Virginia Health Insurance Marketplace 2026: Enrollment Guide
Virginia’s Insurance Marketplace at Marketplace.Virginia.gov is the state’s official health insurance exchange and the only place Virginians can apply for premium tax credits or cost-sharing reductions on individual coverage. The Marketplace launched for plan year 2024 — replacing HealthCare.gov for Virginia residents — and has now enrolled more than 573,700 people. For 2026, eight carriers offer plans on the exchange, the open enrollment window was extended to January 30, 2026 (two weeks longer than the federal deadline), and about 86% of enrollees still qualified for subsidies despite enhanced federal credits expiring at the end of 2025. This guide covers how the Marketplace works, the 2026 deadlines and carriers, how Cardinal Care and It all runs through the Virginia health insurance marketplace.
What brings you here today?
How is this different from HealthCare.gov?
Virginia’s state-based exchange explained
See difference ↓Virginia’s 2026 Open Enrollment Deadline: January 30
Virginia’s 2026 open enrollment period ran November 1, 2025 through January 30, 2026 — two weeks longer than the federal HealthCare.gov deadline of January 15. As a state-based exchange, Virginia’s Insurance Marketplace sets its own enrollment calendar independent of the federal window. Virginians who missed the deadline can still enroll outside open enrollment through a special enrollment period if they qualify, or year-round through Cardinal Care or FAMIS if income qualifies.
The Virginia Health Benefit Exchange extended the 2026 OEP by two weeks specifically because of the premium increases driven by the expiration of enhanced federal Advanced Premium Tax Credits at the end of 2025. Director Keven Patchett noted that price comparison was more important than ever, and the extension gave Virginia residents a full three months to review plan options and decide That choice happens on the Virginia health insurance marketplace each fall.
Virginians who enrolled by December 31, 2025 had coverage effective January 1, 2026; those who completed enrollment between January 1 and January 30, 2026 had coverage effective February 1, 2026. Outside open enrollment, the Marketplace allows special enrollment for qualifying life events: losing other coverage, getting married or divorced, having a baby or adopting, becoming a U.S. citizen, or moving to a different Virginia county. The next open enrollment period for plan year 2027 will likely run November 1, 2026 through late January 2027.
How Marketplace.Virginia.gov Differs from HealthCare.gov
Marketplace.Virginia.gov is Virginia’s own state-based exchange platform — not HealthCare.gov, which is the federal exchange that 30 states still use. Virginia transitioned away from HealthCare.gov for plan year 2024 to gain control over its enrollment calendar, plan certification, consumer assistance program, and Cardinal Care Medicaid integration. About 21 states plus DC operate fully state-based exchanges with their own technology platforms; Virginia is one of the most recent additions to that group.
The most visible practical difference is the enrollment URL. Virginia residents shopping for individual marketplace coverage must use Marketplace.Virginia.gov, not HealthCare.gov — applications submitted through the federal site will not work for Virginia residents. The Virginia Health Benefit Exchange, a division of the State Corporation Commission, operates the platform; the SCC’s Bureau of Insurance reviews and approves These filings set Virginia health insurance marketplace premiums.
Beyond the URL, the operational differences matter. Virginia’s exchange certifies which plans can be sold on the Marketplace, runs a network of more than 4,300 certified assisters and licensed agents, operates its own Marketplace Help Center at 888-687-1501, and integrates Cardinal Care and FAMIS screening into the same application. Virginia also sets its own open enrollment dates — and used that authority to extend the 2026 OEP by two weeks, something HealthCare.gov states cannot do.
Quick check: Are you in the right place?
If you live in Virginia and you’re shopping for individual or family marketplace health insurance for 2026, your starting point is Marketplace.Virginia.gov — not HealthCare.gov. The federal site will not return Virginia plan results. Small business SHOP coverage for Virginia employers is also handled through the same state platform. Cardinal Care Medicaid and FAMIS applications can be submitted through Marketplace.Virginia.gov or through Cover Virginia at coverva.dmas.virginia.gov.
Virginia’s 2026 Rate Increase and the Subsidy Story
Virginia’s 2026 ACA marketplace premiums increased by an overall average of 21.6% before subsidies, according to the SCC Bureau of Insurance — the largest annual increase since the early ACA years. The largest driver was the expiration of enhanced federal Advanced Premium Tax Credits at the end of 2025. About 86% of Virginia marketplace enrollees still qualified for advance premium tax credits in 2026, but the after-subsidy cost rose for nearly every household.
