Health Insurance in Chesterfield, Virginia
- Marketplace Virginia / HealthCare.gov serves residents of Chesterfield, offering subsidized health plans.
- In 2026, 6 health insurance carriers provide marketplace plans in Rating Area 3, which includes Chesterfield County.
- Virginia Medicaid (FAMIS Plus) covers adults with household incomes up to 138% of the Federal Poverty Level (FPL).
- Chesterfield's uninsured rate is 6.5%, significantly lower than the national average.
- Marketplace shoppers in Virginia can choose from HMO, PPO, and EPO plan structures, offering diverse network options.
Get Your Free Health Insurance Quote
A licensed agent can compare coverage options for you at no cost.
You're all set!
A licensed agent will reach out shortly.
What Are Your Health Insurance Options in Chesterfield, Virginia?
Residents of Chesterfield, Virginia, primarily access health insurance through Marketplace Virginia / HealthCare.gov, the state-based marketplace utilizing the federal platform. This exchange is designed to provide individuals and families with affordable health coverage options, often with financial assistance.Understanding Marketplace Plans and Subsidies
The Affordable Care Act (ACA) marketplace offers four main metal tiers of plans: Bronze, Silver, Gold, and Platinum. Each tier balances monthly premiums with out-of-pocket costs like deductibles, copayments, and coinsurance.- Bronze plans typically have the lowest premiums but the highest out-of-pocket costs, covering about 60% of medical expenses.
- Silver plans have moderate premiums and out-of-pocket costs, covering about 70% of expenses. These plans are particularly valuable for individuals and families with incomes between 100% and 250% FPL, as they may qualify for Cost-Sharing Reductions (CSRs), which significantly lower deductibles, copays, and out-of-pocket maximums.
- Gold plans feature higher premiums but lower out-of-pocket costs, covering approximately 80% of expenses.
- Platinum plans have the highest premiums but the lowest out-of-pocket costs, covering around 90% of expenses.
Available Plan Types in Virginia
Unlike some states where marketplace options are limited to HMO and EPO plans, Virginia offers a broader selection. Shoppers in Chesterfield can choose 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.
- Preferred Provider Organization (PPO) plans: Offer more flexibility, allowing you to see any provider without a referral, though you'll pay less for in-network care. PPO plans ARE available on-exchange in Virginia.
- Exclusive Provider Organization (EPO) plans: Combine features of HMOs and PPOs. You don't need a referral to see a specialist, but you must stay within the plan's network for covered services.
Understanding Virginia Medicaid and FAMIS in Chesterfield
Virginia expanded its Medicaid program in 2019, significantly broadening access to health coverage for low-income adults. This expansion means that more Chesterfield residents can qualify for comprehensive, low-cost health insurance.Virginia Medicaid Expansion (FAMIS Plus)
Adults in Chesterfield with household incomes up to 138% of the Federal Poverty Level (FPL) are eligible for Virginia Medicaid, often referred to as FAMIS Plus. This program provides extensive benefits, including doctor visits, hospital stays, prescription drugs, mental health services, and more, typically with no monthly premiums or deductibles.Coverage for Pregnant Women and Children (FAMIS Moms and FAMIS)
Virginia also offers robust coverage for pregnant women and children:- FAMIS Moms: Pregnant women in Virginia can qualify for Medicaid with household incomes up to 200% FPL. This coverage includes comprehensive prenatal care, labor and delivery services, and extended postpartum care for 12 months after birth, a benefit adopted by Virginia under the American Rescue Plan.
- FAMIS (Family Access to Medical Insurance Security): This program provides low-cost health coverage for uninsured children in families with incomes up to 200% FPL, aligning with the threshold for pregnant women. For children in families with incomes between 200% and 400% FPL, FAMIS Select offers additional low-cost options.
