Best Health Insurance in Virginia 2026: 8 Carriers Compared
Eight carriers offer individual marketplace plans in Virginia for 2026 — Anthem HealthKeepers, Sentara Health Plans, Cigna, Kaiser Foundation Health Plan of the Mid-Atlantic, CareFirst BlueChoice, Optimum Choice (UnitedHealthcare), Group Hospitalization and Medical Services, and Oscar Insurance Company. Aetna and Innovation Health exited the individual market at the end of 2025, leaving approximately 13,721 Virginia members to choose a new plan. The right carrier depends on which Metropolitan Statistical Area you live in (Virginia has 12), which providers you use, and whether you need national PPO reciprocity. This guide ranks the carriers head-to-head on covered lives, 2026 rate change, MSA avai These factors decide the best health insurance in Virginia for each buyer.
What brings you here today?
Virginia’s 2026 Marketplace Lineup: 8 Carriers After Aetna Exit
Virginia’s Insurance Marketplace has eight carriers for 2026 after Aetna Health Inc. and Innovation Health exited the individual market at the end of 2025. The exit was part of Aetna’s nationwide withdrawal from individual ACA coverage, leaving approximately 13,721 Virginia members to select a new 2026 plan. Marketplace.Virginia.gov auto-mapped many enrollees to alternative carriers, but auto-mapped Virginians should review their assignments — the auto-mapped plan may not include their current doctors.
The 2026 lineup is Virginia’s narrowest individual market footprint since the state-based exchange launched in 2024. Aetna remains active in Virginia’s Medicaid managed care market through Aetna Better Health, a Cardinal Care MCO — the exit applies only to individual ACA marketplace coverage, not to Cardinal Care or employer-sponsored plans.
| 2026 Virginia Marketplace Carrier | Covered Lives (2026 Projected) | 2026 Rate Change | MSAs Available |
|---|---|---|---|
| Anthem HealthKeepers | ~106,600 | +20.9% | All 12 MSAs (statewide) |
| Sentara Health Plans | ~89,092 | +22.4% | All MSAs (Hampton Roads strongest) |
| Kaiser Mid-Atlantic | ~24,250 | +11.8% | MSAs 7, 10, 12 (NoVA, Richmond, Lynchburg) |
| Cigna Health and Life | ~21,838 | +22.8% | MSAs 7, 10, 11, 12 |
| Optimum Choice (UnitedHealthcare) | ~16,280 | +35.4% | MSAs 5, 7, 10, 11, 12 |
| CareFirst BlueChoice | ~7,636 | +18.2% | MSA 10 (Northern Virginia ONLY) |
| Group Hospitalization & Medical Services | ~1,345 | +1.1% | MSA 10 (Northern Virginia) |
| Oscar Insurance Company | ~587 | +3.0% | MSAs 7, 10 |
If you had Aetna or Innovation Health in 2025
Marketplace.Virginia.gov auto-mapped many former Aetna and Innovation Health enrollees to alternative 2026 carriers — but the auto-mapped plan may not include your current doctors. Log into your Marketplace.Virginia.gov account, look up your auto-mapped 2026 plan, and verify that your primary care physician, specialists, and preferred hospital are in-network. If they are not, you can switch to a different carrier through the Marketplace if you act before the next plan year — or trigger a special enrollment period if you qualify (loss of coverage from Aetna’s exit may itself qualify, depending on your circumstances).
Virginia Carrier Profiles: Anthem, Sentara, Cigna, Kaiser, CareFirst
Virginia’s five major individual marketplace carriers each occupy a distinct position. Anthem HealthKeepers is the largest with statewide reach. Sentara Health Plans is the Hampton Roads anchor tied to Sentara Healthcare. Kaiser Mid-Atlantic is the NoVA-Richmond integrated HMO with the lowest 2026 rate change. CareFirst BlueChoice serves Northern Virginia exclusively. Cigna offers the broadest national PPO reciprocity. The best fit depends on your MSA, your providers, and whether you need out-of-state network access.
Anthem HealthKeepers
Anthem’s Virginia HMO brand and the state’s largest individual marketplace carrier with about 106,600 covered lives projected for 2026. HealthKeepers operates statewide across all 12 Virginia rating regions and contracts with most major Virginia health systems — HCA Virginia, Inova in Northern Virginia, Bon Secours across multiple regions, and Carilion in the Roanoke and Blue Ridge area. Approved 2026 rate change: +20.9%. Strongest fit for Virginians who need broad statewide network coverage and want a single carrier whether the Geography drives the best health insurance in Virginia by region.
