CareFirst BlueChoice Health Insurance in Richmond, VA

Updated July 2026 · VirginiaPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

CareFirst BlueChoice is a confirmed carrier offering plans on the Marketplace Virginia (HealthCare.gov) for Richmond residents in 2026.
Richmond is part of Virginia Rating Area 3, which includes 13 counties and has 6 marketplace carriers for 2026.
Virginia expanded Medicaid in 2019, covering adults up to 138% of the Federal Poverty Level (FPL).
Marketplace plans in Virginia include HMO, PPO, and EPO options, with PPO plans available on-exchange.
The uninsured rate in Richmond is 8.8%, slightly below the national average, per U.S. Census Bureau ACS 2024 5-year estimates.

Navigating health insurance options in Richmond, Virginia, can be straightforward, especially with carriers like CareFirst BlueChoice participating in the Marketplace Virginia (HealthCare.gov). For 2026, Richmond residents have access to a variety of plans and potential financial assistance to make coverage more affordable. This article focuses on how CareFirst BlueChoice fits into the local health insurance landscape, what plan types are available, and how to assess your eligibility for subsidies or Virginia Medicaid. Understanding these factors is key to choosing a plan that meets your healthcare needs and budget.

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What CareFirst BlueChoice Plans Are Available in Richmond?

CareFirst BlueChoice is one of the six health insurance carriers confirmed to offer plans on the Marketplace Virginia for residents in Richmond during the 2026 plan year. As part of Virginia's Rating Area 3, which covers Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, Powhatan, Richmond, Richmond counties, CareFirst BlueChoice provides various plan options designed to meet different needs and budgets. Virginia's health insurance marketplace offers a range of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. Unlike some other states, PPO plans ARE available on-exchange in Virginia, giving consumers more choice in how they access care. When selecting a CareFirst BlueChoice plan, it's crucial to review the plan's specific network and benefits to ensure it aligns with your preferred doctors and local hospitals, such as Medical College of Virginia Hospitals or Bon Secours St Marys Hospital.

Understanding Your Eligibility for Financial Assistance in Richmond

Affordability is a major factor in choosing health insurance. In Richmond, many residents qualify for financial assistance through the Marketplace Virginia, which can significantly reduce the cost of monthly premiums and out-of-pocket expenses.

Premium Tax Credits

Premium tax credits, also known as subsidies, are available to individuals and families with household incomes between 100% and 400% of the Federal Poverty Level (FPL). These credits can be applied directly to your monthly premium, lowering the amount you pay out-of-pocket. The exact amount of your subsidy depends on your income, household size, and the cost of the benchmark Silver plan in your area.

Cost-Sharing Reductions (CSRs)

For those with incomes up to 250% FPL, Cost-Sharing Reductions (CSRs) are available. CSRs reduce the amount you have to pay for deductibles, copayments, and coinsurance. To receive CSRs, you must enroll in a Silver-tier plan. These reductions make Silver plans particularly valuable for eligible individuals, as they offer enhanced benefits beyond standard Silver plan designs.

Virginia Medicaid Expansion

Virginia expanded Medicaid in 2019, making coverage available to more adults. If your household income is up to 138% of the Federal Poverty Level, you may qualify for Virginia Medicaid (also known as FAMIS Plus). This program provides comprehensive health coverage with no monthly premiums and minimal out-of-pocket costs. For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL, including 12 months of postpartum care. Children in households up to 200% FPL can also get coverage through FAMIS (Family Access to Medical Insurance Security).

Health Insurance Carriers in Richmond

In 2026, 6 carriers offer marketplace plans in Rating Area 3, which includes Richmond, Virginia. These carriers provide a competitive environment with a variety of plan options across different metal tiers (Bronze, Silver, Gold, Platinum) and plan types (HMO, PPO, EPO). The confirmed carriers for Richmond and Rating Area 3 are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

Richmond, Virginia, with a population of 229,359 and an uninsured rate of 8.8% per U.S. Census Bureau ACS 2024 5-year estimates, is served by four acute care hospitals including Medical College of Virginia Hospitals and Bon Secours St Marys Hospital. When choosing a plan, it is important to check if your preferred doctors and these major local health systems are in-network with your chosen carrier.

