Your Insurance Detective › Virginia, private health insurance
What Are My Private Health Insurance Options in Virginia, and What Do They Cost?
Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published October 6, 2026
Private health insurance in Virginia is any coverage you buy yourself instead of getting it from a job or a government program. On Virginia's Insurance Marketplace, the state-run exchange, the 2026 average list price for a 40-year-old ran from $351 a month (lowest-cost Bronze) to $455 (benchmark Silver), before any subsidy, and the Bureau of Insurance approved 2027 average increases of 3.9% to 22.7% for the seven companies selling there. You have several kinds to choose from: a marketplace plan, the same kind of plan bought direct, a private plan priced on your own health, a fixed-benefit plan, and for people with business income, a pre-established ERISA group plan. I'm Dick Tracy, a licensed health insurance broker, licensed in Virginia and based in Buffalo, NY. I educate, you decide.
My license number is NPN 20414610, I hold licenses in 25 states, and I work with 80+ carriers. My office is in Buffalo, New York, so I work with Virginians by phone or Zoom with the plan documents on the screen, whether you are in Fairfax, Richmond, Roanoke, or Virginia Beach. This page is for anyone in Virginia without job coverage: you are between jobs, you retired before 65, you work for yourself, or you earn too much for a subsidy and the marketplace price made you blink.
per month before any subsidy
marketplace companies
marketplace for 2027 (9 filings in all)
Sources: KFF, 2026 marketplace premiums; Virginia State Corporation Commission, Bureau of Insurance, 2027 ACA Individual Market Rate Summary (checked October 6, 2026).
What "private health insurance" actually means
People type "private health insurance" when they mean "insurance I buy on my own." That is the right instinct. Health coverage in this country comes from three places: a government program (Medicare, Medicaid, FAMIS), a job, or the private market where you buy it yourself. If it is not from the government and not from an employer, it is private.
One thing surprises people. A plan on Virginia's Insurance Marketplace is private health insurance too. The state runs the store, but the plans on the shelf come from private insurance companies. So the real question is not "marketplace or private." It is "which kind of private coverage fits my health, my income, and my doctors."
The kinds of private coverage a Virginia resident can buy
| Kind of coverage | What sets the price | Tax credit possible? | Who it tends to fit |
|---|---|---|---|
| Marketplace plan on Virginia's Insurance Marketplace | Age, where you live, tobacco use, plan level | Yes, if your income qualifies | Anyone who qualifies for a credit, and anyone with a health condition |
| The same kind of plan bought direct from the company | Age, where you live, tobacco use, plan level | No | Someone who wants that company's plan and gets no credit either way |
| Private plan priced on your own health | Your own health, plus age and location | No | Healthy people with no credit coming who want a broad PPO network |
| Fixed-benefit plan | Mostly the benefit amounts you choose | No | Healthy people who want a low premium and are comfortable shopping for care |
| Pre-established ERISA group plan | Group rates | No | People with self-employment or business income, especially with a family on the policy |
| COBRA (keeping your old job plan) | The full group premium, which you now pay yourself | No | Someone mid-treatment who needs the exact same plan for a while |
Marketplace plans, and the same plans bought direct, take everyone with no health questions. Other private plans can be priced on your own health, which means health questions, and not everyone qualifies. I sort out which is which for you on the call.
COBRA is a continuation of a job plan, not a new private plan. It is in the table because it is usually the first price a person between jobs sees.
A marketplace plan on Virginia's Insurance Marketplace
Virginia runs its own marketplace. It opened on November 1, 2023 in place of healthcare.gov, so if you have been typing healthcare.gov out of habit, the state site is where Virginia plans live now. Every plan on it takes everyone, and charges the same price for the same plan, age, location and tobacco status. No health questions. It is also the only place a premium tax credit applies, and the only place the new Virginia Premium Savings applies. The trade-offs are real: the price is built on everyone in the pool, not on you, the company lineup depends on where you live, and the credit is tied to an income estimate you have to get right. Guess low and you may owe some of it back at tax time.
Fits: anyone whose income qualifies for a credit, and anyone whose health would not pass health questions.
