HealthKeepers Health Insurance Plans in Norfolk, Virginia
- In 2026, 6 health insurance carriers, including HealthKeepers, offer Marketplace plans in Norfolk's Rating Area 4.
- Virginia residents can choose from HMO, PPO, and EPO plans on the Marketplace, with PPOs being a confirmed option.
- Individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL) may qualify for significant subsidies to lower plan costs.
- Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% FPL, and pregnant women up to 200% FPL.
- Norfolk, with a population of 233,596, has an uninsured rate of 9.1% per U.S. Census Bureau ACS 2024 5-year estimates.
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What HealthKeepers Plans Are Available in Norfolk?
HealthKeepers is one of the key carriers providing health insurance coverage in Norfolk, Virginia, through the Marketplace Virginia / HealthCare.gov. For the 2026 plan year, HealthKeepers offers a range of plan types, including both Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) options. This is significant because PPO plans are available on-exchange in Virginia, offering more flexibility in provider choice compared to states where only HMO or Exclusive Provider Organization (EPO) plans are subsidized. HealthKeepers plans, like others on the marketplace, are categorized into metal tiers: Bronze, Silver, Gold, and Platinum. These tiers reflect the actuarial value of the plan, indicating the percentage of healthcare costs the plan is expected to cover versus what you pay out-of-pocket:- Bronze plans: Typically cover 60% of costs, with you paying 40%. They have lower monthly premiums but higher deductibles and out-of-pocket maximums, making them suitable for those who expect minimal healthcare use or want protection from catastrophic costs.
- Silver plans: Cover 70% of costs, with you paying 30%. These are a popular choice, especially for individuals and families who qualify for Cost-Sharing Reductions (CSRs), which can significantly lower deductibles, copayments, and out-of-pocket maximums. CSRs are only available with Silver plans.
- Gold plans: Cover 80% of costs, with you paying 20%. Gold plans have higher monthly premiums than Bronze or Silver but offer lower deductibles and out-of-pocket costs when you need care, ideal for those who anticipate regular medical services.
- Platinum plans: Cover 90% of costs, with you paying 10%. These plans have the highest monthly premiums but the lowest out-of-pocket costs, offering comprehensive coverage for individuals with extensive healthcare needs.
Understanding Subsidies and Eligibility in Norfolk, Virginia
Many Norfolk residents can significantly reduce their health insurance costs through financial assistance available via the Marketplace Virginia / HealthCare.gov. These subsidies come in two main forms: Advanced Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs). Advanced Premium Tax Credits (APTCs): These credits reduce your monthly premium payments. Eligibility is based on your household income relative to the Federal Poverty Level (FPL). In Virginia, APTCs are available to individuals and families with incomes between 100% and 400% FPL, and even above 400% FPL for some households, ensuring that the cost of a benchmark Silver plan remains an affordable percentage of your income. For a single person, this typically means incomes between approximately $14,580 and $58,320 (based on 2024 FPL figures). Cost-Sharing Reductions (CSRs): CSRs lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. These are available only with Silver tier plans and for individuals and families with incomes up to 250% FPL. This means that if you qualify for CSRs, a Silver plan will provide enhanced benefits, effectively making it more robust than a standard Silver plan, sometimes even comparable to a Gold or Platinum plan in terms of cost-sharing.Virginia Medicaid (FAMIS Plus)
Virginia expanded Medicaid in 2019 (known as Virginia Medicaid Expansion or FAMIS Plus). This means that adults with household incomes up to 138% of the Federal Poverty Level may qualify for comprehensive, low-cost health coverage. For a single individual, this threshold is approximately $20,782 per year (based on 2024 FPL figures). Pregnant women and children also have expanded eligibility through Virginia Medicaid (FAMIS Moms) and FAMIS, covering pregnant women up to 200% FPL and children up to 200% FPL respectively. Applications can be submitted through commonhelp.virginia.gov.Income Guidelines for 2026 (based on 2024 FPL)
This table provides approximate income thresholds for subsidy eligibility. Actual amounts may vary slightly based on updated FPL guidelines and household size.| Household Size | 100% FPL (Approx. Minimum for APTC) | 138% FPL (Approx. Medicaid Expansion Limit) | 250% FPL (Approx. CSR Limit) | 400% FPL (Approx. APTC Limit for Most) |
|---|---|---|---|---|
| 1 | $14,580 | $20,119 | $36,450 | $58,320 |
| 2 | $19,720 | $27,214 | $49,300 | $78,880 |
| 3 | $24,860 | $34,308 | $62,150 | $99,440 |
| 4 | $30,000 | $41,400 | $75,000 | $120,000 |
Figures are approximate and based on 2024 Federal Poverty Level (FPL) guidelines. Actual 2026 FPL figures will be released closer to the enrollment period.