How to Choose the Right CareFirst BlueChoice Plan

Choosing the right health insurance plan, whether from CareFirst BlueChoice or another carrier, involves evaluating several factors based on your individual or family needs.

Plan Tier	Key Characteristics	Best For
Bronze	Lowest monthly premiums, highest deductibles and out-of-pocket maximums. Covers essential health benefits.	People who expect to use healthcare services infrequently and want protection against catastrophic costs.
Silver	Moderate premiums and out-of-pocket costs. Only tier eligible for Cost-Sharing Reductions (CSRs).	Individuals and families who qualify for CSRs, or those who want a balance between premiums and cost-sharing.
Gold	Higher monthly premiums, lower deductibles and out-of-pocket maximums.	People who expect to use healthcare services frequently and prefer to pay more upfront for lower costs when they need care.

Consider your anticipated medical expenses for the year. If you expect to have many doctor visits, prescriptions, or procedures, a Gold plan might save you money in the long run despite its higher premium. If you are generally healthy and primarily want coverage for emergencies, a Bronze plan could be more suitable. Silver plans are often a good middle-ground, especially if you qualify for Cost-Sharing Reductions. Always verify that your preferred doctors, specialists, and hospitals, such as Bon Secours Richmond Community Hospital or Cjw Medical Center, are within the plan's network. Out-of-network care can be significantly more expensive or not covered at all.

Next Steps: Getting Covered in Richmond

Once you've considered your options, the next step is to apply for coverage through the Marketplace Virginia.

If your income is below 138% FPL: You likely qualify for Virginia Medicaid. Apply through commonhelp.virginia.gov to determine your eligibility for Virginia Medicaid or FAMIS Plus.
If your income is 100%–400% FPL: You are eligible for premium tax credits. You can apply through HealthCare.gov during Open Enrollment or a Special Enrollment Period. Be sure to select a Silver plan if you qualify for Cost-Sharing Reductions to maximize your savings.
If your income is above 400% FPL: You can still purchase a plan through the Marketplace Virginia at full price, or explore off-exchange options directly from carriers.

A licensed health insurance producer can provide free, personalized assistance to help you compare CareFirst BlueChoice plans with other carriers, calculate your potential subsidies, and guide you through the enrollment process.

Frequently Asked Questions

Can I get CareFirst BlueChoice plans on the Marketplace Virginia in Richmond?

Yes, CareFirst BlueChoice is one of six confirmed carriers offering plans on the Marketplace Virginia (HealthCare.gov) for residents in Rating Area 3, which includes Richmond, during the 2026 plan year. You can compare their plans alongside other carriers during Open Enrollment.

What types of plans does CareFirst BlueChoice offer in Richmond?

In Virginia's Marketplace, carriers including CareFirst BlueChoice offer a range of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. The specific types offered by CareFirst BlueChoice will vary by plan and metal tier.

Are subsidies available for CareFirst BlueChoice plans in Richmond?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits to lower your monthly insurance payments. Additionally, those with incomes up to 250% FPL may be eligible for Cost-Sharing Reductions (CSRs) on Silver plans to reduce out-of-pocket costs.

How do I choose the best CareFirst BlueChoice plan for my needs?

Consider your anticipated healthcare usage, budget, and preferred doctors. Bronze plans have lower premiums but higher out-of-pocket costs, while Gold plans have higher premiums but lower out-of-pocket costs. Silver plans offer a balance and are the only plans eligible for Cost-Sharing Reductions. Review the provider network to ensure your doctors and hospitals, such as Medical College of Virginia Hospitals or Bon Secours St Marys Hospital, are included.

What is the enrollment period for 2026 health plans in Richmond?

Open Enrollment for 2026 plans typically runs from November 1st to January 15th each year. If you miss this period, you may still be able to enroll during a Special Enrollment Period (SEP) if you experience a qualifying life event, such as marriage, birth of a child, or loss of other coverage.