Health Insurance in Chesterfield County, Virginia
- In 2026, six health insurance carriers offer plans through Marketplace Virginia (HealthCare.gov) in Rating Area 3, which includes Chesterfield County.
- Virginia Medicaid (FAMIS Plus) provides coverage for adults with income up to 138% of the Federal Poverty Level (FPL).
- Marketplace Virginia allows shoppers in Chesterfield County to choose from HMO, PPO, and EPO plan types, with PPO options available on-exchange.
- Chesterfield County's uninsured rate is 6.5%, lower than the national average, per U.S. Census Bureau ACS 2024 5-year estimates.
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What Health Insurance Options Are Available in Chesterfield County?
Residents of Chesterfield County have several pathways to securing health insurance, primarily through Marketplace Virginia (HealthCare.gov) and Virginia Medicaid programs.- Marketplace Virginia (HealthCare.gov): This is the primary avenue for individuals and families who do not receive health insurance through an employer or government program. Plans are categorized into metal tiers (Bronze, Silver, Gold, Platinum) based on how costs are split between you and the insurer. Financial subsidies, in the form of premium tax credits and cost-sharing reductions, are available to eligible individuals and families to help lower monthly premiums and out-of-pocket costs.
- Virginia Medicaid (FAMIS Plus): Virginia expanded its Medicaid program in 2019, making it available to adults with household incomes up to 138% of the Federal Poverty Level (FPL). This program provides comprehensive, low-cost or free health coverage.
- FAMIS Programs: For families, Virginia offers FAMIS (Family Access to Medical Insurance Security) for uninsured children in households up to 200% FPL, and FAMIS Moms for pregnant women up to 200% FPL. FAMIS Select is also available for children with incomes between 200% and 400% FPL.
- Employer-Sponsored Plans: Many residents obtain coverage through their employers.
- Off-Marketplace Plans: Private plans can also be purchased directly from insurance companies outside of Marketplace Virginia, though these plans do not qualify for federal subsidies.
Understanding Marketplace Plans and Subsidies
Marketplace Virginia, which uses the HealthCare.gov platform, provides a range of plans designed to make health insurance more affordable. The availability of financial assistance is a key feature, helping to reduce the burden of healthcare costs for many Chesterfield County residents.Premium Tax Credits
These subsidies lower your monthly premium payments. Eligibility is based on your household income relative to the Federal Poverty Level (FPL). For 2026, individuals and families with incomes between 100% and 400% FPL (and higher for some) may qualify for these credits. The exact amount depends on your income, household size, and the cost of the benchmark Silver plan in your area.Cost-Sharing Reductions (CSRs)
CSRs reduce the amount you pay out-of-pocket for deductibles, co-payments, and co-insurance. These are only available if you enroll in a Silver-tier plan and have a household income between 100% and 250% FPL. Silver plans with CSRs offer better coverage than standard Silver plans, effectively acting like Gold or Platinum plans but with lower premiums due to tax credits.Plan Types Available
Unlike some states, Virginia offers a broad choice of plan types on-exchange. In Chesterfield County, you can select from:- Health Maintenance Organization (HMO) Plans: Typically require you to choose a primary care provider (PCP) within the plan's network and get referrals for specialists. They often have lower premiums.
- Preferred Provider Organization (PPO) Plans: Offer more flexibility, allowing you to see out-of-network providers (though at a higher cost) and usually not requiring referrals for specialists. PPO plans ARE available on-exchange in Virginia, providing greater choice for marketplace shoppers.
- Exclusive Provider Organization (EPO) Plans: Similar to HMOs in that they generally don't cover out-of-network care (except in emergencies), but typically do not require a PCP referral for specialists within the network.
Virginia Medicaid and FAMIS Eligibility
For many Chesterfield County residents, Virginia's expanded Medicaid program, known as Virginia Medicaid Expansion or FAMIS Plus, offers a vital safety net.Adults with household incomes up to 138% of the Federal Poverty Level are eligible for Virginia Medicaid. This means individuals earning below this threshold can access comprehensive health benefits with no or very low out-of-pocket costs. If your income falls within this range, it's crucial to apply through commonhelp.virginia.gov to determine your eligibility.