The same kind of plan, bought direct from the insurance company
The companies that sell on the marketplace also sell plans directly, and the Bureau's 2027 table lists every marketplace filing as sold both on and off the marketplace. The rules are the same: no health questions, same rating factors. The difference is that no tax credit applies. For most people there is little reason to pay full price this way without first pricing the other kinds.
Fits: a narrow group. I mention it so you know it exists.
A private plan priced on your own health
This is the kind most people have never been shown. Outside the marketplace, and outside the Affordable Care Act rules, an insurance company can price a plan on your own health instead of the average of everyone in the pool. These plans usually run on large national PPO networks, so you are not tied to one hospital system, which matters if your doctors are across the line in Maryland or DC. They are not marketplace plans. They ask health questions and not everyone qualifies, so I walk you through the plan documents before anyone signs.
Fits: healthy people with no credit coming who want to pick their own doctors. Does not fit: anyone with a health condition that keeps them from qualifying. That is arithmetic, not a judgment, and it is one reason the marketplace takes everyone.
A fixed-benefit plan
A fixed-benefit plan pays a set dollar amount per service: this much for an office visit, this much per hospital day, this much for a surgery. It does not pay a percentage of the bill. In my experience the premiums usually run below a major medical plan. I explain these honestly because they get oversold: they are a foundation, not a roof. Pair one with catastrophic protection, or use it as the everyday layer on top of something bigger. Which specific products are approved for Virginia residents changes, so I confirm what is on the table for you on the call.
Fits: healthy people who want a low premium and are comfortable shopping for care. Does not fit: anyone expecting a big surgery or a chronic-condition year who wants one plan to carry the whole load.
A pre-established ERISA group plan
There are group plans that already exist, and a person with self-employment or business income can be merged into one. If you qualify, you get group rates and a PPO network without needing employees or a payroll of your own. I confirm eligibility on the call. In Virginia this is one option among several, not the automatic answer. If you are retired or between jobs with no business income, it is likely off the table, and I will tell you that on the call. The Virginia self-employed page covers this route in detail.
Fits: owners and 1099 earners who want a group-style PPO, especially with a spouse or children on the policy.
A word on supplemental plans. Accident and critical illness plans pay set dollar amounts when something happens. They are useful add-ons on top of a medical plan, not a replacement for one.
How much does private health insurance cost in Virginia?
Here are the published averages, so you have an honest anchor. These are 2026 marketplace prices for a 40-year-old buying on their own, before any subsidy:
| 2026 marketplace average (age 40, before any subsidy) | Virginia | US average |
|---|---|---|
| Lowest-cost Bronze plan | $351/month | $456/month |
| Benchmark Silver plan | $455/month | $625/month |
| Lowest-cost Gold plan | $441/month | $615/month |
Source: KFF analysis of marketplace data, 2026 plan year.
Two things stand out. Virginia's sticker prices sit well under the national averages, partly because the state's reinsurance program pays part of the largest claims so companies can file lower rates; the Bureau of Insurance says that program keeps rates 15% or more below where they would otherwise be. And the lowest-cost Gold plan averaged less than the benchmark Silver plan, which is why I never judge a metal level by its name.
I can only publish marketplace prices here. The other kinds are priced on the person or the group, so there is no honest average to print. That number comes from a quote, and a quote takes one call.
Low does not mean flat. The benchmark Silver premium for a 40-year-old went from $372 a month in 2025 to $455 in 2026, per KFF, and the Bureau's approved 2026 changes ran from 1.1% to 35.4% by company, with the two largest companies by projected enrollment at 20.9% and 22.4%.