Health Insurance Carriers in Chesterfield
For the 2026 plan year, residents of Chesterfield, Virginia, benefit from a competitive marketplace with multiple insurance providers. In 2026, 6 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, and Richmond counties. This broad coverage ensures that residents across these 13 counties have access to a variety of plan choices. The confirmed local carriers providing plans in Rating Area 3 for 2026 are:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Local Healthcare Access: Hospitals in Chesterfield County
Access to quality healthcare facilities is a key consideration when choosing a health insurance plan. Chesterfield County is served by a major acute care hospital, ensuring residents have local access to essential medical services. Chesterfield, Virginia, with a population of 377,869 and an uninsured rate of 6.5% per U.S. Census Bureau ACS 2024 5-year estimates, is served by Bon Secours St Francis Medical Center in Midlothian. This area is part of Virginia Rating Area 3, which encompasses 13 counties including Chesterfield, ensuring a broad network of providers for residents. Bon Secours St Francis Medical Center provides a wide array of medical services, from emergency care to specialized treatments, serving the healthcare needs of the community. When selecting a health plan, it's important to ensure your preferred doctors and facilities, including Bon Secours St Francis Medical Center, are within the plan's network.How to Choose the Right Plan in Chesterfield
Selecting the ideal health insurance plan in Chesterfield depends on your unique financial situation, health needs, and preferences. Here’s a guide to help you make an informed decision:| Household Income (as % FPL) | Primary Recommendation | Key Benefits |
|---|---|---|
| Below 138% FPL | Virginia Medicaid (FAMIS Plus) | Comprehensive coverage with no premiums or deductibles. Covers most medical services. Apply via commonhelp.virginia.gov. |
| 100% - 250% FPL | Silver plans with Cost-Sharing Reductions (CSRs) | Lower monthly premiums through Premium Tax Credits and significantly reduced out-of-pocket costs (deductibles, copays, out-of-pocket maximums). |
| 250% - 400% FPL | Bronze or Silver plans with Premium Tax Credits | Significant premium assistance available. Choose Bronze for lower premiums and higher deductibles, or Silver for a balance of costs and benefits. |
| Above 400% FPL | Bronze, Silver, Gold, or Platinum plans (full cost) | No income-based subsidies, but can choose any metal tier. Consider Gold or Platinum for more predictable costs if you expect frequent medical care. |
- Your Health Needs: If you anticipate frequent doctor visits, specialist care, or prescription medications, a Gold or Platinum plan with lower out-of-pocket costs might be more cost-effective despite higher premiums. If you primarily need catastrophic coverage, a Bronze plan might suffice.
- Preferred Doctors and Hospitals: Verify that your current or preferred healthcare providers, including Bon Secours St Francis Medical Center, are in the network of any plan you consider. PPO plans offer more flexibility than HMOs but may have higher premiums.
- Prescription Drug Coverage: Check the formulary (list of covered drugs) for any plans you are considering to ensure your medications are covered and understand their cost-sharing structure.
- Deductibles and Out-of-Pocket Maximums: Understand how much you might have to pay before your insurance starts covering costs, and the maximum amount you'd pay in a year.
Frequently Asked Questions
Is pregnancy considered a qualifying life event for health insurance in Virginia?
No, pregnancy alone is not a qualifying life event (QLE) for a Special Enrollment Period through Marketplace Virginia / HealthCare.gov. However, the birth of a baby is a QLE, allowing you to enroll in a new plan or add your child to an existing one. Virginia Medicaid (FAMIS Moms) offers comprehensive coverage for pregnant women up to 200% FPL.
Can I get a PPO health insurance plan on the Marketplace in Chesterfield, Virginia?
Yes, unlike some states, PPO plans are available on-exchange through Marketplace Virginia / HealthCare.gov. Residents of Chesterfield, Virginia can choose from HMO, PPO, and EPO plan structures, allowing for more flexibility in provider choice compared to states where only HMOs and EPOs are offered on the marketplace.
What are the income limits for Virginia Medicaid in Chesterfield?
Virginia expanded Medicaid in 2019. Adults in Chesterfield may qualify for Virginia Medicaid (FAMIS Plus) if their household income is at or below 138% of the Federal Poverty Level (FPL). For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL, and children are covered by FAMIS up to 200% FPL.
How many health insurance carriers offer plans in Chesterfield, Virginia?
In 2026, residents of Chesterfield, Virginia, can choose from plans offered by 6 health insurance carriers on Marketplace Virginia / HealthCare.gov. These carriers include CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare, all serving Rating Area 3.