- ~106,600 covered lives — largest in 2026
- All 12 MSAs (statewide)
- HCA Virginia, Inova, Bon Secours, Carilion
- +20.9% approved rate change
Sentara Health Plans
Tied to Sentara Healthcare, the Norfolk-based hospital system that dominates Hampton Roads. Sentara serves about 89,092 Virginia covered lives for 2026 — second-largest carrier — with strongest network depth in the Tidewater region (Norfolk, Virginia Beach, Chesapeake, Newport News, Hampton), plus solid presence in Charlottesville and Richmond. Approved 2026 rate change: +22.4%. Rebranded from Optima Health in 2024. Sentara also operates Sentara Community Plan as a Cardinal Care MCO. Strongest fit for Hampton Roads resi For them the best health insurance Virginia offers ties to Sentara.
- ~89,092 covered lives
- Hampton Roads dominant + statewide
- Sentara Healthcare hospital system
- +22.4% approved rate change
Kaiser Foundation Health Plan of the Mid-Atlantic
Kaiser Permanente’s Mid-Atlantic plan covers about 24,250 Virginia lives for 2026 with the lowest approved rate change of any major Virginia carrier — +11.8%. Kaiser uses an integrated HMO model: members must use Kaiser-employed physicians and Kaiser facilities for in-network care. Available in Northern Virginia (MSA 10), Richmond (MSA 7), and Lynchburg (MSA 12) only. Strongest fit for NoVA and Richmond Virginians who prefer the Kaiser integrated care model and don’t need a broad multi-system network.
- ~24,250 covered lives
- NoVA, Richmond, Lynchburg only
- Integrated HMO — Kaiser facilities
- +11.8% — lowest among major carriers
Cigna Health and Life Insurance
Cigna covers about 21,838 Virginia lives for 2026 with PPO-style network access in Richmond (MSA 7), Northern Virginia (MSA 10), Winchester (MSA 11), and Lynchburg (MSA 12). Approved 2026 rate change: +22.8%. Cigna’s broader national network appeals to Virginians who travel for work, have family in other states, or live near state borders. Cigna also offers off-exchange PPO products for Virginians above 400% FP That group often finds the best health insurance in Virginia off-exchange.
- ~21,838 covered lives
- 4 MSAs across Virginia
- Strong national PPO reciprocity
- +22.8% approved rate change
CareFirst BlueChoice
CareFirst is the DC-metro Blue Cross BlueShield licensee, offering individual marketplace plans in Northern Virginia (MSA 10) only — Arlington, Alexandria, Fairfax, Loudoun, Prince William, and surrounding counties. About 7,636 NoVA enrollees for 2026. Approved 2026 rate change: +18.2%. CareFirst’s BlueCard reciprocity provides national network access. Strongest fit for federal employees, contractors, and DC-metro commuters who need integrated DC + Maryland + Northern Virginia network coverage — a regional Blue Cross territ It is one reason some call it the best health insurance in Virginia for travelers.
- ~7,636 covered lives (NoVA only)
- MSA 10 only — Arlington, Fairfax, Loudoun
- BlueCard national reciprocity
- +18.2% approved rate change
Optimum Choice (UnitedHealthcare)
UnitedHealthcare’s HMO brand on Virginia’s Insurance Marketplace, available in MSAs 5 (Bristol), 7 (Richmond), 10 (Northern Virginia), 11 (Winchester), and 12 (Lynchburg). About 16,280 Virginia covered lives for 2026. Approved 2026 rate change: +35.4% — the largest in Virginia. The high rate change reflects underwriting and risk pool dynamics specific to Optimum’s plan designs. UnitedHealthcare also operates UnitedHealthcare Community P Medicaid sits beneath the best health insurance Virginia shoppers buy commercially.
- ~16,280 covered lives
- 5 MSAs across Virginia
- UnitedHealthcare brand
- +35.4% — largest 2026 increase in VA
Two smaller carriers round out the 2026 lineup. Group Hospitalization and Medical Services (a CareFirst affiliate) covers about 1,345 Northern Virginia lives with a +1.1% rate change but the highest per-member per-month rate in Virginia at $1,308.89. Oscar Insurance Company covers ~587 Virginia lives in Richmond and NoVA with the lowest per-member per-month rate at $489.04.
