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Virginia Health Insurance in 2027: Rules and Options

Virginia buyers shop on Virginia's Insurance Marketplace, the state-run exchange and the only place to apply for federal premium tax credits and the new state help called Virginia Premium Savings. Starting with 2027 plans, Virginia Premium Savings lowers premiums for households earning 138 to 250 percent of the federal poverty level, is applied after any federal credit, and is paid from a fixed state appropriation, so funding may not reach everyone who qualifies. Virginia also runs a state reinsurance program, administered by the Bureau of Insurance and approved through 2027, that helps hold down individual-market premiums. The enhanced federal credits ended after 2025, and excess advance credits must now be repaid in full at tax time, so self-employed tradespeople should keep their income estimate current. Leaving a small employer gives you 12 months of state continuation, short-term plans are held to three months at a time and six months in any year, and open enrollment runs to January 29, 2027.

Private health insurance in Virginia

Most people 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.

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Learn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace

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 are sold outside the exchange by licensed agents and can start the first of any month if you are approved.

Leaving a small employer

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.

Short-term health 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. Short-term plans are medically underwritten, exclude pre-existing conditions and cap benefits, so they fit only a defined gap.

2027 premium changes

Virginia individual-market premiums are set to rise 15.8% to 16.9% on average for 2027, with small-group plans up about 10.7%. The full breakdown is on the Virginia 2027 rate page.

More Virginia guides by job and situation

Virginia questions

Where do Virginia residents buy individual health insurance for 2027?

What happens to my group coverage if I leave a small employer in Virginia?

How long can a short-term health plan last in Virginia?

How much are Virginia premiums rising for 2027?

Individual-market premiums are set to rise 15.8% to 16.9% on average, and small-group plans about 10.7%, based on final rate filings.

Sources: law.lis.virginia.gov, www.dpor.virginia.gov, law.lis.virginia.gov, www.marketplace.virginia.gov. Checked October 21, 2026. More on health insurance in Virginia.

Licensed in Virginia. I compare Marketplace and private plans side by side for your household, no fee.

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