Health Insurance Companies in Virginia in 2026
Ultimate Guide to Coverage, Costs, Private and Public Plans
Health insurance in Virginia continues to change significantly in 2026. Premiums are shifting, subsidies have been adjusted, carriers are entering and exiting the market, and new open enrollment rules apply. Whether you need coverage for yourself, a partner, your family, or you are nearing retirement, this guide explains your options, how coverage works, and what you can expect to pay.
Table of Contents
- Understanding Health Insurance in Virginia
- Private Health Insurance Carriers in Virginia
- Public Health Plan Options
- Cost of Health Insurance in Virginia 2026
- Comparing Plans: Premiums, Deductibles, Out of Pocket
- How to Enroll in a Plan
- Tips for Choosing the Best Plan
- Frequently Asked Questions
- Resources
1. Understanding Health Insurance in Virginia
Health insurance provides financial protection and peace of mind in case of medical needs. In Virginia you can find:
- Individual and Family Plans through the Virginia health insurance Marketplace
- Employer-Sponsored Plans
- Medicaid and FAMIS for low-income residents
- Medicare and Medicare Advantage for those 65 or older or with certain disabilities
All individual and family plans in the Marketplace must cover 10 essential health benefits including doctor visits, hospitalization, prescription drugs, preventive care, maternity care, and mental health services.
Enrollment in Marketplace plans for 2026 is open through January 30, 2026. After that, you can only change plans if you have a qualifying life event.
Medicaid enrollment is available year-round, but eligibility is based on income and household size.
Official source: Virginia SCC - Open Enrollment 2026
2. Private Health Insurance Carriers in Virginia
Virginia’s Marketplace offers plans from several private insurance carriers. These companies provide Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and in some cases Preferred Provider Organization (PPO) plans.
Major Private Carriers in 2026
| Insurance Company | Type of Plans Offered | Notes |
|---|---|---|
| Kaiser Permanente | HMO | Large network, highly rated |
| HealthKeepers (Anthem) | HMO | Available in multiple regions |
| Sentara Health Plans | HMO | Often among lowest premiums |
| Cigna Healthcare | EPO | Serves select areas |
| Optimum Choice | Various Marketplace Plans | Higher average premiums |
| CareFirst BlueChoice | HMO | Select regions |
| Oscar Insurance | EPO/HMO options | Often lowest cost Bronze plans |
Some carriers may exit the individual market or offer plans only in specific areas. Participation in the ACA Marketplace changes yearly.
Official source: Virginia SCC – Health Insurance Providers
3. Public Health Plan Options
Medicaid and FAMIS
- Medicaid is free or low cost for qualifying low-income adults.
- FAMIS is Virginia’s health insurance for children.
These public programs cover the same essential benefits as Marketplace plans but often require little or no premium from qualifying families. Eligibility is based on income relative to the federal poverty level.
Official source: Cover Virginia - Medicaid and FAMIS
Medicare Plans
For residents 65 or older or those with certain disabilities, Medicare is the federal health insurance program.
| Plan Name | Type | Typical Features |
|---|---|---|
| Original Medicare | Part A/B | Hospital and medical coverage |
| Medicare Advantage | Part C | Private plans with extra benefits |
| Medicare Supplement | Medigap | Covers gaps in Original Medicare |
| Part D | Prescription drug plans | Optional coverage |
Popular Medicare Advantage carriers in Virginia include UnitedHealthcare, Molina Healthcare, Cigna, and Kaiser Permanente, offering HMO and PPO options. Medicare plans are priced annually and may vary by county.
Official source: Medicare.gov - Virginia
4. Cost of Health Insurance in Virginia 2026
Health insurance costs vary widely based on age, location, tobacco use, plan tier (Bronze to Platinum), and whether you qualify for subsidies.
Costs by Metal Tier
| Tier | What It Means | Typical Cost Range |
|---|---|---|
| Bronze | Lower premium, higher out-of-pocket | $350 - $450/mo |
| Silver | Moderate premium and costs | $450 - $600/mo |
| Gold | Higher premium, lower out-of-pocket | $500 - $650/mo |
| Platinum | Highest premium, lowest out-of-pocket | $600+ |
Example Deductibles and Out of Pocket
| Tier | Typical Deductible | Max Out of Pocket |
|---|---|---|
| Bronze | ~$8,000 | ~$10,000 |
| Silver | ~$4,000 - $6,000 | ~$9,000 |
| Gold | ~$2,000 | ~$8,000 |
Many Virginians qualify for premium tax credits that reduce what you pay each month. Subsidies are based on income and family size.
Official source: Virginia SCC – Marketplace Plan Costs
5. Comparing Plans: Premiums, Deductibles, Out of Pocket
To compare plans effectively consider:
- Monthly premium: what you pay each month
- Deductible: how much you must pay before insurance starts to pay
- Copay and coinsurance: fees for services after deductible
- Out-of-pocket maximum: the most you pay in a year
| Plan Feature | Why It Matters |
|---|---|
| Monthly premium | Lower premiums save money monthly but may cost more when you use care |
| Deductible | Higher deductible means you pay more before insurance helps |
| Copay | Fixed cost per visit or service |
| Coinsurance | Percentage you pay after deductible |
| Network | If your doctors are included |
Plan Categories Explained
- HMO: Lower cost but requires you to use network providers
- PPO: More flexible but more expensive
- EPO: In network only, like HMOs but without referrals
6. How to Enroll in a Plan
Marketplace Enrollment
- Go to the Virginia Insurance Marketplace website
- Create or log in to your account
- Compare plans side by side
- Use the cost calculator to estimate your final premium after subsidies
- Submit your application before January 30, 2026
Official source: Virginia SCC – Open Enrollment
Employer-Sponsored Coverage
If your employer offers health insurance, you can enroll during your company’s open enrollment period. Employer plans vary widely in coverage and cost.
Medicaid and FAMIS
Check eligibility through Cover Virginia. If eligible, you can enroll anytime.
Official source: Cover Virginia
Medicare
Enroll in Medicare three months before turning 65. Medicare Advantage and Part D enrollments have yearly windows in the fall.
Official source: Medicare.gov
7. Tips for Choosing the Best Plan
- Check Your Provider Network: Make sure your doctors are in network
- Estimate Total Annual Cost: Low premium does not always mean low total cost
- Use the Marketplace Cost Calculator to estimate subsidies
- Consider Future Needs: If you expect hospital care, choose a higher tier
- Talk to a Certified Navigator for free assistance
Official source: Virginia SCC – Health Insurance Guides
8. Frequently Asked Questions
Do all Virginia plans offer the same basic coverage?
Yes. All ACA-compliant plans cover essential benefits. Differences are in cost-sharing and network.
Can I keep my current plan if premiums change?
You must review and actively enroll if your plan’s offering changes or if your subsidy situation changes.
What if I miss open enrollment?
You may only enroll if a qualifying life event occurs.