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What Are the Income Limits for Virginia's Insurance Marketplace in 2026? Medicaid, FAMIS, and Tax Credit Lines by Family Size

Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published September 18, 2026

🔍 Find my family's lines 📊 The full 2026 table 🧮 Estimate my tax credit in dollars

For 2026 coverage, Virginia's Insurance Marketplace gives a federal premium tax credit to households up to 400% of the poverty level: $62,600 for one person and $128,600 for a family of four. One dollar over and the credit is zero, because the enhanced credits expired December 31, 2025. Adults under 138% ($22,025 for one person, $45,540 for four) go to Virginia Medicaid, so in practice the credit starts just above that line. Children are covered by FAMIS Plus up to 148% of poverty and by FAMIS up to 205% ($67,650 for a family of four), with no premium. One thing that confuses people: the marketplace's own savings page shows a range of $22,025 to $39,900 for one person. That is not the tax credit limit. It is Virginia Premium Savings, a new state subsidy that starts with 2027 plans. Every line for households of one to eight is below, then the doors if you are over the top one. I educate, you decide.

The full Virginia income chart for 2026

Two programs, two poverty tables. The tax-credit range for 2026 coverage runs on the 2025 poverty guidelines ($15,650 for one person plus $5,500 each), because the federal rule sets a plan year's eligibility with the prior year's table. Virginia Medicaid, FAMIS Plus, and FAMIS run on the 2026 guidelines ($15,960 plus $5,680), on charts that took effect January 13, 2026. The marketplace does not publish a dollar chart for the tax credit; its FAQ says households between 100% and 400% of poverty qualify and sends you to a calculator. The federal credit technically starts at 100%, but a Virginia adult between 100% and 138% is sent to Medicaid instead. A pregnant woman counts as at least two people, so her line starts in the household-of-two row.

Sources: Virginia DMAS, Medicaid eligibility manual income charts (effective January 13, 2026); Cover Virginia, Medicaid for children and FAMIS; Virginia Health Care Foundation, Medicaid and FAMIS income chart; Virginia's Insurance Marketplace FAQs. For 2027 coverage the tax credit table moves to the 2026 guidelines: $63,840 for one and $132,000 for four at the cliff.

What Virginia adds: reinsurance now, and a state subsidy starting with 2027 plans

Virginia had no state premium subsidy for 2026. What it had, and still has, is the Commonwealth Health Reinsurance Program, which pays part of the largest claims so carriers file lower rates. The State Corporation Commission puts the 2026 effect at a 16.5% average premium reduction. That discount is in the sticker price, so it helps people over the line too, and the General Assembly has directed a five-year extension.

The new piece is Virginia Premium Savings. The 2026 to 2028 state budget put $150 million into a Virginia Health Insurance Affordability Fund, and starting with 2027 plans it lowers monthly premiums by up to 70% for households between 138% and 250% of poverty. The marketplace gives the range as $22,025 to $39,900 for an individual and $45,540 to $82,500 for a household of four, and the SCC estimates about 200,000 Virginians could qualify. Two cautions. It starts with 2027 coverage, not 2026. And it stops at 250% of poverty, so a household between there and the 400% line gets the federal credit only, and a household over the 400% line gets nothing from either.

Sources: Virginia SCC, Commonwealth Health Reinsurance Program; Virginia SCC, July 6, 2026; Virginia's Insurance Marketplace, financial savings; Virginia SCC, August 27, 2026.

What marketplace plans cost in Virginia in 2026

Sources: KFF, 2026 benchmark premiums; KFF, marketplace enrollment.

Virginia's sticker prices are among the lower ones I see, $455 a month for the benchmark against $625 nationally, and they still rose about 22% in a year. The SCC's final rate summary for 2026 shows the average change by carrier: HealthKeepers (Anthem) 20.9%, Sentara Health Plans 22.4%, Kaiser 11.8%, Cigna 22.8%, Optimum Choice (UnitedHealthcare) 35.4%, CareFirst BlueChoice 18.2%, and Oscar 3.0%. The SCC did not publish one overall average; ACA Signups weights it out to 21.6%. The number that matters more is what people actually pay after the smaller federal credit, and the SCC says that went up 75% on average. By July 2026 the SCC reported enrollment down 20% from the same time a year earlier and about 100,000 Virginians who had lost coverage during the year, roughly 45% of them in the 138% to 250% income band the new state subsidy is aimed at. For 2027, carriers requested changes from 3.9% to 22.7%, averaging 16.7%.

