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 uses the federal HealthCare.gov marketplace 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

Health insurance premiums in Virginia vary significantly based on age, plan type (Bronze, Silver, Gold, Platinum), insurer, and income-based subsidies. The figures below represent estimated 2026 benchmark premiums before ACA subsidies for a 40-year-old individual and family of four.

Coverage Type	Monthly Premium	Annual Premium
Individual (benchmark Silver)	$475/mo	$5700/yr
Family of Four (benchmark Silver)	$1,358/mo	$16296/yr
Avg. Annual Deductible	$4,400

Premiums shown are before ACA subsidies. Most marketplace enrollees receive premium tax credits that significantly reduce these costs. Use our Health Insurance Calculator to estimate your net premium after subsidies.

Marketplace Enrollment in Virginia

Virginia residents can enroll in individual and family health insurance plans through HealthCare.gov (Federal). Open enrollment runs November 1 – January 15 (federal marketplace). Outside of open enrollment, a qualifying life event (job loss, marriage, birth of a child, move to a new state) triggers a Special Enrollment Period during which you can enroll or change plans.

Average Premiums by City in Virginia

Health insurance premiums vary by location within Virginia, reflecting local healthcare costs, provider availability, and insurer competition. The following estimated monthly individual premiums are based on a benchmark Silver plan for a 40-year-old non-smoker.

City	Est. Monthly Premium (Silver, age 40)
Virginia Beach	$482/mo
Norfolk	$488/mo
Chesapeake	$478/mo
Richmond	$475/mo
Arlington	$492/mo
Alexandria	$490/mo
Newport News	$480/mo

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

Premium tax credits (subsidies) are available for Virginia residents who purchase coverage through the marketplace and have incomes between 100% and 400% of the federal poverty level (or higher in states with additional state subsidies). The subsidy amount is based on the cost of the benchmark Silver plan in your area and your income. For 2026, the enhanced subsidies first enacted in the American Rescue Plan have been extended, providing more substantial assistance across a broader income range than before.

Cost-sharing reductions (CSRs) provide additional savings on deductibles and copays for those who enroll in Silver plans with incomes between 100-250% of the federal poverty level. Silver plans with CSRs often provide Gold or Platinum-level value at Silver premiums, making them the best value for eligible enrollees.

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 – January 15 (federal marketplace)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.
• Check both Medicaid eligibility and marketplace subsidy eligibility — your income determines which program you qualify for.
• Don't just compare premiums — also compare deductibles, out-of-pocket maximums, and whether your doctors are in-network.
• Silver plans with cost-sharing reductions (for incomes 100-250% FPL) typically offer the best overall value despite higher premiums than Bronze plans.
• Use our Health Insurance Calculator to estimate your total annual cost (premium + expected out-of-pocket) for different plan options.

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 HealthCare.gov (Federal) 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.