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

Health Insurance in Richmond, Virginia: Your 2026 Guide

Richmond residents can choose from 6 confirmed marketplace carriers in Rating Area 3, including Cigna and United Healthcare.
Virginia expanded Medicaid in 2019 (FAMIS Plus), covering adults with incomes up to 138% of the Federal Poverty Level.
The uninsured rate in Richmond is 8.8%, significantly below the national average, per U.S. Census Bureau ACS 2024 5-year estimates.
Marketplace Virginia, operating through HealthCare.gov, offers HMO, PPO, and EPO plans, with subsidies available based on income.

Navigating health insurance options in Richmond, Virginia, for 2026 involves understanding both federal marketplace plans and Virginia's expanded Medicaid program. Residents of Richmond can access a variety of comprehensive health plans through HealthCare.gov, the federal platform for Virginia's state-based marketplace. These plans are regulated by the Affordable Care Act (ACA) and offer financial assistance, known as subsidies, to make coverage more affordable based on household income. Additionally, many Richmond residents may qualify for Virginia Medicaid (FAMIS Plus) if their income falls within the expanded eligibility guidelines. Whether you're seeking individual, family, or short-term coverage, knowing your options and eligibility is the first step toward securing essential health benefits in the Richmond area.

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What health insurance options are available in Richmond, Virginia?

Richmond residents have several pathways to securing health insurance coverage, primarily through the ACA marketplace on HealthCare.gov or Virginia's Medicaid program. The marketplace offers a range of plan types designed to meet diverse needs and budgets:

Marketplace Plans (ACA Plans): Available through HealthCare.gov, these plans are offered by private insurance companies and are categorized into metal tiers: Bronze, Silver, Gold, and Platinum. All ACA plans cover essential health benefits, including doctor visits, prescription drugs, hospital care, and mental health services. Crucially, Virginia's marketplace offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, giving consumers flexibility in choosing their provider networks.
Virginia Medicaid (FAMIS Plus): For individuals and families with lower incomes, Virginia's expanded Medicaid program, known as FAMIS Plus, provides comprehensive, low-cost or no-cost health coverage. Eligibility is based on household income relative to the Federal Poverty Level (FPL).
FAMIS and FAMIS Moms: Virginia also offers the Family Access to Medical Insurance Security (FAMIS) program for uninsured children and FAMIS Moms for pregnant women, providing critical coverage for these vulnerable populations.
Off-Marketplace Plans: While not eligible for subsidies, some private plans are available directly from insurance companies outside of HealthCare.gov. These might be suitable for individuals who do not qualify for subsidies or prefer specific plan features not found on the marketplace.

How much does health insurance cost in Richmond?

The cost of health insurance in Richmond varies significantly based on factors such as your age, household income, plan tier, and the number of people covered. However, many Richmond residents can receive financial assistance to lower their monthly premiums and out-of-pocket costs through HealthCare.gov.

Premium Tax Credits: These subsidies reduce your monthly premium payments and are available to individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL). For example, a Richmond individual earning $35,000 (approximately 238% FPL for a single person in 2026) would likely qualify for significant tax credits, substantially lowering their monthly premium.
Cost-Sharing Reductions (CSRs): Available only with Silver-tier plans, CSRs reduce your deductibles, copayments, and out-of-pocket maximums. These are offered to individuals and families with incomes up to 250% FPL. For instance, a Richmond family of four earning $75,000 (approximately 254% FPL in 2026) might still benefit from some CSRs, making Silver plans a particularly good value.

Without subsidies, a Bronze plan typically has the lowest monthly premium but the highest out-of-pocket costs, while Gold and Platinum plans have higher premiums but lower out-of-pocket expenses when you need care.

Who offers health insurance plans in Richmond, Virginia?

For 2026, Richmond, Virginia, is part of Rating Area 3, which covers Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, Powhatan, Richmond, Richmond counties. In 2026, 6 carriers offer marketplace plans in Rating Area 3. These confirmed local carriers provide a range of options for residents to choose from on HealthCare.gov:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When reviewing plans, it is important to consider not only the premium but also the plan's network, deductibles, copayments, and out-of-pocket maximums to ensure it aligns with your healthcare needs and budget. A licensed agent can help you compare these options.

