See your Virginia health insurance coverage options.

To qualify for health coverage through the Virginia Marketplace, you must: ⁷

• Live in Virginia
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁸

The open enrollment period for individual/family health coverage runs from November 1 to January 15 in Virginia.⁹

If you need your coverage to start on January 1, you must apply by December 15. If you apply between December 16 and January 15, your coverage will begin on February 1.⁷

The same deadlines will continue to be used by Virginia’s Insurance Marketplace after the state transitions away from HealthCare.gov in the fall of 2023.

Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage. Note that once Virginia’s Insurance Marketplace is in use, Virginia will be able to offer a special enrollment period in conjunction with the state’s tax-season “easy enrollment” program.

If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods.

To enroll in an ACA Marketplace plan in Virginia, you can: 

• Visit HealthCare.gov to access Virginia’s health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans. Starting in November 2023, for coverage effective in 2024, you’ll use Virginia’s Insurance Marketplace instead of HealthCare.gov.

• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity (EDE).¹⁰ (Note that as of November 2024, there will no longer be EDEs in Virginia, which means all Marketplace enrollments will have to be completed directly through the Virginia Insurance Marketplace. But brokers, Navigators, and enrollment assisters will continue to be available.)

For enrollment in 2023 coverage, you can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

You may find affordable health insurance options in Virginia by signing up through HealthCare.gov. Starting in the fall of 2023, you’ll use Virginia’s Insurance Marketplace instead.

As of early 2023, nearly nine out of ten eligible enrollees in Virginia saved money on premium payments that amounted to an average savings of $407/month – reducing the average net premium of subsidy-eligible enrollees to $86/month after subsidies.¹¹

The Affordable Care Act provides income-based advance premium tax credits (subsidies) that offset your premium payments to help keep your expenses down. People with household incomes below 250% of the federal poverty level also qualify for cost-sharing reductions (CSR) that may reduce your deductibles and out-of-pocket expenses when you buy a Silver plan. Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.

Source: CMS.gov¹¹

There are 13 insurers that offer health plans in Virginia’s exchange for 2024, including two separate Aetna entities.²

One carrier that offered plans in 2023, Piedmont Community Healthcare, opted to withdraw from the individual/family market in Virginia at the end of 2023, so their plans are not available for 2024.¹²

The insurers that offer individual market coverage through Virginia’s exchange initially proposed rate changes for 2024 that amounted to an average increase of about 28%.¹³ But that was before the legislature had approved continued funding for the state’s reinsurance program. The insurers proposed revised rates once the reinsurance funding was allocated. The revised rates, which were approved, amount to a weighted average increase of only about 1%.¹⁴

According to SERFF and the Virginia Bureau of Insurance, Virginia’s insurers will implement the following average rate changes for 2024:¹⁵ (Note that these rates are calculated before subsidies are applied; most enrollees qualify for subsidies and thus do not pay full price for their coverage.)

Source: Virginia SERFF Filings¹⁵

For perspective, here’s a summary of how overall average pre-subsidy premiums have changed in Virginia’s Marketplace over the years:

• 2015: 10.2% increase
• 2016: 8.5% increase¹⁶
• 2017: 16.4% increase¹⁷
• 2018: 57.7% increase¹⁸ (Optima/Sentara, which had the most significant increase, is facing a lawsuit from the U.S. Department of Justice over allegations that their rate filings for 2018 and 2019 were fraudulent.¹⁹)
• 2019: 9.6% increase²⁰
• 2020: 3.6% decrease²¹
• 2021: 3.7% decrease²²
• 2022: 3% decrease²³
• 2023: 12.9% decrease²⁴ (reinsurance took effect)

During the open enrollment period for 2023 coverage, 346,140 Virginia residents enrolled in private qualified health plans (QHPs) through the Virginia ACA marketplace.²⁵

This was the highest enrollment the state had seen since 2018, and likely was connected to the American Rescue Plan (ARP). Under the ARP, subsidies are more significant and accessible. And this has been extended through the end of 2025 by the Inflation Reduction Act. ²⁶

Source: 2014,²⁷ 2015,²⁸ 2016,²⁹ 2017,³⁰ 2018,³¹ 2019,³² 2020,³³ 2021,³⁴ 2022,³⁵ 2023²⁶

HealthCare.gov 800-318-2596 (for enrollments with a 2023 effective date)

Virginia’s Insurance Marketplace
The state-run exchange began to be used starting in November 2023, and is used for all plans with effective dates of 2024 or later.

Virginia Health Care Foundation

Virginia Consumer Assistance Program
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 310-6560 / [email protected]

State Exchange Profile: Virginia
The Henry J. Kaiser Family Foundation overview of Virginia’s progress toward creating a state health insurance exchange.