What the Bureau of Insurance approved for 2027
| Company (name on the filing) | Where it filed for 2027 | Highest 2027 average change requested | Final 2027 average change approved |
|---|---|---|---|
| CareFirst BlueChoice, Inc. | Washington, Arlington, Alexandria area | +6.7% | +5.8% |
| Group Hospitalization and Medical Services, Inc. | Washington, Arlington, Alexandria area | +9.7% | +8.4% |
| HealthKeepers, Inc. | All areas | +14.3% | +12.6% |
| Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. | Richmond, Washington area, and outside the metro areas | +11.8% | +11.3% |
| Optimum Choice, Inc. | Bristol, Richmond, Washington area, Winchester, and outside the metro areas | +15.9% | +3.9% |
| Oscar Insurance Company | Charlottesville, Richmond, Washington area, and outside the metro areas | +14.3% | +13.4% |
| Sentara Health Plans | All areas | +22.8% | +22.7% |
| Anthem Health Plans of Virginia, Inc. (off the marketplace only) | All areas | +12.6% | +9.1% |
| Sentara Health Insurance Company (off the marketplace only) | Virginia Beach and Norfolk area | +10.8% | +10.6% |
Source: Virginia State Corporation Commission, Bureau of Insurance, 2027 ACA Individual Market Rate Summary, checked October 6, 2026. The Bureau notes that a company's filing in an area does not mean it sells in every part of that area, and that the requested column shows the highest change a company asked for during the review. The Bureau's August 27, 2026 release put the average requested increase across the individual market at 16.7%. These are approved changes to each company's average rate, not what your own plan changes by. I will update this table if the Bureau revises it.
Now the part averages hide. Those are marketplace-style prices, and by law a marketplace plan cannot ask about your health. A healthy 40-year-old and a 40-year-old on three prescriptions pay the same rate. Your own number moves with your age, where you live (Virginia prices Northern Virginia differently than Southwest Virginia), tobacco use, the network you pick, and the kind of plan. That last one is the lever. A plan priced on your own health is where the averages stop applying. Anyone who quotes your premium without asking about you first is guessing.
And if a subsidy is in play: for 2026 coverage, the premium tax credit ends at 400% of the poverty level, which is $62,600 for one person and $128,600 for a household of four. For 2027 coverage the line is 400% of the 2026 poverty guideline: $63,840 for one person and $132,000 for a household of four, unless Congress changes the rule. One dollar over and the whole credit is gone. Virginia adds a second layer starting with 2027 plans: Virginia Premium Savings, a state subsidy for households between 138% and 250% of the poverty level, which the marketplace gives as $22,025 to $39,900 for one person and $45,540 to $82,500 for a household of four. It only applies to plans bought on the marketplace, and it stops at 250%, so a household between there and the 400% line gets the federal credit only. Every line by household size is on the Virginia's Insurance Marketplace income limits 2026 page.
Which companies sell individual health insurance in Virginia?
The Bureau of Insurance's 2027 individual market rate summary, checked October 6, 2026, lists seven companies with approved plans sold on and off Virginia's Insurance Marketplace, here in alphabetical order: CareFirst BlueChoice, Group Hospitalization and Medical Services, HealthKeepers, Kaiser Foundation Health Plan of the Mid-Atlantic States, Optimum Choice, Oscar Insurance Company, and Sentara Health Plans. Two more filings, Anthem Health Plans of Virginia and Sentara Health Insurance Company, are sold only off the marketplace, so no tax credit applies to them.
Where you live decides your list. Only HealthKeepers, Sentara Health Plans, and Anthem Health Plans of Virginia filed for all areas of the state. CareFirst BlueChoice and Group Hospitalization and Medical Services filed for the Washington, Arlington, and Alexandria area only. Kaiser, Optimum Choice, and Oscar filed for Richmond, the Washington area, and the counties outside the metro areas, with Optimum Choice adding Bristol and Winchester and Oscar adding Charlottesville. Sentara Health Insurance Company filed for the Virginia Beach and Norfolk area. Cigna sold marketplace plans in Virginia in 2026 and is not on the 2027 list; healthinsurance.org reports it is leaving the marketplace at the end of 2026 in every state where it sold. Lists like this can change before open enrollment starts, so I confirm what is actually sold in your zip code on the call.
That is the marketplace list. Outside it, other companies sell private plans on national PPO networks to Virginia residents who qualify. I do not rank companies on this page, because the right one depends on where you live, your doctors, and your health. On a call I put both lists side by side for your zip code.
Sources: Virginia Bureau of Insurance, 2027 ACA Individual Market Rate Summary (company list, areas filed, and the 2026 table showing Cigna); federal rate review site (ratereview.healthcare.gov), search for Virginia, Individual market, plan year 2027, which lists eight Virginia individual filings, the seven on-marketplace companies plus one that sells only off the marketplace; healthinsurance.org, Virginia marketplace guide (updated October 2, 2026, the Cigna exit). All checked October 6, 2026.