Compare All 8 Virginia Carriers Side-by-Side
No single carrier is best for every Virginian. A licensed Virginia agent pulls all eight 2026 carriers for your exact MSA, checks whether your doctors at Inova, Sentara, HCA Virginia, Bon Secours, or Carilion sit in each network, and flags the Aetna-exit auto-mapping if it moved you off your physicians. Free, no obligation.
Carrier Availability by Virginia MSA (Rating Region)
Virginia uses 12 Metropolitan Statistical Areas for marketplace pricing, and not every carrier sells in every MSA. Anthem HealthKeepers is the only carrier statewide. Sentara Health Plans is statewide but strongest in Hampton Roads. Kaiser is limited to NoVA, Richmond, and Lynchburg. CareFirst BlueChoice and Group Hospitalization are Northern Virginia only. Cigna and Optimum Choice cover multiple but not all MSAs. Use this guide to identify which carriers are available where you live.
| Virginia MSA / Region | Major Cities | Carriers Available |
|---|---|---|
| MSA 10 — Northern Virginia | Arlington, Alexandria, Fairfax, Loudoun, Prince William | Anthem, Sentara, Cigna, Kaiser, CareFirst, Optimum, Group Hosp., Oscar |
| MSA 7 — Richmond | Richmond, Henrico, Chesterfield, Hanover | Anthem, Sentara, Cigna, Kaiser, Optimum, Oscar |
| MSA 9 — Hampton Roads | Virginia Beach, Norfolk, Chesapeake, Newport News, Hampton | Anthem, Sentara |
| MSA 8 — Roanoke | Roanoke, Salem, Blacksburg, Christiansburg | Anthem, Sentara |
| MSA 11 — Winchester | Winchester, Frederick County | Anthem, Sentara, Cigna, Optimum |
| MSA 12 — Lynchburg | Lynchburg, Bedford | Anthem, Sentara, Cigna, Kaiser, Optimum |
| MSA 5 — Bristol | Bristol, far southwest Virginia | Anthem, Sentara, Optimum |
| MSA 2 — Charlottesville | Charlottesville, Albemarle | Anthem, Sentara |
Northern Virginia (MSA 10) has the most carrier choice — 8 carriers compete for NoVA enrollees, partly because of the dense federal worker and contractor population in the DC metro region. Hampton Roads (MSA 9) and Charlottesville (MSA 2) have the narrowest choice with just 2 carriers — Anthem HealthKeepers and Sentara Health Plans — reflecting That dominance shapes the best health insurance in Virginia for Tidewater.
PPO Plans in Virginia: Marketplace and Off-Exchange Options
PPO plans in Virginia are available both on Virginia’s Insurance Marketplace and off-exchange. Cigna and CareFirst BlueChoice offer the broadest PPO-style network access on the marketplace, with national network reciprocity through BlueCard for CareFirst members. Off-exchange PPO plans are available directly from major carriers including Anthem, Cigna, and CareFirst — these typically offer broader networks at higher premiums than marketplace HMOs but are not eligible for premium tax credits. Most Virginia individual marketplace plans are HMOs.
Virginia’s marketplace is HMO-dominated — Anthem HealthKeepers, Sentara Health Plans, Kaiser Mid-Atlantic, and Optimum Choice all sell HMO products as their marketplace offerings. Cigna and CareFirst BlueChoice are the exceptions, offering PPO and EPO-style products with looser referral requirements. For Virginians who need national network coverage — federal contractors who travel, retirees with out-of-state vacation homes — PPO plans typically For frequent travelers that can be the best health insurance in Virginia.
Off-exchange PPO plans are sold directly by carriers — not through Marketplace.Virginia.gov — and are not eligible for advance premium tax credits. For Virginians above 400% of FPL who don’t qualify for marketplace subsidies anyway, off-exchange PPO plans often deliver better network value at comparable premium costs. For nationwide PPO plan comparison and quote tools, see our PPO health insurance plans hub — covers PPO availability in all 50 states with quote-by-zip.
