In Virginia, as in many other states, your health insurance options are somewhat dependent on your health status.  Even if you are sick, however, the laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
• All group health plans in Virginia must limit exclusion of pre-existing conditions. There are rules about when a pre-existing condition exclusion period can be applied and how long you must wait before a new health plan will begin to pay for care for that condition. Generally, if you join a new plan your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
• Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable.
• If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA continuation coverage or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
• If you lose your fully insured group health plan and meet other qualifications, you may be able to buy a conversion policy. This is an individual policy from the company that insured your former group policy. You will not face a new pre-existing condition exclusion period. However, there are few limits on what you can be charged for a conversion policy and the benefits may be less generous than your previous group coverage.
• If you are HIPAA eligible, you are guaranteed the right to buy any individual health insurance policy that an insurance company sells in Virginia. However, an insurance company may charge you significantly higher premiums due to your health status, age, or other factors.
• All Virginia residents are guaranteed the right to buy individual health insurance from either Anthem Blue Cross Blue Shield or CareFirst Blue Cross Blue Shield, depending on where you live. This is called guaranteed issue.
• If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All health plans for small employers must be sold on a guaranteed issue basis.
• If you are purchasing a small group standardized plan, there are limits on what you can be charged because of the health status, claim experience, and other characteristics of those in your group. Most small group plans, however, do not have similar limits on the premiums that can be charged.
• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Virginia Medicaid program offers free health coverage for pregnant women, families with children, and elderly and disabled individuals with very low incomes.
• If your children are 18 years old or younger, do not have health insurance and meet other qualifications, they may be eligible to buy health insurance for them through the Family Access to Medical Insurance Security (FAMIS).
• If you believe that you have or are at risk for breast or cervical cancer, you may be eligible for free screening and treatment. The Every Woman’s Life Program provides qualified women with free breast and cervical cancer screening. In addition, women diagnosed with cancer through this program may be eligible for treatment through the Virginia Medicaid Program.
• If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help you pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and is equal to 65% of the cost of qualified coverage, including COBRA and health insurance offered through Anthem Blue Cross Blue Shield and Carefirst Blue Cross Blue Shield.
• If you are a retiree aged 55-65 and are receiving benefits from Pension Benefit Guarantee Corporation (PBGC), then you may be eligible for the HCTC.