Virginia Health Insurance — Built Around Your Life

Ryan Michalek, Licensed Health & Life Insurance Agent, NPN 21043091. Last updated November 7, 2026

How health coverage works in Virginia

Since the 2024 plan year, Virginia has run its own marketplace, Virginia's Insurance Marketplace, for ACA plans, which are guaranteed-issue and subsidy-eligible if your income qualifies. But it is not your only path. Many self-employed Virginians and families who earn too much for a subsidy — or saw their premium jump at renewal — turn to private under-65 plans, which often offer PPO-style flexibility and year-round enrollment. I help you compare both honestly, and you decide. For 2027, the marketplace in Richmond offers no PPO plans at any metal level, only HMO and EPO networks (public marketplace quotes checked October 31, 2026). Can you still get a PPO in 2027? Hampton Roads reaches into northeastern North Carolina; an individual plan generally follows the state you live in, so if home is on that side of the line, see North Carolina health insurance.

Northern Virginia, Richmond, and Virginia’s contractors

Virginia has one of the highest concentrations of independent contractors in the country, and a lot of that is my work. Northern Virginia — the DC suburbs — runs on government and defense contracting, consulting, and tech, a world where 1099 and small-firm income is everywhere. Richmond adds finance, law, and a growing startup scene; Hampton Roads brings the shipbuilding and maritime trades; and the rest of the state spans ag, university towns, and small business. For self-employed Virginians earning above the subsidy line, I’ll walk you through your marketplace and private under-65 options so you see the full picture.

A self-employed health insurance broker in Virginia, for anyone over the subsidy line

The short answer: if your household income is above 400% of the federal poverty level, a plan on Virginia's Insurance Marketplace comes with no premium tax credit for 2027, so you pay the full rate. For 2027 coverage that line is about $63,840 for one person or $86,560 for a couple, based on the 2026 HHS poverty guidelines (as of November 2026). That's where a private under-65 plan is worth a side-by-side look.

• Virginia's 2027 rates. The Virginia Bureau of Insurance approved 2027 rates with a weighted average increase of about 15.8% before subsidies for plans on Virginia's Insurance Marketplace.
• A new state subsidy, with an income limit. For 2027, Virginia added its own help, called Virginia Premium Savings, for households with income between 138% and 250% of the poverty level who buy through Virginia's Insurance Marketplace. If your income qualifies, that's a marketplace question, and I'll point you to Virginia's Insurance Marketplace. It doesn't reach people above the subsidy line.
• Medicaid. Virginia expanded Medicaid in 2019, so lower-income adults have a route there.
• Fewer full-price shoppers stayed. About 31,700 Virginians with household income above four times the poverty level picked a plan on the state marketplace for 2025. For 2026, after the extra federal help ended, that number was about 25,800 (CMS Open Enrollment state-level public use files).
• Where to go next. Covering a family on self-employed income · COBRA alternatives when a job plan ends · staying covered between jobs · what the 2027 subsidy cliff means for your income.

I answer my own phone, evenings and weekends included. If a plan on Virginia's Insurance Marketplace or the coverage you have now fits you better, I'll tell you plainly and point you to the right help.

Figures as of November 2026. Sources: HHS 2026 poverty guidelines (400% line, multiplied out); Virginia Bureau of Insurance 2027 individual market rate summary (via healthinsurance.org); WHRO and Cardinal News (Virginia Premium Savings eligibility); KFF (Medicaid expansion status).

Virginia in plain terms: NoVA, Richmond, Tidewater, the Valley and Southwest Virginia

Ask a Virginian where they're from and you'll get a region before a town, and the coverage conversation changes as you head west on I-64 or south on I-95. Here's what I, Ryan Michalek, watch for in each part of the state. The population and income numbers below come from the Census Bureau's newest one-year American Community Survey (2025 data), pulled November 7, 2026.

• Northern Virginia. Across the Washington metro area as the Census draws it (Arlington, Alexandria, Fairfax, Loudoun and Prince William, plus D.C. and the Maryland suburbs), about 46 of every 100 households earn $150,000 or more, and about 66 of every 100 adults aged 19 to 64 live above four times the poverty level (tables B19001 and B27016). For most NoVA consultants, the subsidy question is settled before the first quote; the real question is network and price.
• Greater Richmond and the Tri-Cities. In Richmond, a 60-year-old with no subsidy faces a 2027 benchmark silver plan of about $1,121 a month, and the Richmond marketplace has no PPO at any metal level (my price check, October 31, 2026). About 27 of every 100 households in the Richmond area earn $150,000 or more.
• Hampton Roads. Norfolk, Virginia Beach, Chesapeake, Portsmouth, Newport News and Hampton make up a Navy and shipbuilding region, and the Census metro area reaches across the line into Currituck County, North Carolina. Only about 6 of every 100 people under 65 here buy their own coverage. If you're separating from the service or leaving a shipyard job to work for yourself, the end of that coverage is typically a loss of coverage that opens a 60-day special enrollment window.
• Charlottesville and central Virginia. Around the University of Virginia, about 13 of every 100 workers are self-employed, the highest rate of the Virginia metro areas I track, and about 32 of every 100 households earn $150,000 or more (table B24080). That's a lot of solo practices, consultants and small farms buying a plan on their own.
• The Shenandoah Valley and Winchester. The Winchester metro area spills into West Virginia's Eastern Panhandle, and only about 3 of every 100 people under 65 there buy their own coverage, so most people come to it new, after a job ends or a business starts.
• Roanoke, Lynchburg and the Blue Ridge. About 41 of every 100 working-age adults (26 to 64) around Roanoke are 50 to 64, and about 40 in Lynchburg, against about 36 statewide. Here the bridge from a job plan to Medicare comes up more often, and I walk through health insurance for early retirees for exactly that stretch.
• Southwest Virginia. The Census counts Bristol, Virginia, and Kingsport, Tennessee, as one metro area. About 43 of every 100 working-age adults there are 50 to 64, the oldest mix in my Virginia figures, and about 37 of every 100 adults aged 19 to 64 live above four times the poverty level, against about 66 in the D.C. area, so more families in the coalfields and the Mountain Empire land under the subsidy line. If that's you, a subsidized marketplace plan may fit better, and I'll say so.

