Health Insurance in Virginia

Medicaid expansion

Virginia expanded Medicaid in January 2019 after years of political debate. The expansion extended coverage to adults under 65 earning up to 138% of the federal poverty level (about $22,025 for a single person for 2027 coverage). As of mid-2025, roughly 652,000 Virginians were enrolled in expansion Medicaid, making it one of the more successful late-adopting states.

The expansion closed what would have been a coverage gap for low-income adults. Before 2019, childless adults earning below the poverty line had almost no path to affordable coverage. Now, Medicaid picks them up, and marketplace subsidies cover those between 100% and 400% FPL.

Virginia's Medicaid program, run through the Department of Medical Assistance Services (DMAS), also covers the standard populations: children, pregnant women, elderly, and disabled individuals. You can apply through CoverVA.

Virginia's own marketplace

Virginia transitioned from HealthCare.gov to its own state-based marketplace in 2023. Enrollment happens at marketplace.virginia.gov, not at HealthCare.gov. Open Enrollment for 2027 coverage runs from November 1, 2026, through January 29, 2027, two weeks longer than HealthCare.gov's January 15 deadline.

The state marketplace offers certified assisters and navigators for free enrollment help. You can call 888-687-1501 for personalized assistance.

New for 2027: Virginia Premium Savings

Virginia Premium Savings is a new state-funded program that lowers monthly premiums for eligible marketplace enrollees. It is applied on top of any federal premium tax credit. You may qualify if you live in Virginia, enroll through Virginia's Insurance Marketplace, and have household income between 138% and 250% of the federal poverty level (larger households may qualify above that range). The marketplace estimates about 200,000 Virginians may qualify, with some saving as much as 70%.

The savings do not apply automatically. You have to enroll, and for most people Open Enrollment is the only chance to get them for 2027.

What plans cost in 2027

For 2027, the Bureau of Insurance approved rate changes for marketplace insurers ranging from 3.9% to 22.7%. Insurers had requested an average increase of 16.7%. That follows an average increase of about 21.6% for 2026. KFF puts Virginia's average benchmark Silver premium for a 40-year-old at $549 a month for 2027, up from $455 in 2026, before any tax credit.

The enhanced premium tax credits expired after 2025 and were not extended. For 2027, federal premium tax credits go only to households with income between 100% and 400% FPL (up to about $63,840 for a single person or $86,560 for a household of two). Preliminary 2026 enrollment data showed a drop of roughly 20,000 enrollees compared to the same point in the prior year, suggesting some people were priced out of coverage.

For those who qualify for help, Silver plans with cost-sharing reductions are often the best value, and Virginia Premium Savings can lower the premium further for people between 138% and 250% FPL.

Major carriers in Virginia (2027)

Seven insurance companies sell 2027 plans on Virginia's marketplace. Cigna left the marketplace for 2027, after Aetna and Innovation Health exited at the end of 2025.

• Anthem HealthKeepers (Anthem Blue Cross Blue Shield) is the largest marketplace carrier in Virginia with the widest geographic reach. Offers plans across most of the state with broad provider networks.
• CareFirst BlueCross BlueShield (through CareFirst BlueChoice and Group Hospitalization and Medical Services) operates primarily in Northern Virginia and parts of the eastern half of the state. Strong presence in the D.C. metro area.
• Kaiser Permanente offers HMO plans in Northern Virginia and parts of the Richmond area. Known for its integrated care model where insurance and providers are part of the same organization.
• Oscar Health operates in parts of Virginia and is popular with younger enrollees for its app-based experience and virtual-first care model.
• Sentara Health Plans covers the Hampton Roads and parts of eastern Virginia, tied to the Sentara hospital system.
• Optimum Choice (a UnitedHealthcare company) offers plans in parts of the state, including the Richmond, Washington suburbs, Bristol, and Winchester areas.

Key regions

Northern Virginia

Fairfax, Arlington, Loudoun, and Prince William counties have the most carrier competition in the state. Kaiser, CareFirst, Anthem, Oscar, and Optimum Choice all offer plans. Premiums tend to be higher than other parts of Virginia because of the high cost of living and medical services in the D.C. metro area, but the number of plan options gives consumers more ability to shop around.

Richmond

The Richmond metro has solid options from Anthem and Kaiser (in some areas), along with Oscar and Optimum Choice. Premiums are moderate compared to Northern Virginia. The VCU Health and HCA Virginia hospital systems are central to most carrier networks.

Hampton Roads

Norfolk, Virginia Beach, Newport News, and surrounding areas are served by Anthem and Sentara Health Plans. Sentara was approved for a 22.7% increase for 2027, the largest among marketplace insurers. Sentara's integrated health system (hospitals, clinics, and insurance) gives it an advantage in this region.

Southwest and rural Virginia

Rural parts of the state, particularly in Southwest Virginia and the Shenandoah Valley, have fewer carrier options. Anthem and Sentara are the only insurers with plans in every region of the state, though not necessarily in every county. Premiums can be higher due to less competition, and provider networks are smaller. Access to specialists often requires travel to larger cities.

Estimate your subsidy

Resources for Virginians

• Virginia's Insurance Marketplace for plan shopping and enrollment
• CoverVA for Medicaid and CHIP applications
• Virginia State Corporation Commission for insurance rate data and consumer protection
• Call 888-687-1501 for free enrollment help from certified marketplace navigators