Am I eligible for Virginia Medicaid (FAMIS Plus) in Richmond?

Virginia expanded its Medicaid program in 2019, significantly broadening eligibility for adults in Richmond and across the state. This program, often referred to as Virginia Medicaid Expansion or FAMIS Plus, provides comprehensive health coverage for eligible low-income individuals and families.

Adults: If your household income is at or below 138% of the Federal Poverty Level (FPL), you may qualify for Virginia Medicaid. For a single adult, this means an income of approximately $20,782 or less per year in 2026. For a family of three, the threshold is around $35,390.
Pregnant Women (FAMIS Moms): Virginia Medicaid offers coverage for pregnant women with household incomes up to 200% FPL. This extended coverage includes prenatal care, labor and delivery, and 12 months of postpartum care, which was extended under the American Rescue Plan and adopted by Virginia.
Children (FAMIS): Uninsured children in households with incomes up to 200% FPL are eligible for the FAMIS program. For children between 200% and 400% FPL, FAMIS Select offers low-cost coverage options.

You can apply for Virginia Medicaid and FAMIS programs through commonhelp.virginia.gov. It's important to apply even if you are unsure of your eligibility, as circumstances and thresholds can change.

Understanding Richmond's Healthcare Landscape

Richmond, Virginia, with a population of 229,359 and a median age of 34.7 years, is a dynamic urban center with a robust healthcare infrastructure. The city's uninsured rate stands at 8.8%, lower than the national average, per U.S. Census Bureau ACS 2024 5-year estimates. Residents of Richmond have access to several major medical facilities, including Medical College of Virginia Hospitals, Bon Secours St Marys Hospital, Bon Secours Richmond Community Hospital, and Cjw Medical Center. These acute care hospitals, located within the city, provide a wide range of services to the community, ensuring comprehensive care is available locally.

Making the Right Choice for Your Health Coverage

Choosing the right health insurance plan in Richmond depends on your individual health needs, financial situation, and preferred access to doctors.

If your income is at or below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus). This provides comprehensive, low-cost or no-cost coverage. Apply directly through commonhelp.virginia.gov.
If your income is between 100% and 250% FPL: You are eligible for significant Premium Tax Credits and Cost-Sharing Reductions. A Silver plan will offer the best value, combining lower premiums with reduced out-of-pocket costs.
If your income is above 250% FPL (up to 400% FPL): You still qualify for Premium Tax Credits to lower your monthly premiums, making marketplace plans more affordable. Consider Bronze for lower premiums and higher deductibles, or Gold for lower deductibles and higher monthly costs.
If your income is above 400% FPL: While you won't qualify for subsidies, you can still purchase a comprehensive ACA plan through HealthCare.gov or directly from a carrier off-marketplace.

The best way to ensure you're making an informed decision is to compare plans on HealthCare.gov or consult with a licensed health insurance producer. An agent can help you navigate the options, understand your subsidy eligibility, and enroll in a plan that best fits your specific needs, all at no additional cost to you.

Frequently Asked Questions

What types of health insurance plans are available in Richmond, Virginia?

In Richmond, Virginia, marketplace plans available through HealthCare.gov include Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) options. Virginia's expanded Medicaid program, FAMIS Plus, also provides coverage for eligible residents.

Who are the confirmed health insurance carriers in Richmond for 2026?

For 2026, residents in Richmond, Virginia, which is part of Rating Area 3, have access to marketplace plans from 6 confirmed carriers: CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare. You can compare plans from these carriers on HealthCare.gov or with a licensed agent.

What are the income limits for Virginia Medicaid in Richmond?

Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level (FPL). For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL, and children (FAMIS) are covered up to 200% FPL. You can apply through commonhelp.virginia.gov.

Is pregnancy considered a qualifying life event for special enrollment in Richmond?

No, pregnancy itself is not a qualifying life event for a Special Enrollment Period (SEP) under the Affordable Care Act (ACA). However, the birth of a child is a qualifying life event, allowing you to enroll in or change your health plan within 60 days of the baby's arrival.