Which route fits you?
Between jobs, and the COBRA price made you sit down
Price everything against COBRA before you sign it. COBRA keeps your exact plan, but you pay the full cost because your former employer stops contributing. Losing job coverage is also a life event that lets you buy a marketplace plan outside open enrollment. If you are in the middle of treatment, keeping the same plan may be worth the price. Here are the alternatives to COBRA, side by side.
Retired before 65, waiting on Medicare
Health first, then income. If you are healthy, a private PPO priced on your own health may carry you to 65, and I check the renewal terms with you first. If you are not, the marketplace takes you with no questions. Retirement income is often easier to plan than a paycheck, which matters if a tax credit or Virginia Premium Savings is on the table.
Self-employed or 1099
You have the most routes of anyone on this page. On top of the others, a pre-established ERISA group plan is open to people with business income. It is one option among several in Virginia, so I price them side by side. Your premiums may be deductible on your federal return through the self-employed health insurance deduction if you show a net profit and were not eligible for a subsidized plan through any employer, yours or a spouse's. The IRS spells out the conditions in the Form 7206 instructions, and your tax preparer makes the call. The Virginia self-employed page walks through it. Own a business with employees? The Virginia small business page is the one you want.
Healthy, and you earn too much for a tax credit
Start with a plan priced on your own health. With no credit, a marketplace plan is full price, built on the whole pool. A plan priced on your own health can come in lower, and the network is often broader. I price both and show you the two numbers side by side. Private vs. marketplace, compared.
A serious diagnosis in the last five years
A guaranteed-issue Affordable Care Act plan, for now. It cannot turn you down or charge you more for your health. Stay on a plan like that, get the care you need, and we look at the other routes down the road.
Income on the lower side
Check the subsidy math first. If your income is low enough, a subsidized marketplace plan, with Virginia Premium Savings on top for 2027, or Virginia Medicaid may be the best deal you can get, and I will tell you so.
Sources for the COBRA and life event rules: healthcare.gov, COBRA coverage; Virginia's Insurance Marketplace FAQs.
How to buy private health insurance in Virginia
Bring five facts: your age, your city or county, tobacco use, a rough household income for the year, and how you use care. That means your doctors, your prescriptions, and anything planned. With those I can tell you which kinds of coverage you qualify for and price them from the companies I work with, usually the same day.
Timing is the other piece. Marketplace plans are sold during open enrollment, which Virginia's Insurance Marketplace has posted as November 1, 2026 through January 29, 2027 for 2027 coverage, or after a life event such as losing coverage. If you are reading this outside that window with no coverage, do not assume you are stuck until November. Call me and I will tell you what you can apply for today.
Using a broker does not add to your premium. The price of a plan is the same whether you buy it through me or on your own. What you get is someone who reads the plan documents with you before you sign and who picks up the phone after.
Source for enrollment dates: Virginia's Insurance Marketplace FAQs ("Open Enrollment for Plan Year 2027 runs from November 1 through January 29, 2027").
Common questions about private health insurance in Virginia
What are my private health insurance options in Virginia?
Private health insurance is any coverage that is not a government program and not a plan from your job. In Virginia that means five main kinds: a plan on Virginia's Insurance Marketplace, the state-run exchange, which asks no health questions and is the only place a premium tax credit applies; the same kind of plan bought directly from the insurance company with no credit; a private plan priced on your own health, usually on a national PPO network; a fixed-benefit plan that pays set dollar amounts per service; and, if you have self-employment or business income, a pre-established ERISA group plan. Supplemental plans such as accident or critical illness coverage are add-ons to one of those, not a substitute for one.
How much is private health insurance in Virginia?
For a 40-year-old in 2026, Virginia marketplace averages before any subsidy were $351 a month for the lowest-cost Bronze plan, $455 for the benchmark Silver plan, and $441 for the lowest-cost Gold plan, per KFF. Those are lower than the US averages of $456, $625, and $615. For 2027, the Virginia Bureau of Insurance approved average increases of 3.9% to 22.7% for the seven companies selling on the marketplace, and 9.1% and 10.6% for the two filings sold only off the marketplace. Those are marketplace-style prices, which cannot ask about your health. Outside the marketplace, a private plan can be priced on your own health, so a healthy person who gets no subsidy may pay less than those averages. The only way to know is to price it. Your real number depends on your age, where you live in Virginia, tobacco use, network, and the kind of plan.