Approved rate changes by carrier varied widely for plan year 2026. Optimum Choice (UnitedHealthcare) approved at +35.4% saw the largest increase among Virginia carriers; Cigna at +22.8%, Sentara Health Plans at +22.4%, Anthem HealthKeepers at +20.9%, CareFirst BlueChoice at +18.2%, and Kaiser Mid-Atlantic at the lowest +11.8%. Aetna Health Inc. exited Virginia’s individual market entirely at the end of 2025, leaving approximately 13,721 Virginia members to select a new 2026 plan. The Bureau of Insurance reviews each carrier’s rate filing through SERFF (System for Electronic Rate and Form Filing) State review shapes the Virginia health insurance marketplace consumers see.
| Virginia 2026 Marketplace Carrier | Approved Rate Change | 2026 Avg. Per-Member Per-Month Rate |
|---|---|---|
| Anthem HealthKeepers | +20.9% | $616.71 |
| Sentara Health Plans | +22.4% | $562.81 |
| Cigna Health and Life | +22.8% | $589.55 |
| Kaiser Mid-Atlantic | +11.8% | $591.61 |
| CareFirst BlueChoice (NoVA only) | +18.2% | $662.70 |
| Optimum Choice (UnitedHealthcare) | +35.4% | $553.16 |
| Group Hospitalization & Medical Services | +1.1% | $1,308.89 |
| Oscar Insurance Company | +3.0% | $489.04 |
The 21.6% statewide average is calculated before subsidies. For most subsidized Virginians, the after-subsidy premium increase is much smaller because the subsidy formula adjusts to keep the enrollee’s contribution proportional to income. Virginia’s reinsurance program (in effect since 2023) further moderates increases for non-subsidized enrollees. If your 2026 premium jumped sharply on Marketplace.Virginia.gov, log in, update your income and household information, and re-shop — many enrollees who skip the update Reporting income protects Virginia health insurance marketplace subsidies.
Get Help with Marketplace.Virginia.gov
Because Virginia runs its own exchange, the application lives at Marketplace.Virginia.gov, not HealthCare.gov, and the rules differ. A licensed Virginia agent screens you for Cardinal Care and FAMIS first, then walks the state portal with you, applies your premium tax credit, and confirms your providers across all eight 2026 carriers. Free, no obligation.
Eight Carriers on Virginia’s Insurance Marketplace for 2026
Eight carriers offer individual marketplace plans on Virginia’s Insurance Marketplace for 2026 — down from ten in 2025 after Aetna and Innovation Health exited at the end of 2025. Carrier availability varies by Metropolitan Statistical Area: some carriers are statewide, others limited to Northern Virginia, Richmond, or specific MSAs. Virginia uses 12 rating regions for marketplace pricing.
Anthem HealthKeepers
Anthem’s Virginia HMO brand. Statewide across all 12 rating regions. About 106,600 covered lives projected for 2026 — the largest individual marketplace carrier in Virginia. Approved 2026 rate change: +20.9%. Network covers most major Virginia health systems including Networks like these define Virginia health insurance marketplace plans.
Sentara Health Plans
Tied to Sentara Healthcare hospital system, dominant in Hampton Roads. About 89,092 covered lives projected for 2026 — second-largest carrier. Approved 2026 rate change: +22.4%. Strongest network coverage in Tidewater, Charlottesville, and Richmond. Sentara remains a Virginia health insurance marketplace anchor.
Cigna Health and Life
Available in MSAs 7 (Richmond), 10 (Northern Virginia), 11 (Winchester), and 12 (Lynchburg). About 21,838 Virginia covered lives for 2026. Approved rate change: +22.8%. Strong national PPO network reciprocity for Virginians who Such buyers weigh Virginia health insurance marketplace network reach.
Kaiser Foundation Health Plan of the Mid-Atlantic
Integrated HMO model — members use Kaiser-employed physicians and Kaiser facilities. About 24,250 Virginia covered lives for 2026. Approved rate change: +11.8% — the lowest among major Virginia carriers. Strongest fit for NoVA and Richmond residents Kaiser is one Virginia health insurance marketplace option among eight.
CareFirst BlueChoice
DC-metro Blue Cross BlueShield licensee. Available in MSA 10 (Northern Virginia) only — Arlington, Alexandria, Fairfax, Loudoun, Prince William. About 7,636 NoVA enrollees for 2026. Approved rate change: +18.2%. Strongest fit for federal employees, contractors, and DC-metro commuters needing DC + MD + NoVA network coverage.
Optimum Choice (UnitedHealthcare)
UnitedHealthcare’s HMO brand on Virginia’s Insurance Marketplace. Available in MSAs 5, 7, 10, 11, and 12. About 16,280 Virginia covered lives for 2026. Approved rate change: +35.4% — the largest in Virginia. UnitedHealthcare also operates UnitedHealthcare Community Plan Medicaid sits beside the Virginia health insurance marketplace.
