Can I get health insurance if I'm self-employed in Richmond?

Yes, self-employed individuals in Richmond can access comprehensive health insurance through Marketplace Virginia (HealthCare.gov). You may qualify for significant subsidies based on your household income, making plans more affordable.

What income qualifies me for Virginia Medicaid as self-employed?

In Virginia, adults with household income up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (FAMIS Plus). This program provides comprehensive, low-cost or free health coverage. For 2026, this threshold is approximately $21,114 for an individual or $43,056 for a family of four.

How do I apply for self-employed health insurance in Richmond?

You can apply for health insurance through Marketplace Virginia by visiting HealthCare.gov during open enrollment or a special enrollment period. It's recommended to work with a licensed health insurance producer who can help you compare plans, estimate subsidies, and complete your application at no cost.

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

Self-Employed Health Insurance in Richmond, Virginia

Q: Are PPO plans available on Marketplace Virginia for self-employed individuals?

Yes, self-employed individuals in Richmond can choose from HMO, PPO, and EPO plans on Marketplace Virginia. Several carriers, including HealthKeepers, Cigna, and United Healthcare, offer PPO options in Rating Area 3, which covers Richmond.

Self-employed individuals in Richmond can purchase health insurance through Marketplace Virginia (HealthCare.gov).
Virginia expanded Medicaid in 2019, covering adults with income up to 138% of the Federal Poverty Level (FPL).
In 2026, 6 carriers offer marketplace plans in Rating Area 3, which includes Richmond, with options for HMO, PPO, and EPO plan types.
Subsidies are available to reduce monthly premiums and out-of-pocket costs for individuals earning between 100% and 400% FPL.

Navigating health insurance options when you're self-employed in Richmond, Virginia, can seem complex, but robust solutions are available. The primary avenue for self-employed individuals to secure comprehensive and affordable health coverage is through Marketplace Virginia, which operates on the HealthCare.gov platform. These plans comply with the Affordable Care Act (ACA), meaning they cover essential health benefits, cannot deny coverage for pre-existing conditions, and offer financial assistance to eligible households. In 2026, Richmond residents have access to a variety of plans and carriers, often with significant subsidies that can drastically reduce monthly premium costs and even out-of-pocket expenses.

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Understanding Your Health Insurance Options in Richmond

For self-employed individuals in Richmond, your eligibility for different types of health insurance largely depends on your household income and family size.

Marketplace Virginia Plans (ACA Plans)

Marketplace Virginia offers a range of health plans categorized by metal tiers: Bronze, Silver, Gold, and Platinum. These plans are available to anyone not offered affordable, comprehensive coverage through an employer or government program like Medicare.

Bronze Plans: These plans have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They are suitable for those who want protection against catastrophic medical costs and expect to use healthcare services infrequently.
Silver Plans: Offering a balance between premiums and out-of-pocket costs, Silver plans are particularly beneficial for individuals who qualify for Cost-Sharing Reductions (CSRs). CSRs are extra savings that reduce your deductibles, copayments, and coinsurance, significantly lowering your out-of-pocket expenses.
Gold and Platinum Plans: These tiers come with higher monthly premiums but lower deductibles and out-of-pocket maximums. They are ideal if you anticipate frequent medical care or prefer more predictable costs throughout the year.

Unlike some states, Virginia allows self-employed individuals in Richmond to choose from HMO, PPO, and EPO plan structures on Marketplace Virginia, offering greater flexibility in provider networks.

Financial Assistance: Subsidies and Tax Credits

Many self-employed individuals qualify for financial help to make marketplace plans more affordable.

Premium Tax Credits (PTCs): These subsidies reduce your monthly premium. Eligibility is based on your household income, generally between 100% and 400% of the Federal Poverty Level (FPL).
Cost-Sharing Reductions (CSRs): Available exclusively with Silver plans, CSRs lower your deductibles, copayments, and coinsurance. You qualify for CSRs if your income is between 100% and 250% FPL.

For 2026, a single individual in Richmond earning up to approximately $62,000 (400% FPL) or a family of four earning up to approximately $127,000 (400% FPL) may be eligible for premium tax credits.

