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 $21,600 for a single person). 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. The open enrollment period for 2026 coverage ran from November 1, 2025, through January 30, 2026, which is two weeks longer than the federal marketplace deadline.

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

What plans cost in 2026

Virginia's Bureau of Insurance approved an average rate increase of about 21.6% for 2026, before subsidies. The primary drivers are the expiration of enhanced premium tax credits at the end of 2025 and rising medical costs.

The subsidy expiration hit Virginia's marketplace hard. Only consumers with household income between 100% and 400% FPL qualify for premium tax credits in 2026, compared to the broader eligibility under the enhanced credits. Preliminary 2026 enrollment data shows a drop of roughly 20,000 enrollees compared to the same point in the prior year, suggesting some people priced out of coverage.

For those who do qualify for subsidies, Silver plans with cost-sharing reductions remain the best value. A 40-year-old in Northern Virginia might pay $500-$700/month for a benchmark Silver plan before subsidies, but far less after credits are applied depending on income.

Major carriers in Virginia (2026)

Eight insurers offer health plans on Virginia's marketplace for 2026, down from ten in 2025. Aetna and Innovation Health (an Aetna subsidiary) both 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.
• Cigna offers plans in select Virginia markets, providing another option for people who want national network access.
• 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 and Educators Health (EMI) round out the carrier options in specific regions.

Key regions

Northern Virginia

Fairfax, Arlington, Loudoun, and Prince William counties have the most carrier competition in the state. Kaiser, CareFirst, Anthem, Cigna, and Oscar 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 Cigna and Oscar. 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'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 is often the only marketplace insurer in these counties. 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