Health Insurance for Physicians in Virginia
Most physicians in Virginia are paid in ways that leave them shopping for their own coverage, whether they work around Northern Virginia or anywhere else in the state. Most of the ones I work with choose a private plan priced on their health, not their income, that can start any month if approved. Virginia Marketplace premiums are rising 15.8% to 16.9% on average for 2027, so the private option is worth pricing first.
Private health insurance in Virginia
Most physicians I help in Virginia end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.
Why people leave the Marketplace
- Premiums keep climbing. Virginia Marketplace premiums are rising 15.8% to 16.9% on average for 2027.
- The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
- Surprise tax bills. Underestimate your income and you repay the tax credit in April.
- Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
- High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
- One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.
What a private plan does differently
- Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
- Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Virginia too. Networks vary by plan.
- Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
- Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
- Approval is based on health. You answer health questions, and acceptance is not guaranteed.
With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.
Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.
Get a private plan quoteLearn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace
Virginia health insurance in 2027
Virginia's finalized 2027 increase averages about 16 to 17 percent for the individual market, depending on the tracker, with small-group plans up about 10.7 percent.
- Marketplace rates: up 15.8% to 16.9% on average for 2027 (final).
- Benchmark silver plan, age 40: $549 a month in 2027, up from $455 in 2026.
- The subsidy cliff in Virginia: earning $1 over $63,840 costs a single 60-year-old about $7,466 more a year for that plan, and $1 over $86,560 costs a 60-year-old couple about $19,135.
- Where to enroll: Virginia's Insurance Marketplace, the state's own exchange, which sets its own 2027 enrollment dates.
More: Virginia 2027 rate changes · 2027 subsidy cliff by state. General information, not tax advice.
How physicians work in Virginia
Group private practices employ about 33 percent of Virginia physicians, the largest share of any setting, and another 9 percent work in solo practice, according to the state's 2024 workforce survey. Only 60 percent of all physicians received health insurance through their main job, which leaves a large group of owners, partners, part-timers and contract doctors to arrange their own. About 15 percent hold more than one position, and 39 percent use telemedicine. Practice owners often compare an individual plan for their own family with the cost of starting a small-group plan for staff.
Virginia licensing for physicians
Both MDs and DOs in Virginia are licensed by the Board of Medicine, which grants a full license after just 12 months of postgraduate training. Virginia is not a member of the Interstate Medical Licensure Compact, so out-of-state doctors apply to the board directly, though state law requires a decision within 20 days on completed endorsement applications from neighboring states. Licenses renew every two years in the physician's birth month. Licensed physicians are exempt from the Board of Pharmacy's controlled substances registration; beyond the medical license, the extra prescribing credential is a DEA registration tied to a Virginia address.
The Virginia market for physicians
Virginia's physician workforce numbered about 29,756 doctors in 2024, providing 27,909 full-time equivalents, according to the state Healthcare Workforce Data Center. Only 6 percent of them work in non-metro areas, so care is concentrated in Northern Virginia, Richmond, Hampton Roads and around the academic centers in Charlottesville, Richmond, Norfolk and Roanoke. HRSA counts 180 primary care shortage designations covering about 2.1 million Virginians and estimates that 286 more primary care practitioners would be needed to remove them. Four in ten Virginia physicians expect to retire by age 65.
Virginia coverage rules that apply to you
- Leaving a job: Virginia requires insured group plans that are not subject to federal COBRA, which generally means employers with fewer than 20 employees, to offer 12 months of continuation after at least three months of coverage, at the group rate plus an administrative fee of up to 2 percent.
- Short-term plans: Virginia law caps short-term plans at an initial term of three months and no more than six months of coverage in any 12-month period, a state limit that applies regardless of how federal rules are enforced.
- Where to enroll: Virginia runs its own exchange, Virginia's Insurance Marketplace, and open enrollment for 2027 coverage runs November 1, 2026 to January 29, 2027, with a December 15 deadline for coverage that starts January 1. Private, medically underwritten plans can start the first of any month if approved.
- 2027 rates: individual plans 15.8% to 16.9% on average. See the Virginia 2027 rate page.
Why most independent physicians skip the Marketplace
A practice owner, partner or locum earning a physician's income is far above the 2027 subsidy line, so a Marketplace plan costs full price, and 2027 premiums are rising again in most states. Many Marketplace plans are narrow HMOs or EPOs, and some leave out the very academic centers physicians want for their own families. A private, medically underwritten plan is priced on health instead of income, can start the first of any month if approved, and often uses a national PPO network.
Gaps that catch doctors
The months between residency and the first attending job, the wait for credentialing at a new hospital, a partnership track with delayed benefits and the switch to locum work are the moments physicians go uninsured. Line up a private plan to start the day the old coverage ends.
Owners and partners
A physician who owns a practice can offer staff a small-group plan or an ICHRA and still choose a private plan for the family. Pair any plan with own-occupation disability coverage, which protects the income the practice depends on.
When the Marketplace still makes sense
The Marketplace fits physicians with a significant health condition, because acceptance is guaranteed, and households whose 2027 income stays under 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four), where a tax credit lowers the price. Above that line it costs full price. The full guide for physicians goes deeper.
Quote for a physician in Virginia
Private plans priced first, with the Marketplace alongside when it fits. No fee.
Questions from Virginia physicians
What license do physicians need in Virginia?
Both MDs and DOs in Virginia are licensed by the Board of Medicine, which grants a full license after just 12 months of postgraduate training. Virginia is not a member of the Interstate Medical Licensure Compact, so out-of-state doctors apply to the board directly, though state law requires a decision within 20 days on completed endorsement applications from neighboring states. Licenses renew every two years in the physician's birth month. Licensed physicians are exempt from the Board of Pharmacy's controlled substances registration; beyond the medical license, the extra prescribing credential is a DEA registration tied to a Virginia address.
How much are Virginia health insurance premiums rising for 2027?
Individual-market premiums in Virginia are set to rise 15.8% to 16.9% on average for 2027. Households above 400 percent of the poverty level get no tax credit and pay the full increase.
What happens to my coverage if I leave a job in Virginia?
Virginia requires insured group plans that are not subject to federal COBRA, which generally means employers with fewer than 20 employees, to offer 12 months of continuation after at least three months of coverage, at the group rate plus an administrative fee of up to 2 percent. Losing employer coverage also opens a 60-day Marketplace special enrollment period, and if approved, a private plan can start the first of any month.
Do employed physicians need their own health insurance?
Usually not while employed, but they often do between residency and an attending job, during credentialing delays, on a partnership track or when moving to locum work.
What health insurance do locum tenens physicians use?
Most buy their own coverage, often a private plan with a national PPO network so it works wherever the assignment is. The Marketplace is the fallback for a physician with a significant health condition.
Sources: www.dhp.virginia.gov, data.hrsa.gov, law.lis.virginia.gov, law.lis.virginia.gov. Facts checked October 2026. See all Virginia health insurance rules.
Physicians in other states
Written by Frank Caballero, licensed health insurance agent in Virginia and 30 other states, NPN 21032307.