Virginia Medicaid (FAMIS Plus)

Virginia expanded its Medicaid program in 2019, making it accessible to more adults, including many self-employed individuals. If your household income is at or below 138% of the FPL, you may qualify for Virginia Medicaid (also known as FAMIS Plus). This program provides comprehensive health coverage with little to no cost for premiums or out-of-pocket expenses. For 2026, 138% FPL is approximately $21,114 for an individual and $43,056 for a family of four. You can apply for Virginia Medicaid through commonhelp.virginia.gov.

Special Enrollment Periods for Self-Employed

While Open Enrollment is the main period to sign up for ACA plans, certain life events trigger a Special Enrollment Period (SEP). If you become self-employed and lose your previous employer-sponsored coverage, this loss of coverage is a qualifying life event that allows you to enroll in a new plan outside of Open Enrollment. Other qualifying events include moving to Richmond, marriage, birth of a child, or significant changes in household income.

Health Insurance Carriers in Richmond

In 2026, 6 carriers offer marketplace plans in Rating Area 3, which covers Richmond and surrounding areas including Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, and Powhatan counties. This provides self-employed individuals in Richmond with a competitive selection of plans. The confirmed carriers for Rating Area 3 are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When comparing plans, consider each carrier's network of doctors and hospitals, specific plan types (HMO, PPO, EPO), and overall out-of-pocket costs in addition to the monthly premium.

Local Healthcare Landscape in Richmond

Richmond, Virginia, with a population of 229,359, is served by a robust healthcare infrastructure. The city's uninsured rate stands at 8.8% per U.S. Census Bureau ACS 2024 5-year estimates. Richmond County, which encompasses the city, provides access to several major acute care hospitals. These include Medical College of Virginia Hospitals, Bon Secours St Marys Hospital, Bon Secours Richmond Community Hospital, and Cjw Medical Center. Self-employed individuals should review the provider network of any plan they consider to ensure their preferred doctors and facilities are included.

Making Your Decision: Next Steps for Self-Employed Coverage

Choosing the right health insurance plan as a self-employed individual in Richmond depends on your income, health needs, and budget.

If your income is below 138% FPL: Apply for Virginia Medicaid (FAMIS Plus) through commonhelp.virginia.gov. This is typically your lowest-cost, most comprehensive option.
If your income is between 100% and 250% FPL: Strongly consider a Silver plan on Marketplace Virginia. You will likely qualify for both premium tax credits and valuable Cost-Sharing Reductions, making your out-of-pocket costs significantly lower.
If your income is between 250% and 400% FPL: Explore all metal tiers (Bronze, Silver, Gold, Platinum) on Marketplace Virginia. You will still qualify for premium tax credits, which can help offset the cost of any plan.
If your income is above 400% FPL: You can still purchase plans on Marketplace Virginia at full price. Compare the benefits and network of various plans to find the best fit for your needs.

A licensed health insurance producer can provide personalized assistance, help you navigate the Marketplace Virginia website, compare plans and subsidies, and enroll in a plan that meets your specific requirements—all at no cost to you.

Frequently Asked Questions

Can I deduct health insurance premiums if I'm self-employed in Richmond?

Yes, generally, self-employed individuals can deduct health insurance premiums for themselves, their spouse, and dependents on their federal income tax return. This is known as the self-employed health insurance deduction, and it can be a significant tax benefit. Consult a tax professional for advice specific to your situation.

What types of plans are available on Marketplace Virginia for self-employed individuals?

Marketplace Virginia offers various plan types, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs). Richmond residents in Rating Area 3 have access to all three types, allowing for choice in how provider networks are structured.

What are the income limits for subsidies on Marketplace Virginia in 2026?

For 2026, premium tax credits are available to self-employed individuals and families in Virginia with household incomes between 100% and 400% of the Federal Poverty Level (FPL). For an individual, this is approximately $15,500 to $62,000. For a family of four, it's about $31,900 to $127,600. Cost-Sharing Reductions are available for those on Silver plans with incomes up to 250% FPL.

Where can I find hospitals in Richmond included in health insurance networks?

Richmond is home to several major hospitals, including Medical College of Virginia Hospitals, Bon Secours St Marys Hospital, and Bon Secours Richmond Community Hospital. Most health insurance plans offered on Marketplace Virginia will include these and other local facilities in their networks. It is crucial to verify that your preferred providers and hospitals are in-network for any specific plan you consider.