For pregnant women, Virginia Medicaid (FAMIS Moms) provides coverage up to 200% FPL, including comprehensive prenatal care, labor and delivery, and 12 months of postpartum care. Children are covered by FAMIS (Family Access to Medical Insurance Security) for uninsured children in households up to 200% FPL. For families with children earning between 200% and 400% FPL, FAMIS Select offers low-cost coverage options.
Health Insurance Carriers in Chesterfield County
In 2026, six health insurance carriers offer marketplace plans in Virginia Rating Area 3, which covers Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, Powhatan, Richmond, Richmond counties. These carriers provide a variety of plan options across the metal tiers (Bronze, Silver, Gold). The confirmed carriers for Chesterfield County and Rating Area 3 include:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Making Your Health Insurance Decision in Chesterfield County
Choosing the right health insurance plan requires evaluating your personal health needs, financial situation, and access to local providers. Here’s a guide to help you decide:| Your Situation | Recommended Action | Key Considerations |
|---|---|---|
| Household income ≤ 138% FPL | Apply for Virginia Medicaid (FAMIS Plus) through commonhelp.virginia.gov. | You likely qualify for comprehensive, low-cost or free coverage. |
| Household income 138% - 250% FPL | Shop on Marketplace Virginia (HealthCare.gov) for Silver plans. | You are eligible for both premium tax credits and significant cost-sharing reductions (CSRs), making Silver plans a strong value. |
| Household income 250% - 400% FPL (and higher) | Shop on Marketplace Virginia (HealthCare.gov) for any metal tier plan. | You are eligible for premium tax credits to lower your monthly costs. Compare Bronze, Silver, and Gold plans based on your expected healthcare usage. |
| Pregnant Women (income ≤ 200% FPL) | Apply for Virginia Medicaid (FAMIS Moms) through commonhelp.virginia.gov. | Comprehensive prenatal, delivery, and 12 months postpartum care. |
| Children (income ≤ 200% FPL) | Apply for FAMIS through commonhelp.virginia.gov. | Low-cost or free coverage for uninsured children. Consider FAMIS Select for 200-400% FPL. |
| High expected medical costs | Consider Gold or Platinum plans for lower out-of-pocket costs, or Silver with CSRs if eligible. | Higher premiums but lower deductibles and co-pays. |
| Low expected medical costs | Consider Bronze plans for lower monthly premiums. | Good for catastrophic coverage, but be prepared for higher out-of-pocket costs if you need significant care. |
Frequently Asked Questions
How many health insurance carriers offer plans in Chesterfield County, Virginia?
In 2026, six health insurance carriers offer plans through Marketplace Virginia (HealthCare.gov) in Rating Area 3, which includes Chesterfield County. These carriers are CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare.
Can I get a PPO plan on the health insurance marketplace in Chesterfield County?
Yes, PPO plans are available on-exchange through Marketplace Virginia (HealthCare.gov) in Chesterfield County. You can choose from various plan types including HMO, PPO, and EPO structures when shopping for coverage.
What are the income limits for Medicaid in Virginia?
Virginia expanded Medicaid in 2019 (known as Virginia Medicaid Expansion or FAMIS Plus). Adults with household income up to 138% of the Federal Poverty Level (FPL) may qualify. For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with income up to 200% FPL, and children can qualify for FAMIS up to 200% FPL.
Where do Chesterfield County residents get acute medical care?
Chesterfield County residents have access to acute care facilities such as Bon Secours St Francis Medical Center, located in Midlothian. This hospital provides comprehensive medical services to the county's population.
Is pregnancy considered a qualifying life event for special enrollment in Chesterfield County?
No, pregnancy alone is not a qualifying life event for a Special Enrollment Period (SEP) to get health insurance through Marketplace Virginia. However, the birth of a baby IS a qualifying life event, allowing you to enroll in or change plans within 60 days of the child's birth.