Two smaller carriers also participate: Group Hospitalization and Medical Services (a CareFirst affiliate, NoVA only, ~1,345 lives) and Oscar Insurance Company (Richmond and NoVA, ~587 lives). Aetna and Innovation Health enrollees from 2025 may have been auto-mapped to alternative carriers for 2026 — review your assignment, because the auto-mapped Always verify before trusting a Virginia health insurance marketplace auto-map.
How Cardinal Care and FAMIS Screening Works
Marketplace.Virginia.gov screens every applicant for Cardinal Care and FAMIS eligibility before showing marketplace plan options. Adults below 138% of the federal poverty level are routed to Cardinal Care Medicaid through the Virginia Department of Medical Assistance Services. Children in families up to 200% of FPL are routed to FAMIS — Virginia’s CHIP program. This means Virginians don’t need to apply to programs separately — one application covers Marketplace, Cardinal Care, and FAMIS together.
Cardinal Care covers adults at or below 138% of FPL — roughly $21,597 for a single adult and $44,367 for a family of four in 2026 — through five managed care organizations: Anthem HealthKeepers Plus, Sentara Community Plan, Aetna Better Health, UnitedHealthcare Community Plan, and Humana Healthy Horizons. FAMIS covers children up to 200% of FPL with comprehensive coverage including dental and vision through the same MCOs. Pregnant women qualify for Cardinal Care up to 205% of FPL.
Cardinal Care and FAMIS are open year-round. Virginians can also apply directly through Cover Virginia at coverva.dmas.virginia.gov or by calling 1-855-242-8282. Children enrolled in FAMIS receive 12 months of protected continuous coverage from enrollment date — coverage cannot be terminated during Outside it, Virginia health insurance marketplace access needs a qualifying event.
How to Enroll on Marketplace.Virginia.gov
Enrolling on Marketplace.Virginia.gov takes most Virginians 30–60 minutes if they have their household income, social security numbers, and current coverage information ready. The Marketplace screens for Cardinal Care and FAMIS first, then displays marketplace plans with subsidy amounts calculated in real time. Free help is available statewide through 4,300+ certified assisters and licensed agents, the Marketplace Help Center at 888-687-1501, or local in-person navigators.
Step 1 — Gather your household information
You’ll need: household members’ names and dates of birth, social security numbers (or document numbers for legal residents), expected 2026 household income, current coverage information if you have any, and your Virginia residential address. Marketplace.Virginia.gov verifies household composition and income against IRS and Social Security data — accurate income reporting Income drives every Virginia health insurance marketplace subsidy.
Step 2 — Apply at Marketplace.Virginia.gov
Create an account at Marketplace.Virginia.gov and complete the application. The system automatically screens for Cardinal Care and FAMIS eligibility before showing marketplace plans. If anyone in your household qualifies for Cardinal Care or FAMIS, they’re routed to the appropriate program; the rest of the household sees marketplace plan options with subsidy amounts.
Step 3 — Compare plans and select coverage
Marketplace.Virginia.gov displays Bronze, Silver, Gold, and Catastrophic tier plans from the carriers available in your Virginia rating region (MSA). Compare premiums, deductibles, networks, and provider lookup. A licensed Virginia agent can verify your specific providers across Inova, Sentara, HCA Virginia, Bon Secours, Carilion, and other Virginia Provider checks finalize a Virginia health insurance marketplace choice.
Step 4 — Pay your first premium
Coverage doesn’t start until you pay the first month’s premium directly to the carrier. The Marketplace passes your enrollment to the carrier (Anthem, Sentara, Cigna, etc.) and the carrier sends a bill — typically within 7–14 days of enrollment. Pay by the due date to activate coverage. Auto-pay setup is recommended to avoid coverage lapses.
Free help is available statewide. The Marketplace publishes a directory of certified assisters by Virginia county, and the Marketplace Help Center at 888-687-1501 offers phone and online support. The SCC Bureau of Insurance publishes the annual ACA Individual Market Rate Summary and consumer complaint data for additional research before choosing a carrier.
Frequently Asked Questions
Common questions about Virginia’s Insurance Marketplace cover what the platform is, when Virginia left HealthCare.gov, the January 30 open enrollment deadline, whether subsidies are still available in 2026, the enrollment drop following premium increases, and how Cardinal Care and FAMIS screening fits into the same application.
What is Virginia’s Insurance Marketplace?
Virginia’s Insurance Marketplace is the Commonwealth of Virginia’s official state-based health benefit exchange, operating at Marketplace.Virginia.gov. It launched for plan year 2024, replacing HealthCare.gov for Virginia residents shopping for individual and family health insurance. The Marketplace is operated by the Virginia Health Benefit Exchange, a division of the State Corporation Commission. It is the only place Virginians can apply for advance premium tax credits and cost-sharing reductions for individual coverage. More than 573,700 Virginians have enrolled through the Marketplace since it launched in 2023.