Health Insurance Carriers in Norfolk
Norfolk, Virginia, is part of Rating Area 4, which covers Chesapeake, Franklin, Franklin, Hampton, Isle of Wight, James City, Newport News, Norfolk, Northampton, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York counties. In 2026, 6 carriers offer marketplace plans in Rating Area 4. These carriers provide a competitive landscape for health insurance shoppers, including options from HealthKeepers. The confirmed health insurance carriers offering plans on the Marketplace Virginia / HealthCare.gov in Norfolk's Rating Area 4 for the 2026 plan year are:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Local Healthcare Landscape in Norfolk
Norfolk, Virginia, is home to a robust healthcare infrastructure, providing residents with access to a variety of medical services. The city's healthcare network includes several major hospitals and health systems that are often part of the networks offered by carriers like HealthKeepers. Norfolk County's 3 acute care hospitals, including Sentara Norfolk General Hospital and Sentara Leigh Hospital, serve a population of 233,596 with a 9.1% uninsured rate, per U.S. Census Bureau ACS 2024 5-year estimates. Sentara Norfolk General Hospital is a prominent facility in the city, known for its comprehensive services. Childrens Hospital of the Kings Daughters Inc also provides specialized pediatric care. When selecting a HealthKeepers plan, it is essential to verify that your preferred doctors and hospitals, such as those within the Sentara Health Plans system, are in the plan's network to ensure seamless access to care.Making Your Health Insurance Decision in Norfolk
Choosing the right health insurance plan in Norfolk involves assessing your individual or family's healthcare needs, financial situation, and preferred providers. Here’s a guide to help you decide:- If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus), which provides comprehensive coverage with minimal or no costs. Apply through commonhelp.virginia.gov.
- If your income is between 100% and 250% FPL: You are eligible for significant Advanced Premium Tax Credits (APTCs) to lower your monthly premiums, and crucially, Cost-Sharing Reductions (CSRs) if you choose a Silver plan. CSRs will substantially reduce your deductibles, copayments, and out-of-pocket maximums. A Silver plan with CSRs often provides the best value in this income range.
- If your income is between 250% and 400% FPL: You qualify for APTCs to reduce your premiums. Consider a Silver or Gold plan. Silver plans offer a balance of premium and out-of-pocket costs, while Gold plans have higher premiums but lower costs when you use care.
- If your income is above 400% FPL: You may still qualify for APTCs depending on the cost of the benchmark plan in your area. Without subsidies, you'll pay the full premium. Evaluate Bronze plans for lower premiums and catastrophic coverage, or Gold/Platinum plans for more comprehensive coverage with lower out-of-pocket costs.
Frequently Asked Questions
How many health insurance carriers offer plans in Norfolk, Virginia?
For the 2026 plan year, 6 health insurance carriers offer plans on the Marketplace Virginia / HealthCare.gov in Rating Area 4, which includes Norfolk. These carriers are CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare.
Can I get a PPO plan through the HealthCare.gov marketplace in Virginia?
Yes, PPO plans are available on-exchange in Virginia through the Marketplace Virginia / HealthCare.gov. Shoppers in Norfolk can choose from HMO, PPO, and EPO structures, including options from HealthKeepers Plus PPO, Cigna, and United Healthcare.
What income level qualifies for Medicaid in Virginia?
Virginia expanded Medicaid in 2019. Adults with income up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (FAMIS Plus). This means individuals earning below approximately $20,782 per year or a family of four earning below $43,056 per year (based on 2024 FPL figures) could be eligible.
Do subsidies help lower HealthKeepers plan costs in Norfolk?
Yes, individuals and families in Norfolk may qualify for Advanced Premium Tax Credits (APTCs) to reduce monthly premiums, and Cost-Sharing Reductions (CSRs) to lower out-of-pocket costs like deductibles and copays. Eligibility for these subsidies depends on household income and size, with significant assistance available for those earning between 100% and 400% FPL.
Where can I apply for health insurance in Norfolk, Virginia?
Residents of Norfolk can apply for health insurance through the official Marketplace Virginia / HealthCare.gov website. You can also get free, personalized assistance from a licensed health insurance producer who can help you compare plans and enroll.