Plans on the Marketplace cover the 10 essential health benefits required by law, such as:
Doctor visits
Hospitalization
Emergency services
Prescription drugs
Maternity and newborn care
Preventive services
Open Enrollment for 2025 ran from November 1, 2024, to January 22, 2025. Coverage begins February 1 for those who enrolled by the deadline. After Open Enrollment, you can only enroll if you experience a Qualifying Life Event, like losing other coverage or having a baby.
We make the process easy by:
Explaining deductibles, co-insurance, maximum out-of-pocket costs, and co-pays
Checking your preferred doctors and facilities for coverage
Reviewing your medications to ensure they’re covered
Determining your eligibility for subsidies and providing easy-to-read quotes
Handling enrollment through the Marketplace or directly with carriers
Serving as your first point of contact for plan servicing after enrollment
All of these services are FREE and do not affect your plan’s price.
Nine out of ten households qualify for financial help through the Marketplace. Many Virginians pay as little as $10 a month for coverage, thanks to premium tax credits and subsidies. You can check your eligibility for cost-saving programs using the Plan Comparison Tool on the Marketplace website
Since the ACA’s implementation in 2014, the individual market in Virginia has seen frequent changes in available carriers and plan options by county. Carriers may change each year during Open Enrollment, so reviewing your options annually is important.
Contact us today for direct, expert assistance. We’ll guide you through every step, from comparing plans to enrollment and ongoing support—at no extra cost to you.
Contact:
- Phone: 804-601-1501
- Email: hello@ameyacapital.com
Medicaid renewal is an annual process where the state reviews your information to determine if you’re still eligible for Medicaid health coverage. If all your information is up to date, your renewal may be completed automatically. Otherwise, you’ll receive a renewal form in the mail that you must complete and return.
You’ll get a letter in the mail from the state. If your renewal is automatic, the letter will confirm your coverage for another year. If more information is needed, you’ll receive a renewal packet with instructions.
You can renew your coverage in one of three ways:
Online at commonhelp.virginia.gov by selecting “Renew my benefits”
By phone: Call Cover Virginia at 1-855-242-8282 (TTY: 1-888-221-1590)
By mail or in person: Complete the paper renewal form and return it to your local Department of Social Services
If you do not complete your renewal by the deadline, you will lose your Medicaid coverage. If you miss the deadline, you have up to 90 days to submit your renewal and have coverage reinstated if you’re still eligible. After 90 days, you’ll need to submit a new application
If you are found ineligible or lose Medicaid coverage:
You may qualify for health insurance through your employer or the Health Insurance Marketplace.
Losing Medicaid is a Qualifying Life Event, giving you a 60-day Special Enrollment Period to sign up for a Marketplace plan at healthcare.gov.
State agencies and health insurance agents can help you transition to new coverage.
Make sure your contact information (address, phone number, email) is up to date with the state.
Watch your mail for renewal notices and respond promptly.
Gather documents about your income, household, and employment in advance.
If you need help:
Contact Cover Virginia at 1-855-242-8282.
Reach out to a health insurance agent for assistance with Marketplace plans and other coverage options. Our Contact: 804-601-1501 .
Community navigators and local DSS offices can also provide support.
Medicaid Redetermination
Medicaid redetermination is the process where the state reviews each member’s eligibility for Medicaid, CHIP, and Expansion programs. During the COVID-19 Public Health Emergency, most members kept coverage regardless of changes. As of April 1, 2023, Virginia began removing ineligible members from Medicaid, requiring everyone to go through annual renewal again.
You could lose coverage if you no longer meet eligibility requirements—such as changes in income, household size, or other qualifying factors. If you miss the renewal deadline or don’t complete the paperwork, your coverage may also end.
Online: Visit commonhelp.virginia.gov and select “Renew my benefits.”
By phone: Call Cover Virginia at 1-855-242-8282 (TTY: 1-888-221-1590).
By mail or in person: Complete and return the paper renewal form to your local Department of Social Services
Make sure your state agency has your current mailing address and contact information.
Watch for your renewal notice in the mail and respond promptly.
Gather documents about your income, household, and employment.
If you’ve had significant changes, explore other health coverage options in advance.
If you lose Medicaid, you may:
Enroll in health coverage through your employer (you have 60 days from losing Medicaid to do so).
Shop for an Individual or Family Marketplace plan at healthcare.gov or the Virginia Marketplace (you also have a 60-day Special Enrollment Period after losing Medicaid).
