Insurance Questions? We Have Straight Answers.
Insurance is confusing — and that's by design. We're changing that. Here are honest, plain-English answers to the questions our clients ask most.
What Every Virginian Asks Us First.
Plain-English answers to the questions Virginians ask most — about carriers, Medicaid, FAMIS, FEHB, and TRICARE.
Virginia expanded Medicaid in 2019 to cover adults aged 19–64 with household income up to 138% of the Federal Poverty Level. For a single Virginian that is roughly $20,800/year; for a family of four it is around $43,000. Coverage is administered through Cardinal Care (Anthem HealthKeepers Plus, Optima Family Care, and other managed care organizations depending on your region). We screen eligibility before recommending any marketplace plan.
It depends almost entirely on where you live and who your doctors are. CareFirst BCBS dominates in Northern Virginia and DC-metro provider networks. Anthem HealthKeepers has the broadest statewide footprint and carries the largest share of Virginia's Medicaid managed care. Optima Health is owned by Sentara and is dominant across Hampton Roads and parts of the Shenandoah Valley. We check your specific physicians and hospitals against each carrier's network before recommending anything.
FEHB is usually strong for active federal employees and their families, but it is not always the best answer — especially for two-income households where the spouse has employer coverage, for high-income employees who hit the FEHB premium tier, or for contractors who lose FEHB eligibility. We do not sell FEHB plans, but we compare a CareFirst, Kaiser, or Anthem marketplace plan against your specific FEHB option so you can decide with real numbers.
TRICARE itself is excellent for active duty. The gaps are usually (1) civilian-employed spouses who need their own coverage, (2) dental — TRICARE Dental is limited, (3) vision for adults, and (4) retirees aligning TRICARE-for-Life with Medicare. We layer supplemental coverage around what TRICARE already provides so you are never paying twice for the same benefit.
FAMIS is Virginia's Children's Health Insurance Program. It covers children in working families whose income is too high for Medicaid but too low to comfortably afford private coverage — typically up to 200% of the Federal Poverty Level. FAMIS MOMS covers pregnant Virginians in the same income range. Many families assume they earn too much to qualify and never apply; we do the check for you.
Open Enrollment for Virginia runs November 1 through January 15 each year on the federal marketplace at HealthCare.gov. Outside that window, you need a Qualifying Life Event — losing job-based coverage, marriage, a baby, moving to or within Virginia, aging off a parent's plan at 26, or a household income change that affects subsidy eligibility. Medicaid and FAMIS enrollment, by contrast, are open year-round.
More limited than NOVA, but not as limited as people assume. Most Appalachian Virginia counties have at least two marketplace carriers — typically Anthem HealthKeepers and one regional plan — plus broad Medicaid expansion eligibility. Provider networks usually anchor on Carilion Clinic, Ballad Health, or Lewis Gale. The carrier count is smaller, so getting the network right matters more, not less. That is the conversation we have most often with Wise, Lee, Scott, and Buchanan County clients.