When did Virginia leave HealthCare.gov?
Virginia transitioned away from HealthCare.gov for plan year 2024, with Virginia’s Insurance Marketplace launching on November 1, 2023 for the 2024 open enrollment period. Plan year 2026 is the third full plan year on Virginia’s state-based exchange. Before the transition, Virginia residents enrolled in marketplace coverage through HealthCare.gov, the federal platform shared by most states. The transition gave Virginia control over its own enrollment calendar, plan certification process, consumer assistance program, and integration with Cardinal Care Medicaid screening — none of which were possible while Virginia used the federal platform.
When is open enrollment on Virginia’s Insurance Marketplace?
Virginia’s 2026 open enrollment ran November 1, 2025 through January 30, 2026 — two weeks longer than the federal HealthCare.gov deadline of January 15. Virginia’s Insurance Marketplace, as a state-based exchange, sets its own enrollment calendar independent of the federal window. Virginians who enrolled by December 31, 2025 had coverage effective January 1, 2026; those who enrolled between January 1 and January 30, 2026 had coverage effective February 1, 2026. The next open enrollment period for plan year 2027 will likely run November 1, 2026 through late January 2027 — final dates set by the Virginia Health Benefit Exchange.
Can I still get a subsidy on Marketplace.Virginia.gov in 2026?
Yes — about 86% of Virginia marketplace enrollees still qualify for advance premium tax credits in 2026, even after enhanced federal subsidies expired at the end of 2025. The remaining ACA subsidy structure under the Affordable Care Act continues to provide premium tax credits for households between 100% and 400% of the federal poverty level (and above 400% in some cases under the original ACA cliff structure). Cost-sharing reductions remain available for Silver-tier plans for households below 250% of FPL. Virginians should update their household income and information on Marketplace.Virginia.gov each year to ensure their subsidy is calculated correctly.
Did Virginia marketplace enrollment drop in 2026?
Preliminary data from the Virginia Health Benefit Exchange showed enrollment running roughly 20,000 households below the same point in plan year 2025 as the January 30, 2026 deadline approached. About 390,000 Virginia households enrolled through the Marketplace for 2025 — the 2026 final enrollment count was still being tallied at deadline. The drop is widely attributed to premium increases averaging 21.6% before subsidies, driven by the expiration of enhanced federal Advanced Premium Tax Credits at the end of 2025. Some Virginians experienced sticker shock after January renewal notices arrived and either switched to higher-deductible plans or dropped coverage entirely.
How do I apply for Cardinal Care or FAMIS through Marketplace.Virginia.gov?
Marketplace.Virginia.gov screens every applicant for Cardinal Care Medicaid and FAMIS eligibility before showing marketplace plan options. Applicants below the Medicaid expansion threshold (138% of FPL for adults) are automatically routed to the Virginia Department of Medical Assistance Services for Cardinal Care enrollment. Children in families up to 200% of FPL are routed to FAMIS. Cardinal Care and FAMIS enrollment is open year-round — there is no open enrollment window. Virginians can also apply directly through Cover Virginia at coverva.dmas.virginia.gov or by calling 1-855-242-8282.
Compare 2026 Marketplace.Virginia.gov Plans
With the January 30 deadline two weeks past the federal date, Virginians get a little more time, but not unlimited. A licensed Virginia agent compares every plan on Marketplace.Virginia.gov for your MSA, prices your subsidy, and checks Cardinal Care eligibility, so you enroll once in the plan that fits. Free, no obligation.
Virginia’s Insurance Marketplace enrollment help — covers all programs in one call.
Related Virginia Health Insurance Resources
The complete pillar guide to Virginia health insurance for 2026.
Best Health Insurance in VirginiaAnthem, Sentara, Cigna, Kaiser, and CareFirst compared head-to-head.
Affordable Virginia Health InsuranceCardinal Care, FAMIS, subsidies, and the 21.6% rate increase explained.
Individual Health Insurance in VirginiaSelf-employed, freelancer, and family individual marketplace coverage.
SCC Bureau of InsuranceVirginia’s insurance regulator and the source of approved 2026 marketplace rate filings.
Virginia Small Business Health InsuranceGroup plans, SHOP, ICHRA, and QSEHRA for Virginia employers.
Virginia’s Insurance Marketplace (Official)Virginia’s official enrollment portal at marketplace.virginia.gov.
Cover Virginia (Cardinal Care / FAMIS)Official Cardinal Care Medicaid and FAMIS application portal.
Broker Disclosure
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