Welcome to Virginia Medical Plans’ 2021 Health Insurance Enrollment Guide.
Check back frequently! We will update this page with helpful enrollment information for 2021 health insurance in Virginia, Maryland, and District of Columbia.
2021 Health Insurance Enrollment – Virginia
Lay of the Land in Virginia in 2021
We expect premiums in Virginia to remain level overall — or in some cases even go down — in 2021!
Anthem continues to offer coverage in all counties within their service area for 2021. Anthem’s portfolio of HMO plans provides wide access to doctors and hospitals across the state of Virginia.
CareFirst, Cigna, and Kaiser Permanente continue to be major players, as well as Oscar in the Richmond area and Optima in the southeastern part of the state.
Cigna plans will no longer require a referral from a Primary Care Provider to see a specialist in 2021.
Insurance for Self-Employed Individuals
We continue to be excited about Virginia’s law – SB 672. Effective July 1, 2018 self-employed individuals must be allowed to establish a group health plan. (Note, you must meet certain criteria.)
SB 672 has been and continues to be a game-changer for Virginia!
Visit our page on Self-Employed Health Insurance to see if you may qualify, and for more details.
Note, if you are eligible for a subsidy in 2021 based on your income, then a group plan may not be the best option. There are no subsidies for group plans.
Insurance for Small Business Owners/ Partners in a Business
If you own a small business — by yourself or with a partner(s) — you also may be able to set up a small group health plan. If you think this may be an option, visit our page for small business group health insurance to learn more and request a free quote.
Individual/Family Health Insurance in Virginia
Once again, with the exception of the CareFirst service area in northern Virginia (see below), there are no PPO plans available for individuals in the state.
All 2021 plans — from all carriers except Carefirst — are HMO plans. HMOs offer limited provider networks and no out-of-network coverage except in the event of a true emergency.
Details by Carrier in Virginia
Visit each section below for more detailed enrollment information.
- Anthem
- CareFirst (certain parts of Northern VA)
- Cigna (Northern VA and Richmond)
- Kaiser Permanente (Northern VA and Fredericksburg)
- Oscar (Richmond area)
- Optima Health
- Piedmont Community Healthcare
- Virginia Premier – coming soon (Richmond area)
Virginia Service Areas by Carrier
Anthem service area in Virginia: the entire state with the exception of those areas in the CareFirst service area (see next item).
Cigna counties in the Richmond area: Amelia, Charles City, Chesterfield, Dinwiddie, Frederick, Hanover, Henrico, Prince George, Sussex, Colonial Heights City, Hopewell City, Petersburg City, Richmond City,
Kaiser Permanente has facilities in the Northern Virginia and Fredericksburg areas.
Oscar service area: counties in the Richmond Metro area – Chesterfield, Hanover, Henrico, Richmond City
Charlottesville, Harrisonburg, Hampton Roads / Virginia Beach / Norfolk, Halifax & Mecklenburg
Piedmont service area: cities of Lynchburg, Bedford, and Danville; and the counties of Amherst, Appomattox, Bedford, Buckingham, Campbell, Charlotte, Cumberland, Halifax, Lunenburg, Mecklenburg, Nelson, Nottoway, Pittsylvania, and Prince Edward.
Virginia Premier: Richmond area
Health Insurance Enrollment – Maryland
Lay of the Land in Maryland in 2021
For the third year in a row, individual health insurance premiums will fall in Maryland. CareFirst and Kaiser continue to be the major players, and Optimum Choice (United Healthcare’s HMO) is a new entrant for 2021.
Note, we do not sell subsidized plans on the Maryland Health Connection.
If you:
- are self-employed or own a small business;
- live in the or Baltimore area; and
- will not be eligible for a subsidy in 2021
…we may be able to set up a group health plan. Please be in touch right away if this may apply to you.
Details by Carrier in Maryland
Visit the sections below for more details about enrollment.
- CareFirst
- Kaiser Permanente
- Cigna – Dental only – coming soon
Health Insurance Enrollment – District of Columbia
Lay of the Land in DC in 2021
Open enrollment in DC runs from November 1, 2020 – January 31, 2021. The individual mandate remains in place in DC for 2021. This means you are subject to a penalty if you do not have health insurance in 2021.
There are two carriers offering individual plans in 2021 — CareFirst and Kaiser.
All individual health plans in DC continue to be sold via DC Healthlink. The first step in having our assistance with a DC plan is to establish your account on DC Healthlink, and then designate us as your broker. Click here for detailed instructions.
Details by Carrier in DC
Visit the sections below for more details about enrollment.
- CareFirst
- Kaiser Permanente
- Cigna – Dental only – coming soon