Marketplace plans are available to anyone without insurance, including those losing Medicaid. Plans come in Bronze, Silver, and Gold tiers, and many people qualify for subsidies that lower premiums—sometimes to $0 per month. Cost-sharing reductions are also available for those who qualify and enroll in Silver plans.
You have a 60-day Special Enrollment Period from the date you lose Medicaid to enroll in a Marketplace health plan or employer coverage. Open Enrollment for Marketplace plans is November 1 to January 15 each year, but losing Medicaid qualifies you for a special window.
Yes! We can guide you through the application process, help you compare plans, and ensure you find a plan that fits your needs and budget. All our assistance is free and designed to make your transition as smooth as possible.
Contact:
- Phone: 804-601-1501
- Email: hello@ameyacapital.com
Short Term Health Insurance
Short term health insurance provides temporary coverage for individuals who need immediate protection for a limited period—such as those between jobs, waiting for employer benefits to begin, or outside the annual ACA Open Enrollment window.
As of September 1, 2024, Virginia limits short-term health insurance plans to an initial term of up to three months, with a possible one-month renewal, for a total of four months. Some sources note that plans may last up to 364 days with renewals up to 36 months, but current regulations cap the duration at four months for most plans.
Short term plans can be a good fit if you:
Are healthy and need coverage for a specific, short period
Are between jobs or waiting for employer coverage to start
Are a recent graduate or early retiree
Missed ACA Open Enrollment and are not eligible for a Special Enrollment Period
Lower monthly premiums compared to ACA plans
Fast enrollment and quick coverage start dates
Flexible, temporary coverage for gaps in insurance
Excludes pre-existing conditions and may use post-claims underwriting
May not cover essential health benefits like maternity, mental health, or prescriptions
Preventive services and some doctor visits may not be covered or may require meeting the deductible first
Coverage ends after the plan term, and you may need to reapply (and could be declined if your health changes)
No. Short term plans do not meet Affordable Care Act (ACA) standards and may leave significant gaps in coverage. They do not qualify for subsidies and can exclude important benefits.
Premiums typically range from $80 to $300+ per month for individuals, depending on age, location, plan features, and deductible. These plans are generally much cheaper than ACA-compliant plans, but with less comprehensive coverage.
You can apply for short term health insurance at any time of year—there is no open enrollment period.
Each carrier offers different plan features, durations, and exclusions. It’s important to review:
How long the plan lasts before you must re-enroll
Whether you can be declined for coverage after a medical event
What services are covered before meeting the deductible
If any preventive services are included
Contact us for free, expert guidance to find the plan that best fits your needs.
Phone: 804-601-1501
Email: hello@ameyacapital.com
Small Employer
Health insurance is a crucial benefit for attracting and retaining valuable employees. It’s typically the second largest expense after payroll, but it helps build a competitive compensation package and supports workforce health and productivity.
Traditional Group Health Insurance
ACA-compliant plans offer comprehensive coverage and must meet minimum standards.
Employers typically contribute toward premiums and must meet minimum participation requirements.
Plans can be started at any time of year, with deadlines based on your desired start date.
Level-Funded Health Insurance
Combines features of traditional group insurance with the cost control of self-funding.
Monthly premiums may be lower, especially if your group is healthy.
Offers the potential for a refund if claims are lower than expected.
Individual Coverage HRA (ICHRA)
Allows employers of any size to reimburse employees for individual health insurance premiums, with customizable allowances.
Employees choose their own plans, giving them more flexibility.
Qualified Small Employer HRA (QSEHRA)
For employers with fewer than 50 full-time employees.
Lets employers reimburse employees for individual health insurance and medical expenses, up to IRS-set limits.
Association Health Plans (AHPs)
Small businesses in the same industry or area can band together to buy insurance as a group.
May offer lower premiums but are not required to meet all ACA standards and may have limited coverage options.
Employers with 50 or more full-time employees must offer health coverage under the ACA.
Small employers (1-50 employees) can access group health plans through Virginia’s Insurance Marketplace.
To qualify for certain tax credits, small businesses must pay at least 50% of premiums and meet other criteria.
In 2024, the average annual premium was $8,951 for single coverage and $25,572 for family coverage.
Virginia employers typically cover 79% of single premiums and 70% of family premiums.
COBRA (for employers with 20+ employees) and Virginia mini-COBRA (for 2-19 employees) allow former employees to continue their group health coverage for a limited time, but at their own expense.
Contact us for expert assistance in evaluating your options, comparing plans, and implementing the right health insurance solution for your business. We’ll help you navigate requirements, control costs, and support your team’s health—at no extra cost to you.
Phone: 804-601-1501
Email: hello@ameyacapital.com
