Health Care Benefits: Virginia
Federal law and guidance on this subject should be reviewed together with this section.
Author: Patricia A. Morley, Research and Writing Associates
- Virginia originally chose not to establish a state-based Marketplace under the Affordable Care Act, but then switched to a state-based, federally-supported Marketplace. See Health Insurance Marketplaces Under the ACA.
- Same-sex marriage is legal nationwide. See Same-Sex Partner Benefits.
- Small employers in Virginia (one to 50 employees) may purchase basic health insurance coverage for employees. These plans may exclude many of the state-mandated benefits. See Basic Health Insurance Plans.
- Virginia has requirements regarding coverage for preventive health care services and essential health benefits. See Preventive Health Care Services and Essential Health Benefits.
- Group health plans in Virginia must include certain maternity and newborn/adopted child coverage. See Maternity and Newborn/Adopted Child Coverage.
- Most group health plans must provide mental health and substance use disorder benefits in parity with medical and surgical benefits. See Mental Health and Substance Use Disorder Coverage.
- Group health plans must provide certain coverage for autism spectrum disorders. See Autism Spectrum Disorder Coverage.
- Group health plans must provide coverage for specified providers. See Coverage for Specified Providers.
- Health plans that cover mastectomies must also cover reconstructive breast surgery. See Mastectomies and Reconstructive Breast Surgery.
- Certain coverage with regard to children and dependents is mandatory. See Coverage for Children and Dependents.
- Health plans in Virginia must cover certain forms of cancer screening and coverage for new cancer treatments under investigation. See Mandatory Cancer Screenings and Treatment.