What is a qualified health plan (QHP)?

A qualified health plan (QHP) is a type of health insurance plan that meets standards outlined by state and federal regulations for consumer protection. QHPs are available to individuals and small businesses through state health insurance marketplaces or exchanges. In Virginia, these marketplace plans are offered through HealthCare.gov. QHPs must cover a range of essential health benefits like doctor visits, hospitalizations, prescription drugs, maternity care, and mental health services. Additionally, QHPs must meet certain criteria related to cost and accessibility. For example, plans must limit out-of-pocket costs for covered services and limit the number of people a plan can exclude due to pre-existing conditions. QHPs are offered on a tiered system of metal plans. The metal plans vary in cost and benefits. For example, Bronze plans typically involve higher out-of-pocket costs for the patient, have lower premiums, and cover 60% of covered services. Silver plans involve moderate out-of-pocket costs, moderate premiums, and cover 70% of covered services. Gold plans typically involve lower out-of-pocket costs, higher premiums, and cover 80% of covered services. QHPs are an important resource for individuals and small businesses in Virginia. Not only do QHPs provide comprehensive health insurance coverage for those who may not have access to traditional employer-based health plans, but they also provide protections to help individuals and businesses save money on health care costs.

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What is a qualified health plan (QHP)?

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