This guide, including the FAQs below, was developed to help you choose the right health insurance plan for you and your family. The coverage options found in Virginia’s ACA Marketplace may be a good choice for many consumers, and we’re here to help explain the choices available. Scroll down to see frequently asked questions about health insurance in Virginia.
Prior to 2024, Virginia residents enrolled in individual/family health coverage through HealthCare.gov . But the state debuted a new state-run Marketplace plaftorm, called Virginia’s Insurance Marketplace, in the fall of 2023. This platform is where residents shop for coverage effective in 2024 and future years . 1
Virginia’s Insurance Marketplace offers plans from 11 insurers for 2024, down from 12 in 2023. 2 Ten of the carriers have proposed rates and plans for 2025 (details below; there are two Aetna entities in 2024, but only one for 2025).
The federal government helps consumers pay for insurance through an advance premium tax credit (premium subsidy) if they buy coverage from the exchange. Depending on your income and other circumstances, you may also get help to lower your out-of-pocket expenses .
In addition to developing its own state-run exchange platform that debuted in the fall of 2023, Virginia also has a reinsurance program that took effect in 2023 and helped to reduce premiums for people who don’t get subsidies. Ongoing funding for this program was instrumental in preventing large rate increases for 2024.
Virginia also implemented an easy enrollment program in 2021, which helps to get people enrolled in Medicaid as part of the tax filing process. Now that Virginia is running its own Marketplace, the state has the option to use the easy enrollment program to connect people to Marketplace coverage as well, with a special enrollment period. But the 2023 Virginia tax return (filed in early 2024) still only asked uninsured filers if they’d like their eligibility for Medicaid (Medical Assistance) to be considered.
Virginia has received federal approval to update its essential health benefits benchmark plan starting in 2025. The benchmark plan is used to determine specific benefits that must be covered by individual and small-group health plans. The updates include additional coverage for certain prosthetic devices, and coverage of formula and enteral nutrition products for inherited metabolic disorders. 3