How to tell if a Virginia plan is PPO or HMO
Marketplace.Virginia.gov labels every plan with its plan type. Look for “PPO” or “POS” in the plan name or summary — these allow out-of-network access at higher cost-sharing. “HMO” plans require in-network providers for non-emergency care. “EPO” (Exclusive Provider Organization) plans are stricter than PPO but more flexible than HMO — no referrals needed, but no out-of-network coverage. For 2026, Cigna and CareFirst dominate PPO availability on Virginia’s marketplace; the other Plan type is central to choosing the best health insurance in Virginia.
How to Choose the Best Virginia Carrier for Your Situation
The best Virginia health insurance carrier depends on your MSA, your providers, your need for national network access, and your subsidy eligibility. There is no single best carrier statewide. A federal worker in Arlington, a self-employed Norfolk resident, and a small-town family in Bristol will each have different best-fit carriers. The decision-making framework below maps situation to carrier recommendation.
If you live in Northern Virginia (MSA 10)
You have the broadest carrier choice — eight carriers compete in NoVA. CareFirst BlueChoice is the strongest fit if you need DC + MD + NoVA network access (federal workers, DC commuters). Kaiser Mid-Atlantic delivers the lowest 2026 rate change at +11.8% for Virginians who prefer the integrated HMO model. Anthem HealthKeepers and Sentara are the safer choices if you want a Virginia- For many that makes it the best health insurance in Virginia statewide.
If you live in Hampton Roads (MSA 9)
Carrier choice narrows to two — Anthem HealthKeepers and Sentara Health Plans — reflecting Sentara Healthcare’s regional dominance. Sentara is typically the strongest fit if you use Sentara Norfolk General, Sentara Princess Anne, or any of Sentara’s seven Hampton Roads hospitals. Anthem is the better fit if you use Bon Secours hospitals, Riverside Health System, or want broa Reciprocity matters when ranking the best health insurance in Virginia.
If you live in Richmond (MSA 7)
Six carriers compete in Richmond — Anthem, Sentara, Cigna, Kaiser, Optimum, and Oscar. Kaiser delivers the lowest 2026 rate change. Cigna offers the broadest PPO network if you travel. Anthem is the safer broad-network choice. VCU Health and HCA Virginia hospital coverage varies by carrier — ver Provider checks confirm the best health insurance in Virginia for you.
If you live in Roanoke / Southwest Virginia
Bristol (MSA 5) and Roanoke (MSA 8) have narrower carrier choice. Anthem HealthKeepers is the dominant choice for both regions because of its broad network coverage of Carilion Clinic in the Roanoke area and rural southwest Virginia. Sentara also operates in both MSAs. Optimum Choice offers an additional option in Bristol. Subsidies generally make these MSAs the most affordable in Virginia for full-price comparison.
Frequently Asked Questions
Common questions about Virginia health insurance carriers cover the best carrier choice statewide, why Aetna left for 2026, PPO availability, the difference between Anthem HealthKeepers and Anthem Blue Cross Blue Shield branding, which carrier has the broadest network, and how to switch carriers during open enrollment or a special enrollment period.
Which is the best health insurance carrier in Virginia for 2026?
There is no single best carrier for every Virginian — the right choice depends on where you live and which providers you use. Anthem HealthKeepers is the largest individual marketplace carrier statewide with about 106,600 covered lives and the broadest 12-MSA footprint. Sentara Health Plans is dominant in Hampton Roads and tied to Sentara Healthcare hospitals. Kaiser Mid-Atlantic offers the lowest 2026 rate increase at 11.8% but only operates in Northern Virginia, Richmond, and Lynchburg with an integrated HMO model. CareFirst BlueChoice is the strongest fit for Northern Virginia residents needing DC-metro network access, while Cigna offers the broadest natio Travelers often rate it the best health insurance in Virginia.
Why is Aetna no longer offering plans in Virginia for 2026?
Aetna Health Inc. exited the Virginia individual market entirely at the end of 2025, along with its Innovation Health affiliate. The exit was part of Aetna’s nationwide withdrawal from the individual ACA marketplace and was filed with the Virginia Bureau of Insurance in 2025. Approximately 13,721 Virginia members held Aetna or Innovation Health coverage when the exit took effect. Marketplace.Virginia.gov auto-mapped many of these enrollees to alternative carriers for 2026, but auto-mapped enrollees should review their assignment because the auto-mapped plan may not include their current providers. Aetna remains active in Virginia’s Medicaid managed care market Even after its exit, that history informs the best health insurance Virginia debate.
