Health Insurance Plans in Virginia

Virginia Eligibility Requirements

All applicants applying for medical coverage must meet age, dependent status, and residency requirements.

Age and Dependent Requirements
Other Insured Persons may include the following Family Member(s):

Note: A dependent spouse, Domestic Partner or a dependent child must reside in the Service Area, unless the child is covered under a Qualified Medical Child Support Order and lives outside the Service Area. A child eligible to enroll as a dependent under this Policy who resides outside of the Service Area is entitled to receive, while outside the Service Area, only out-of-area emergency benefits under the “Emergency Services” provision of the “Services and Benefits” section. However, that child, when he or she is within the Service Area, is eligible for benefits for Covered Services from Participating Providers, as outlined in this Policy.

• Your lawful spouse or Domestic Partner who lives in the Service Area.
• Your children or anyone who is dependent on You who live in the Service Area and have not yet reached age 26.
• Your stepchildren who live in the Service Area and have not yet reached age 26.
• Your own, or Your spouse's or Domestic Partner’s children, regardless of age, enrolled prior to age 26, who live in the Service Area and are incapable of self-support due to medically certified continuing intellectual or physical disability and are chiefly dependent upon the Insured Person for support and maintenance. Cigna requires written proof of such disability and dependency within 31 days after the child's 26th birthday. Periodically thereafter, but not more often than annually, Cigna may require written proof of such disability or dependency.
• Your own, or Your spouse's or Domestic Partner’s Newborn children are automatically covered for the first 31 days of life. To continue coverage past that time You must enroll the child as an insured Family Member by applying for his or her enrollment as a Family Member within 60 days of the date of birth, and pay any additional Premium. Coverage for a newborn dependent child enrolled within 60 days of birth will be retroactive to the date of the child’s birth. This also applies to a newborn child with respect to whom:
• a decree of adoption by You has been entered within 31 days after the date of the child’s birth; or
• adoption proceedings have been instituted by You within 31 days after the date of the child’s birth and You have temporary custody; or
• the adoption proceedings have been completed and a decree of adoption entered within one year from the institution of proceedings, unless extended by order of the court by reason of the special needs of the child.
• An adopted child is eligible for coverage from the date of adoption or parental placement with an Insured Person, and if the adoption occurred within 31 days of birth, the child shall be considered a newborn child of the Insured Person as of the date of placement. This shall continue unless the placement is disrupted prior to final decree of adoption and the child is removed from placement.
• An adopted child, including a child who is placed with You for adoption, is automatically covered for 31 days from the date of the adopted child’s placement for adoption or initiation of a suit of adoption. To continue coverage past that time You must enroll the child as an insured Family Member by applying for his or her enrollment as a Family Member within 60 days of the date of adoption, and pay any additional Premium. Coverage for an adopted dependent child enrolled within 60 days of adoption will be retroactive to the date of the child’s placement for adoption or initiation of a suit of adoption.
• A child who is placed with You for foster care is automatically covered for 31 days from the date of the foster child’s placement. To continue coverage past that time You must enroll the foster child as an insured Family Member by applying for his or her enrollment as a Family Member within 60 days of the date the child is placed with You for foster care, and pay any additional Premium. Coverage for a foster child enrolled within 60 days of placement for foster care will be retroactive to the date of the child’s placement for foster care.
• If a court has ordered a Policyholder to provide coverage for an eligible child (as defined above) coverage will be automatic for the first 31 days following the date on which the court order is issued. To continue coverage past that time You must enroll the child as an insured Family Member by applying for his or her enrollment as a Family Member within 60 days of the court order date, and paying any additional Premium. Court-ordered coverage for a dependent child enrolled within 60 days of the court order will be retroactive to the date of the court order. If a court has ordered a Policyholder to obtain coverage for a child, and that parent fails to obtain coverage as ordered, the child’s other parent or the Virginia Department of Social Services may enroll the child for coverage as a dependent of the Policyholder.

Please refer to the policy for additional eligibility requirements.

Signature Requirements

All applicants and dependents 18 years and older must sign and date the application.

Residency Requirements

• Must be a citizen or national of the United States, or a non-citizen who is lawfully present in the United States, and are reasonably expected to be a citizen, national, or a non-citizen who is lawfully present for the entire period for which enrollment is sought; and
• You live or reside in the state of Virginia; and
• You live or reside in the Service Area in which You are applying, and intend to continue living there for the entire period for which enrollment is sought; and
• You are not incarcerated other than incarceration pending the disposition of charges; and
• You do not reside in an Institution; and
• You have submitted a completed and signed application for coverage and have been accepted in writing by the Exchange.

Applicants must reside in one of the following Virginia counties at the time of application:

Northern Virginia: Alexandria City, Arlington, Clarke, Fairfax City, Fairfax, Falls Church City, Frederick, Loudoun, Manassas City, Manassas Park City, Prince William, Stafford, Warren, Winchester City, Spotsylvania, Fauquier, Page, Rappahannock, and Shenandoah.

Richmond: Amelia, Charles City, Chesterfield, Dinwiddie, Hanover, Henrico, Prince George, Sussex, Colonial Heights City, Hopewell City, Petersburg City, Richmond City, Cumberland, Louisa, Powhatan, Goochland.