Sources: Virginia SCC, ACA individual market rate summary; healthinsurance.org, Virginia marketplace; Virginia SCC, July 6, 2026; Virginia SCC, August 27, 2026.

Virginia Medicaid and FAMIS: adults, children, and pregnancy

Virginia expanded Medicaid in 2019, so adults 19 to 64 qualify up to 138% of poverty: $1,836 a month for one person, $3,795 for four. Children under 19 qualify for FAMIS Plus, which is children's Medicaid, up to 148%, and for FAMIS up to 205%: $5,638 a month, $67,650 a year, for a family of four. Cover Virginia says there are no monthly premiums, copayments, or deductibles for covered services for children in either program. Pregnant women qualify for Medicaid up to 148% and for FAMIS MOMS up to 205%, counted as a household of at least two. There is no buy-in tier above 205%. The practical point for a family on the marketplace: in a household of four earning $60,000, the children belong in FAMIS and only the adults go on the marketplace plan, which changes the math on the whole family's coverage.

Sources: Cover Virginia, Medicaid for children and FAMIS; Virginia DMAS, income charts.

Virginia Medicaid changes coming October 2026 and January 1, 2027

Virginia's Medicaid agency has posted the federal changes and their dates. On October 1, 2026, full Medicaid for nonpregnant adults narrows to citizens, lawful permanent residents, and a short list of other immigration categories; others get emergency services only. On January 1, 2027, adults 19 to 64 covered through the expansion must meet a work requirement: 80 hours a month, half-time school, or at least $580 a month in income, shown in one of the six months before renewal. The same day, renewals for that group move to every six months, and backdated coverage shrinks to one month. The Governor's August 2026 executive order, Keep Virginia Covered, directs agencies to carry this out with as few barriers as federal law allows, and projects that more than 300,000 Virginians could lose coverage. If you are near the $22,025 line as a single person, the practical effect is that income that drifts above it, or a missed six-month renewal, can put you on the marketplace mid-year. Losing Medicaid is a qualifying event, so report the change the month it happens.

Sources: Virginia DMAS bulletin, September 4, 2026; Virginia DMAS, federal work requirements; Office of the Governor, August 25, 2026.

Open enrollment and special enrollment in Virginia

Open enrollment for 2027 coverage starts November 1, 2026. The end date is where Virginia's own sources disagree as I write this. The SCC's July 6, 2026 release says open enrollment "begins November 1 and runs through December 31." The marketplace's FAQ page still says November 1, 2026 to January 29, 2027. Until they match, I tell people to be done by December 15, which is safe under either one and gets you a January 1 start. Outside the window you need a qualifying event, reported within 60 days. Virginia's list includes pregnancy, a change in income, and a move to a different ZIP code, along with the usual ones such as losing job coverage or Medicaid. The year-round enrollment for households under 150% of poverty ended for 2026. Medicaid and FAMIS take applications year-round. The dates for every state I work in are on my 2027 dates page.

Sources: Virginia SCC, July 6, 2026; Virginia's Insurance Marketplace FAQs; Virginia's Insurance Marketplace, special enrollment.

Over the line in Virginia? More doors than New York

Here is the part that makes Virginia different from New York, where I sit. Off the marketplace, Virginia allows private plans that are medically underwritten. A healthy household earning $135,000 that just watched its credit go to zero is not stuck with the sticker price; it can be priced on its own health, with a national PPO network of the PHCS and MultiPlan type that still works when you cross the river into Maryland or DC, and for healthy people that number is often meaningfully lower. The second door is a fixed-benefit plan, what I call the red bucket, for healthy people who want a low premium and are comfortable shopping for care. The third is the marketplace itself, on or off exchange, which is the right call for anyone with a health condition. The fourth is a pre-established ERISA group plan at group rates, which can pull ahead when a spouse and kids are going on the policy. Short-term plans exist but Virginia keeps them short: three months at a time, no more than six months in any twelve, and none can be issued during open enrollment, so I treat them as a gap-filler, not a plan. I walk through all four doors on the Virginia self-employed guide. Virginia's median household income is $92,090, so a lot of ordinary two-earner families, especially in Northern Virginia, are standing close to the $128,600 line. If you are within $10,000 of it, a Solo 401(k) or SEP contribution, run with your tax professional, is the first lever to pull.

Sources: Code of Virginia 38.2-3407.21, short-term limited-duration plans; Census ACS 2024 one-year estimate, Virginia median household income.

Common questions about Virginia's Insurance Marketplace income limits