Welcome to Virginia Medical Plans, a OneDigital company’s 2022 Health Insurance Enrollment Guide.
Check back frequently! We will update this page with helpful enrollment information for 2022 health insurance in Virginia, Maryland, and District of Columbia.
2022 Health Insurance Enrollment – Virginia
Lay of the Land in Virginia in 2022
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.)
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 2022 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
Open enrollment for 2022 plans runs from November 1, 2021 through January 15, 2022.
Your 2022 coverage start date depends on the date you apply for coverage, as follows:
|If you apply between …||Your coverage will be effective …|
|Nov 15, 2021 – Dec 15, 2021||Jan 1, 2022|
|Dec 16, 2021 – Jan 15, 2022||Feb 1, 2022|
Outside of open enrollment, you must have a qualifying event to enroll in a new individual plan.
As in years past, with the exception of the CareFirst service area in northern Virginia (see below), there are no PPO plans available for individuals in the state.
CareFirst service area in Virginia: Cities of Alexandria and Fairfax; Town of Vienna; Arlington County; Areas of Fairfax and Prince William Counties lying east of Route 123.
All 2022 plans in Virginia — from all carriers except CareFirst — are HMO plans. HMOs offer local-based provider networks and no out-of-network coverage, except in the event of a true emergency. Be aware that some carriers require you to have a referral from a Primary Care Provider (PCP) to see a specialist.
Virtual care (“telehealth”) is a focus in 2022.
Details by Carrier in Virginia
You can buy an Anthem plan if you live in the Anthem service area in Virginia: the entire state with the exception of those areas in the CareFirst service area.
Anthem’s 2022 plans are “open access” HMO plans. This means you do NOT need a referral to see a specialist.
Compare Anthem Plans and Enroll Now
Aetna / Innovation Health
You can buy an Aetna plan if you live in one of Aetna’s service areas:
- In Richmond, Virginia: Counties of Amelia, Chesterfield, Goochland, Hanover, Henrico, New Kent, Powhatan, Richmond City
- In Roanoke Virginia: Counties of Botetourt, Franklin, Montgomery, Radford, Roanoke City, Roanoke County, Salem County
Aenta 2022 plans are HMO plans. You do NOT need a referral from your primary care provider to see a specialist.
Compare Aetna Plans and Enroll Now
You can buy an Innovation Health plan if you live in IH’s service area in Northern Virginia: Alexandria City, Arlington County, Clarke, Fairfax City, Fairfax County, Falls Church City, Fauquier, Fredericksburg City, Loudoun, Manassas City, Manassas Park City, Prince William, Spotsylvania, Stafford, Warren
Innovation Health 2022 plans are HMO plans. You must have a referral from your primary care provider to see a specialist.
Compare Innovation Health Plans and Enroll Now
You can buy a CareFirst plan if you live in CareFirst’s service area in Northern Virginia: Cities of Alexandria and Fairfax; Town of Vienna; Arlington County; Areas of Fairfax and Prince William Counties lying east of Route 123.
Care First is the only provider who offers PPO plans for individuals who live in the service area noted above. CareFirst also offers HMO plans. You do NOT need a referral from a primary care provider to see a specialist.
Compare CareFirst Plans and Enroll Now
You can buy a Cigna plan if you live in one of Cigna’s service areas:
- In the Northern Virginia area: Counties of Alexandria City, Arlington, Clarke, Fairfax, Fairfax City, Falls Church City, Fauquier, Frederick, Loudoun, Manassas City, Manassas Park City, Page, Prince William, Rappahannock, Shenandoah, Spotsylvania, Stafford, Warren, Winchester City
- In the Richmond area: Counties of Amelia, Charles City, Chesterfield, Colonial Heights City, Cumberland, Dinwiddie, Goochland, Hanover, Henrico, Hopewell City, Louisa, Petersburg City, Powhatan, Prince George, Richmond City, Sussex
Cigna’s 2022 plans are HMO plans and utilize the Cigna Connect network. You do NOT need a referral from a primary care provider to see a specialist.
Cigna offers a national network for pharmacy, urgent care, and retail clinics.
Compare Cigna Plans and Enroll Now
Kaiser Permanente has facilities in the Northern Virginia and Fredericksburg areas.
Kaiser Permanente offers HMO plans and provides building-based health care.
This means that all of your medical providers are employed by Kaiser and work in a Kaiser facility. Many people enjoy the convenience of accessing all of their medical care in one building.
Compare Kaiser Virginia Plans and Enroll Now
United Healthcare’s 2022 plans are HMO plans and utilize UHC’s Exchange network. You DO need a referral from a primary care provider to see a specialist.
Compare UHC Virginia Plans and Enroll Now
Oscar service area: counties in the Richmond Metro area – Chesterfield, Hanover, Henrico, Richmond City
Optima service area: 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 2022
CareFirst and Kaiser continue to be the major players. Optimum Choice (United Healthcare’s HMO) was a new entrant in 2021 and returns for 2022.
Note, we do not sell subsidized plans on the Maryland Health Connection.
Health Insurance Enrollment – District of Columbia
Lay of the Land in DC in 2022
Open enrollment in DC runs from November 1, 2021 – January 31, 2022. The individual mandate remains in place in DC for 2022. This means you are subject to a penalty if you do not have health insurance in 2022.
There are two carriers offering individual plans in 2022 — 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.