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2020 Individual and Family Plan Features

Offering Health Plans Throughout Central Virginia

Virginia Premier offers health plans in Richmond City and these eight counties: Amelia, Caroline, Chesterfield, Goochland, Hanover, Henrico, New Kent, Powhatan.

map of where virginia Premier offers individual and family plan coverage

Choose From a Variety of Coverage Options

Preferred Bronze 7200
Preferred Bronze 7000
Preferred Silver 6900
Preferred Silver 5000
Preferred Gold 1700
Deductible
$7,200 individual /
$14,400 family
$7,000 individual /
$14,000 family
$6,900 individual /
$13,800 family
$5,000 individual /
$10,000 family
$1,700 individual /
$3,400 family
Member
Co-insurance
50%
50%
30%
20%
15%
Out-of-pocket maximum
$8,150 individual /
$16,300 family
$8,150 individual /
$16,300 family
$8,150 individual /
$16,300 family
$8,150 individual /
$16,300 family
$8,150 individual /
$16,300 family
Office Visit*
PCP:
50% Coinsurance after deductible

Specialist:
50% Coinsurance after deductible
PCP:
$25 Co-pay


Specialist:
50% Coinsurance after deductible
PCP:
$20 Co-pay


Specialist:
30% Coinsurance after deductible
PCP:
$15 Co-pay


Specialist:
20% Coinsurance after deductible
PCP:
$25 Co-pay


Specialist:
15% Coinsurance after deductible
Prescription Drugs
(30-day supply) †
Preferred generic:
50% Coinsurance after Deductible

Non Preferred generic:
50% Coinsurance after Deductible

Preferred brand:
50% Coinsurance after Deductible

Specialty drugs:
50% Coinsurance after Deductible
Preferred generic:
$8

Non Preferred generic:
$25

Preferred brand:
50% Coinsurance after Deductible

Specialty drugs:
50% Coinsurance after Deductible
Preferred generic:
$4

Non Preferred generic:
$20

Preferred brand:
$60

Specialty drugs:
50% Coinsurance after Deductible

Preferred generic:
$4

Non Preferred generic:
$20

Preferred brand:
$55

Specialty drugs:
50% Coinsurance after Deductible

Preferred generic:
15% Coinsurance after Deductible

Non Preferred generic:
15% Coinsurance after Deductible

Preferred brand:
15% Coinsurance after Deductible

Specialty drugs:
50% Coinsurance after Deductible
Preferred Bronze 7200
Deductible
$7,200 individual / $14,400 family
Member Coinsurance
50%
Out-of-packet Maximum
$8,150 individual / $16,300 family
Office Visit*
PCP: 50% Coinsurance after deductible
Specialist: 50% Coinsurance after deductible
Prescription Drugs (30-day supply) †
Preferred generic: 50% Coinsurance after Deductible
Non Preferred generic: 50% Coinsurance after Deductible
Preferred brand: 50% Coinsurance after Deductible
Specialty drugs: 50% Coinsurance after Deductible
Preferred Bronze 7000
Deductible
$7,000 individual / $14,000 family
Member Coinsurance
50%
Out-of-packet Maximum
$8,150 individual / $16,300 family
Office Visit*
PCP: $25 Co-pay
Specialist: 50% Coinsurance after deductible
Prescription Drugs (30-day supply) †
Preferred generic: $8
Non Preferred generic: $25
Preferred brand: 50% Coinsurance after Deductible
Specialty drugs: 50% Coinsurance after Deductible
Preferred Silver 6900
Deductible
$6,900 individual / $13,800 family
Member Coinsurance
30%
Out-of-packet Maximum
$8,150 individual / $16,300 family
Office Visit*
PCP: $20 Co-pay
Specialist: 30% Coinsurance after deductible
Prescription Drugs (30-day supply) †
Preferred generic: $4
Non Preferred generic: $20
Preferred brand: $60
Specialty drugs: 50% Coinsurance after Deductible
Preferred Silver 5000
Deductible
$5,000 individual / $10,000 family
Member Coinsurance
20%
Out-of-packet Maximum
$8,150 individual / $16,300 family
Office Visit*
PCP: $15 Co-pay
Specialist: 20% Coinsurance after deductible
Prescription Drugs (30-day supply) †
Preferred generic: $4
Non Preferred generic: $20
Preferred brand: $55
Specialty drugs: 50% Coinsurance after Deductible
Preferred Gold 1700
Deductible
$1,700 individual / $3,400 family
Member Coinsurance
15%
Out-of-packet Maximum
$8,150 individual / $16,300 family
Office Visit*
PCP: $25 Co-pay
Specialist: 15% Coinsurance after deductible
Prescription Drugs (30-day supply) †
Preferred generic: 15% Coinsurance after Deductible
Non Preferred generic: 15% Coinsurance after Deductible
Preferred brand: 15% Coinsurance after Deductible
Specialty drugs: 50% Coinsurance after Deductible

Copayments do not count toward satisfying the deductible
† For co-pays, you don’t need to reach deductible before co-pay applies

Plan Documents

virginia premier individual and family health insurance silver plan
Preferred Silver 5000
virginia premier individual and family health insurance gold plan
Preferred Gold 1700

Insurance Terms Made Simple

Use our glossary of common health insurance terms to help you understand your insurance and benefits. To learn more about specific plan coverage, read our plan documents.

Co-payment – A fixed dollar amount you pay for a covered health care service, usually at the time you receive the services. Co-pays do not count toward your deductible.
Co-insurance – The percentage of costs of a covered health care service you pay after you’ve paid your deductible.
Deductible – The amount you pay for covered health services before your insurance begins to pay for your health care.
Formulary – A list of prescription drugs, both generic and brand name, covered by an insurance plan.
Out of Pocket Maximum – The most you have to pay for covered health care services, including deductibles, copayments and coinsurance, in a plan year.
Prescription Drug – A Medication that, by law, requires a prescription to be dispensed. 
Primary Care Physician – The particular doctor you select to be your main doctor to monitor your overall health.

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