Virginia work with its own coverage questions

Virginia's job mix doesn't look like its neighbors'. Federal job counts (BLS, May 2025) show where the state runs heavier than the national average, and each of these comes with its own coverage wrinkle.

• IT and government contractors. Virginia has about 1.7 times the national concentration of computer systems analysts (SOC 15-1211). When a contract ends, the employer plan usually ends with it. Virginia's WARN notices since August 2026 list layoffs at several government-technology and consulting firms in Herndon, Ashburn, Reston, Arlington and Fort Belvoir (Virginia Works, checked November 7, 2026). See health insurance for IT consultants and what to weigh against COBRA.
• Counselors and therapists. Virginia has about 1.4 times the national concentration of mental health and substance-use counselors (SOC 21-1018). If you've left an agency to open your own practice, here's health insurance for private-practice therapists.
• Electricians and plumbers. Virginia runs about 1.2 times the national rate for electricians and 1.1 times for plumbers and pipefitters. A tradesperson who gets a contractor license and goes out on their own is buying a plan for the first time; see health insurance for the skilled trades.
• Real estate agents. Virginia also runs above the national rate for real estate sales agents, from Loudoun new-builds to Virginia Beach. Commission income swings, and health insurance for realtors covers how to plan around it.
• New businesses. Virginians filed about 38,000 high-propensity business applications in 2025, the kind likely to hire (Census Business Formation Statistics). If yours is an LLC, see health insurance for LLC owners.

Living in Virginia and working across a state line

Virginia shares commuter belts with five other states I'm licensed in, and with Washington, D.C. From Alexandria to Bristol the rule of thumb is the same: your individual plan is generally tied to your home address, not the state that issues your paycheck. What changes is the network. If you live in Arlington or Alexandria and your doctors are across the Potomac, check that each one is in the plan's network before you choose. I'll look at the directory with you, but networks can change, so confirm with the doctor's office too.

• The Maryland side of the D.C. suburbs. If home is in Montgomery or Prince George's County, you buy a Maryland plan; see Maryland health insurance.
• Bristol. State Street is the state line, so a Bristol, Virginia, household buys a Virginia plan even if the shop is two blocks away in Tennessee. On the other side, see Tennessee health insurance.
• Winchester and the Eastern Panhandle. If you live in Martinsburg or Charles Town and work in Winchester, your plan comes from West Virginia.
• The coalfield counties. Buchanan, Dickenson and Wise counties sit against eastern Kentucky; a Kentucky address means a Kentucky plan.

Where the Virginia numbers above come from (all checked November 7, 2026): U.S. Census Bureau, 2025 American Community Survey 1-year (tables B01001, B19001, B24080, B27005, B27016); Census Business Formation Statistics (2025); BLS Occupational Employment and Wage Statistics, May 2025 (location quotients); Virginia Works WARN notices; CMS Open Enrollment state-level public use files (2025 and 2026); my 2027 marketplace price checks (October 31, 2026).

Who I help across Virginia

• Northern Virginia consultants and government contractors on 1099 income, between contracts or for good
• Families from Richmond to Tidewater looking outside an employer plan
• Navy and shipyard families in Hampton Roads coming off military or yard coverage
• People whose COBRA is running out after a layoff, or who left a job and need coverage without a gap
• Small business owners from Charlottesville to Roanoke setting up a plan for themselves and their team
• Early retirees in the Blue Ridge and Southwest Virginia who need a bridge to Medicare

The same broker for Virginia clients, from first call to renewal

I'm independent, so whether you're in Ashburn or Abingdon I compare the real options and recommend what fits you, even when that earns me nothing. You work with one licensed advisor from the first call through each renewal, not a call center, and I'm still here after you enroll. Virginia is one of the 31 states where I'm licensed. (Ryan Michalek, NPN 21043091.) You can confirm my Virginia license yourself: choose Agent on the Virginia Bureau of Insurance producer search and search my name, Ryan Michalek.