Virginia Health Insurance Guide

Health Insurance Overview in Virginia

Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the federal poverty level. Virginia has run its own state-based marketplace, Virginia’s Insurance Marketplace, since fall 2023, and has a competitive marketplace, particularly in Northern Virginia and the Richmond metro area. Virginia has worked to improve marketplace insurer participation in rural areas.

Average Health Insurance Costs in Virginia

Marketplace Enrollment in Virginia

Virginia residents can enroll in individual and family health insurance plans through Virginia's Insurance Marketplace (State-Based). Open enrollment runs November 1 – December 31 for 2027 coverage (Virginia’s Insurance Marketplace).

Average Premiums by City in Virginia

Medicaid in Virginia

Virginia Medicaid expanded in January 2019, covering adults with incomes up to 138% of the federal poverty level.

Children's Health Insurance (CHIP) in Virginia

FAMIS Plus covers children up to 200% of the federal poverty level, and FAMIS covers children up to 200% as well.

What Makes Virginia Unique

Virginia's Medicaid expansion in 2019 covered approximately 400,000 previously uninsured Virginians and was notable as a bipartisan legislative achievement in a state with divided government at the time. The expansion was tied to additional healthcare transparency measures and was part of a broader healthcare reform package.

ACA Subsidies: What Virginia Residents Should Know

The enhanced subsidies first enacted in the American Rescue Plan expired at the end of 2025. For 2026, premium tax credits follow the original ACA rules: there is no credit above 400% (the “subsidy cliff”), and enrollees are expected to pay up to 9.96% of income toward the benchmark Silver plan. House in January 2026 but has not become law, so 2027 plans are being priced and subsidized under the same rules unless Congress acts.

Virginia’s Marketplace for 2027: Insurers, Rates, and Dates

Virginia residents enroll through Virginia’s Insurance Marketplace. Full-price premiums rose about 21.6% on average for 2026, before subsidies. 8 insurers sold plans for 2026; Cigna is leaving for 2027, so its enrollees need to choose a new plan.

Open enrollment for 2027: November 1 through December 31, 2026.

What’s Different About Health Coverage in Virginia

Virginia has run its own exchange since fall 2023 and operates a reinsurance program effective 2023. Cigna exits for 2027, leaving seven insurers including CareFirst, Anthem HealthKeepers, Kaiser Permanente, Oscar, and Sentara. Note the shorter window: Virginia’s open enrollment for 2027 ends December 31.

Tips for Choosing Health Insurance in Virginia

Virginia Medicaid covers low-income adults since the 2019 expansion. Northern Virginia residents benefit from a competitive marketplace with multiple insurer options. ACA subsidies are available for incomes 100-400% of the federal poverty level. FAMIS provides children's coverage.

• Enroll during open enrollment (November 1 – December 31 for 2027 coverage (Virginia’s Insurance Marketplace)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.

Frequently Asked Questions

Which insurers are leaving the Virginia marketplace for 2027?

Cigna is leaving for 2027. Enrollees with that insurer should choose a new plan during open enrollment; an automatic replacement may have a different network or drug list.

When is open enrollment in Virginia for 2027?

November 1 through December 31, 2026.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official Virginia's Insurance Marketplace (State-Based) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.