Virginia health plan · 2025

Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision · 86443VA0080023

Innovation Health Plan, Inc. offers this marketplace health insurance plan (Plan ID 86443VA0080023) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Silver Plan type: HMO CSR: 87% AV Level Silver Plan Issuer: Innovation Health Plan, Inc.
Telehealth Data pending HSA eligible No Dental Not listed Vision Not listed
View issuer site

Issuer actuarial value: 87.39%. Expect to pay roughly 12.61% of covered costs out of pocket, based on issuer reporting.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

See plan search for live pricing

Before subsidies

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Deductible

N/A

N/A

See deductible details

Max out-of-pocket

$3,025

N/A

Review MOOP rules

Office visits

Primary care See benefits
Specialist See benefits
HSA Not eligible

Drug tiers

Generic See drug coverage
Preferred brand See drug coverage

View formulary tiers

Issuer profile See benefits
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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Virginia). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • 87% AV Level Silver Plan plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

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  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 86443VA0080023
Coverage year 2025
State Virginia
Issuer Innovation Health Plan, Inc.
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 86443VA0080023-05
Available variants

Standard On Exchange Plan · 86443VA0080023-01

Open to Indians below 300% FPL · 86443VA0080023-02

Open to Indians above 300% FPL · 86443VA0080023-03

73% AV Silver Plan · 86443VA0080023-04

87% AV Silver Plan · 86443VA0080023-05

94% AV Silver Plan · 86443VA0080023-06
Last plan update Fri, 28 Nov 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Virginia 11128
PCPs in Virginia 1745
Telehealth support Data pending
Nationwide providers 15062
11,128 doctors statewide 1,745 PCPs 56 OB/GYN

Provider network(s)

Providers Virginia All US states
All 11128 15062
PCP 1745 2045
Allergy 4 6
OB/GYN 56 75
Dentists 674 772

Drug coverage overview

3,319 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
NON-PREFERRED-GENERIC-NON-PREFERRED-BRAND 2,428
ZERO-COST-SHARE-PREVENTIVE-DRUGS 421
NON-PREFERRED-BRAND-SPECIALTY-DRUGS 258
PREFERRED-BRAND 212
Prior authorization Drugs
Required 586
Not Required 2,733
Step therapy Drugs
Required 186
Not Required 3,133
Quantity limits Drugs
Has Limit 960
No Limit 2,359

Customer highlights

What stands out for members

  • Issuer: Innovation Health Plan, Inc. · Plan ID 86443VA0080023 · 2025 filing.
  • Disease management programs available: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 86443VA0080023-05 (87% AV Silver Plan) currently displayed.
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Variant attributes

Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision · Variant 86443VA0080023-05

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

87% AV Level Silver Plan

HIOS Product ID

86443VA008

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

86443VA0080023-05

Plan Marketing Name

Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision

Plan Variant Marketing Name

Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision

Issuer & service area

Issuer-provided metadata for this variant.

Issuer Actuarial Value

87.39%

Issuer ID

86443

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

VAN001

Out of Country Coverage

No

Out of Service Area Coverage

No

Out of Service Area Coverage Description

Except for Emergencies

Service Area ID

VAS001

State Code

VA

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Inpatient Copayment Maximum Days

3

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

Medical EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$2,200

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$700

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$1,200

SBC Scenario, Treatment of a Simple Fracture, Deductible

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family

per person not applicable | per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family

$3025 per person | $6050 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$3,025

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family

per person not applicable | per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

VAF010

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$20

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

Additional attributes

Issuer-provided metadata for this variant.

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Drug EHB Deductible, Combined In/Out of Network, Family

per person not applicable | per group not applicable

Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Drug EHB Deductible, In Network (Tier 1), Family

$400 per person | $800 per group

Drug EHB Deductible, In Network (Tier 1), Individual

$400

Drug EHB Deductible, Out of Network, Family

per person not applicable | per group not applicable

Drug EHB Deductible, Out of Network, Individual

Not Applicable

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

EHB Percent of Total Premium

93%

First Tier Utilization

100%

Import Date

1/13/2025

HSA Eligible

No

IsItANewPlan

New

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

Yes

Medical EHB Deductible, Combined In/Out of Network, Family

per person not applicable | per group not applicable

Medical EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Medical EHB Deductible, In Network (Tier 1), Family

$0 per person | $0 per group

Medical EHB Deductible, In Network (Tier 1), Individual

$0

Medical EHB Deductible, Out of Network, Family

per person not applicable | per group not applicable

Medical EHB Deductible, Out of Network, Individual

Not Applicable

Plan Effective Date

1/1/2025

Plan Type

HMO

QHP/Non QHP

Both

Source Name

SERFF

Specialist Requiring a Referral

Referral required for all physicians EXCEPT OB/GYN, ER, Internal Medicine, Family Practice, General Medicine and Pediatrician.

Plan ID

86443VA0080023

Unique Plan Design

Yes

Version Number

1

Wellness Program Offered

Yes

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Virginia?

Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision (86443VA0080023) is a Silver HMO from Innovation Health Plan, Inc. in Virginia for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision coverage is not listed for this plan.

Does Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision?

The issuer lists disease management resources for: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.

Is there out-of-country coverage for Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision?

No, out-of-country services are not covered for this plan.

Does Innovation Health - Aetna Silver 10 Advanced: HMO + Adult Dental + Vision cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies. Details: Except for Emergencies

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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