What is the best private health insurance in Virginia?
There is no single best plan. There is a best fit. If you are healthy and your income is too high for a premium tax credit, a private plan priced on your own health, with a national PPO network, is usually where the value is, because a plan that is not a marketplace-style plan can be priced on your health. If your income qualifies you for a premium tax credit, or for the new Virginia Premium Savings that starts with 2027 plans, the credit changes the math and has to be priced first. If you have had a serious diagnosis in the last five years, a guaranteed-issue Affordable Care Act plan is the right fit for now, because it cannot turn you down or charge you more for your health.
Which companies sell private health insurance in Virginia?
The Virginia Bureau of Insurance's 2027 individual market rate summary lists seven companies with approved plans sold on and off Virginia's Insurance Marketplace: CareFirst BlueChoice, Group Hospitalization and Medical Services, HealthKeepers, Kaiser Foundation Health Plan of the Mid-Atlantic States, Optimum Choice, Oscar Insurance Company, and Sentara Health Plans. Two more filings, Anthem Health Plans of Virginia and Sentara Health Insurance Company, are sold only off the marketplace. Only HealthKeepers, Sentara Health Plans, and Anthem Health Plans of Virginia filed for the whole state; the others filed for specific metro areas, so your list depends on where you live. Cigna sold marketplace plans in Virginia in 2026 and is not on the 2027 list. Beyond those, other companies sell private plans on national PPO networks to Virginians who qualify. I work with 80+ carriers and put both lists side by side for your area.
How do I buy private health insurance in Virginia?
Start with five facts: your age, your city or county, tobacco use, a rough household income for the year, and how you use care, meaning doctors, prescriptions, and anything planned. Those five facts decide which kinds of coverage you qualify for and what they cost. Timing matters too. Marketplace plans are sold during open enrollment, which Virginia's Insurance Marketplace has posted as November 1, 2026 through January 29, 2027 for 2027 coverage, or after a qualifying life event such as losing coverage. A broker does not add to your premium and can price every route in one conversation. The next step is a call, a text, or my short details form.
Are private health insurance prices going up in Virginia in 2027?
Yes, for marketplace-style plans. The Virginia Bureau of Insurance approved 2027 average increases for the companies selling on Virginia's Insurance Marketplace that run from 3.9% for Optimum Choice to 22.7% for Sentara Health Plans, with HealthKeepers, the largest by projected enrollment, at 12.6%. The two filings sold only off the marketplace were approved at 9.1% and 10.6%. The Bureau's August 27, 2026 release put the average requested increase at 16.7%. That comes on top of 2026, when approved increases ran from 1.1% to 35.4% by company and the benchmark Silver premium for a 40-year-old went from $372 to $455 a month. One offset: starting with 2027 plans, Virginia Premium Savings lowers the monthly premium for households between 138% and 250% of the poverty level.
Can I be turned down for private health insurance in Virginia?
It depends on the kind. A marketplace plan, and the same kind of plan bought directly from the company, cannot turn you down or charge more because of your health. A private plan priced on your own health asks health questions, and not everyone qualifies. That is why a healthy person may pay less on one, and why someone with a serious diagnosis in the last five years belongs on a plan that cannot turn them down for now.
Is Virginia's Insurance Marketplace private health insurance?
Yes. Virginia's Insurance Marketplace is the state-run exchange Virginia opened on November 1, 2023 in place of healthcare.gov, but the plans sold on it come from private insurance companies. The state runs the store, the federal government funds the premium tax credit, and starting with 2027 plans the state adds Virginia Premium Savings for some households. The insurance itself is private. Virginia Medicaid and FAMIS, which people are also screened for when they apply, are government programs and are not private insurance.
Thirty minutes on the phone or Zoom, no fee, no hard sell. Bring your age, city or county, tobacco status, a rough income number, and how you use care. I price the routes that fit you and put them side by side. I educate, you decide.
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