Does Virginia have PPO health insurance plans?
Yes — Virginia has PPO health insurance plans available both on Marketplace.Virginia.gov and off-exchange. On the marketplace, Cigna and CareFirst BlueChoice offer PPO-style plans with broader provider networks than HMOs, including national network reciprocity through BlueCard for CareFirst members. Off-exchange PPO plans are also available directly from major carriers including Anthem, Cigna, and CareFirst — these typically offer broader networks at higher premiums than marketplace HMOs but are not eligible for premium tax credits. Most Virginia individual marketplace plans are HMOs. For nationwide PPO comparison and quote tools, see our PPO health insurance plans hub.
What is the difference between Anthem HealthKeepers and Anthem Blue Cross Blue Shield in Virginia?
HealthKeepers is the Virginia-specific brand for Anthem’s HMO products sold on Virginia’s Insurance Marketplace. Anthem Health Plans of Virginia is the corporate entity that includes HealthKeepers as its individual HMO line. The marketplace plans you see labeled HealthKeepers and the off-exchange plans labeled Anthem are administered by the same Virginia subsidiary of Anthem Inc. — they share the same provider network across HCA Virginia, Inova, Bon Secours, and Carilion. The HealthKeepers brand is mainly an individual market label; Anthem-branded plans dominate Virginia employer-sponsored group coverage.
Which carrier has the broadest provider network in Virginia?
Anthem HealthKeepers has the broadest individual market network in Virginia, contracting with most major Virginia health systems including HCA Virginia, Inova in Northern Virginia, Bon Secours, Carilion, and Sentara hospitals across all 12 rating regions. CareFirst BlueChoice’s BlueCard reciprocity adds nationwide network access for Northern Virginia residents who travel or have family in other states. Sentara Health Plans dominates Hampton Roads with the strongest network in Tidewater, Charlottesville, and Richmond, anchored around its own hospital system. Cigna offers the broadest national PPO reciprocity in Virginia. Kaiser uses an integrated HMO model — Kaiser facilities and physicians only — so its Integration is a tradeoff in the best health insurance in Virginia search.
How do I switch carriers in Virginia for 2026?
To switch carriers, log into Marketplace.Virginia.gov during open enrollment (November 1, 2025 through January 30, 2026 for plan year 2026) or during a special enrollment period if you experienced a qualifying life event. Within your account, compare 2026 plans from the eight Virginia carriers and select a new plan — the Marketplace handles the cancellation of your old plan automatically when you enroll in the new one. Your new coverage starts the first of the month after enrollment. Outside open enrollment without a qualifying life event, you generally cannot switch carriers until the next OEP. A licensed Virginia agent can help compare provider networks and verify your specific doctors and hospitals before you commit.
Get a 2026 Virginia Carrier Comparison
Tell us your ZIP, your providers, and your 2026 income, and a licensed Virginia agent returns a side-by-side of every available carrier on Marketplace.Virginia.gov, with subsidy math and Cardinal Care screening built in. From Anthem statewide to Sentara in Hampton Roads, you see which carrier actually fits. Free, no obligation.
Virginia carrier comparison — covers all 8 marketplace carriers in one call.
Related Virginia Health Insurance Resources
The complete pillar guide to Virginia health insurance for 2026.
Virginia Health Insurance MarketplaceMarketplace.Virginia.gov enrollment, January 30 deadline, and subsidies.
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.
Cardinal Care Medicaid (Official)Virginia’s expanded Medicaid and FAMIS eligibility for income-qualifying residents.
Virginia Small Business Health InsuranceGroup plans, SHOP, ICHRA, and QSEHRA for Virginia employers.
Virginia’s Insurance Marketplace (Official)Virginia’s official marketplace enrollment portal for 2026 plans.
SCC Bureau of InsuranceCarrier rate filings, consumer complaints, and Virginia DOI resources.
Broker Disclosure
ForHealthInsurance.com is an independent health insurance agency serving Virginia residents. We are not affiliated with any carrier or government agency. We help you compare plans and enroll in coverage that meets your needs at no extra cost to you.