Health Insurance Overview
Virginia offers robust health coverage options for its residents. With Medicaid expansion, low-income adults have access to free or low-cost coverage. Those with higher incomes can find affordable marketplace plans with premium subsidies through HealthCare.gov.
Medicaid in Virginia
Virginia's Medicaid program covers a wide range of residents following the 2019 expansion:
- Adults ages 19-64 with income up to 138% of poverty (about $20,120/individual)
- Children under 19 (higher income limits apply)
- Pregnant women with income up to 148% of poverty
- Seniors age 65 and older who meet income requirements
- Individuals with qualifying disabilities
Medicaid Benefits
Virginia Medicaid provides comprehensive coverage including:
- Doctor visits and specialist care
- Hospital services (inpatient and outpatient)
- Prescription medications
- Mental health and substance use treatment
- Preventive care and wellness visits
- Maternity and newborn care
- Laboratory and imaging services
How to Apply for Virginia Medicaid
You can apply for Virginia Medicaid through:
- Online: Visit CommonHelp
- Phone: Call Cover Virginia at 1-855-242-8282
- In Person: Visit your local Department of Social Services
- Mobile App: Download the CommonHelp mobile app
Health Insurance Marketplace
Virginia uses the federal Health Insurance Marketplace at HealthCare.gov. If you don't qualify for Medicaid, you can find quality coverage with potential subsidies to reduce your costs.
How to Enroll
- Visit HealthCare.gov
- Create an account and complete your application
- See if you qualify for Medicaid or marketplace subsidies
- Compare plans from multiple insurers
- Select a plan and pay your first premium
Average Costs and Subsidies
Virginia residents have access to significant financial assistance:
- Medicaid: Free or very low cost for those who qualify
- Premium Tax Credits: Available for income 100-400% of poverty (and beyond with enhanced subsidies)
- Cost-Sharing Reductions: Lower deductibles and copays on Silver plans for income under 250% poverty
- FAMIS: Low-cost coverage for children in families with moderate income
Frequently Asked Questions
Has Virginia expanded Medicaid?
Yes, Virginia expanded Medicaid in 2019. Adults ages 19-64 with income up to 138% of the federal poverty level (about $20,120 for an individual or $41,400 for a family of four) can now qualify for Medicaid coverage through the Medicaid Expansion program.
How do I apply for Virginia Medicaid?
You can apply for Virginia Medicaid online at CommonHelp (commonhelp.virginia.gov), by phone at 1-855-242-8282, or in person at your local Department of Social Services. There is no enrollment period - you can apply any time of year.
What marketplace options are available in Virginia?
Virginia uses the federal marketplace at HealthCare.gov. Multiple insurance companies offer plans throughout the state, and many Virginians qualify for premium tax credits that significantly reduce monthly costs. Open enrollment runs November 1 to January 15.
Who qualifies for free or low-cost health insurance in Virginia?
Virginians with income up to 138% of poverty may qualify for free Medicaid coverage. Those with income between 100-400% of poverty can get subsidized marketplace plans. Many residents qualify for $0 premium Bronze plans or heavily subsidized Silver plans with lower out-of-pocket costs.
Need Help Finding Coverage in Virginia?
Our licensed agents can help you navigate Virginia's Medicaid program or find the best marketplace plan for your needs.
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