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

Summary

• 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.