Virginia health insurance Marketplace guide

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
• File taxes jointly with your spouse, if you’re married⁹ (with very limited exceptions)¹⁰
• Not be able to be claimed as a tax dependent by someone else.¹¹

The open enrollment period for individual/family health coverage runs from November 1 to January 15 in Virginia.¹²

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 1.¹³

Starting in the fall of 2026, for coverage effective in 2027 and subsequent years, open enrollment will end no later than December 31. And all plans selected during open enrollment will take effect January 1. This is due to a federal rule change that was finalized in 2025.

Outside of open enrollment, a special enrollment period (generally linked to a specific qualifying life event) is necessary to enroll or change your coverage. 

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 Virginia’s health insurance Marketplace to access an online platform to shop, compare, and choose the best health plans.
• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor.
• Call Virginia’s Insurance Marketplace at 888-687-1501.

You may find affordable health insurance options in Virginia by signing up through Virginia’s Insurance Marketplace.

For those who enrolled in private plans through Virginia’s Insurance Marketplace during the open enrollment period for 2025 coverage, more than 86% were eligible for advance premium tax credits (APTC, or premium subsidies). These subsidies averaged $410/month, reducing the average net premium of subsidy-eligible enrollees to $87/month after subsidies.¹⁴

The Affordable Care Act provides the income-based APTC to make premiums much more affordable than they would otherwise be. People with household incomes up to 250% of the federal poverty level also qualify for cost-sharing reductions (CSR) that reduce out-of-pocket expenses on Silver plans (CSR benefits aren’t available at other metal levels).

Due to premium subsidies and cost-sharing reductions, you may find that a plan obtained through Virginia’s Insurance Marketplace is the best option.

Source: CMS.gov¹⁵

Eight insurers will offer health plans in Virginia’s exchange for 2026.⁴ Ten carriers offered plans for 2025, but Aetna and Innovation Health (an Aetna affiliate)¹⁶ are exiting the individual market at the end of 2025.

Aetna is leaving the individual market nationwide at the end of 2025. Enrollees with Aetna or Innovation Health coverage will need to select a new plan for 2026, during the open enrollment period that begins November 1, 2025.

The following average rate changes have been proposed for 2026 by the insurers that offer coverage through Virginia’s health insurance Marketplace, calculated before subsidies are applied.¹⁷

Source: Virginia State Corporation Commission, Bureau of Insurance;⁴ Virginia SERFF;¹⁸ and RateReview.HealthCare.gov¹⁹

The average proposed rate increases listed above are calculated before any subsidies are applied, and most enrollees are subsidy-eligible. But it’s important to understand that the federal subsidy enhancements that have been in place since 2021 are scheduled to expire at the end of 2025. Unless Congress extends them, subsidies will be smaller in 2026, and available to fewer people. This will cause substantial increases in the net (after-subsidy) premiums that Marketplace enrollees pay.

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% increase²⁰
• 2017: 16.4% increase²¹
• 2018: 57.7% increase²²
• 2019: 9.6% increase²³
• 2020: 3.6% decrease²⁴
• 2021: 3.7% decrease²⁵
• 2022: 3% decrease²⁶
• 2023: 12.9% decrease²⁷ (reinsurance took effect)
• 2024: 1.1% increase²⁸ (much lower than proposed, due to extension of reinsurance)
• 2025: 3.9% increase²⁹

During the open enrollment period for 2025 coverage, 388,856 Virginia residents enrolled in private qualified health plans (QHPs) through the Virginia ACA marketplace.³⁰

Unlike most states, where 2025 enrollment reached a record high,³¹ Virginia’s 2025 enrollment was lower than 2024 enrollment had been (see chart below).

Enrollment had grown in each of the three previous years, however, as was the case in other states. The enrollment growth from 2022 through 2024 stemmed from the subsidy enhancements under the American Rescue Plan (ARP) and Inflation Reduction Act, as well as the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Virginia began disenrolling people from Medicaid in 2023 (after a three-year pause on disenrollments), and more than 27,000 people transitioned from Medicaid to a Marketplace plan in Virginia during the unwinding process.³²

Source: 2014,³³ 2015,³⁴ 2016,³⁵ 2017,³⁶ 2018,³⁷ 2019,³⁸ 2020,³⁹ 2021,⁴⁰ 2022,⁴¹ 2023, ⁴² 2024,⁴³ 2025³⁰

Virginia’s Insurance Marketplace
The state-based 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.