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Is Private Health Insurance Cheaper Than ACA in Virginia?

By Martin Elefant · Licensed insurance agent · Updated November 2026 · 5 min read

Short answer: for a healthy person who doesn't qualify for a subsidy, yes, usually by a wide margin. For everyone else, usually no. Here's the math behind that.

When private wins in Virginia

Take a healthy 42-year-old in Richmond earning $95,000. On Virginia's Insurance Marketplace with no subsidy, a Silver plan from Anthem HealthKeepers, CareFirst BlueCross BlueShield, Aetna CVS Health, Kaiser Permanente, Oscar, and UnitedHealthcare is roughly $650–$800 a month in 2026. A private PPO on the Cigna, Aetna and PHCS PPO network for the same person is roughly $380–$480. That's $3,000–$4,500 a year, with a broader network.

When ACA wins in Virginia

Same person earning $45,000: the premium tax credit could bring that Silver plan under $200 a month. No private plan competes with that. Same person with Type 1 diabetes or a recent cancer diagnosis: private plans may decline or exclude; the marketplace accepts them at the same price as anyone else. Medicaid is expanded (since 2019) in Virginia.

What "cheaper" has to include

Compare out-of-pocket maximums, not just premiums. Many private PPOs have individual out-of-pocket caps around $6,000–$9,000, similar to marketplace Silver plans. Check that your doctors are in the PPO network. And remember private plans are month to month — if your income drops into subsidy range during the year, you can move to the marketplace at the next open enrollment or life event.

The Virginia factor

Virginia runs its own state-based marketplace, Virginia's Insurance Marketplace, and Northern Virginia's contractor and consulting workforce is one of the largest self-employed groups on the East Coast.

We run both quotes for every client — it's the only honest way to answer the question. Start here.

ME
Martin Elefant
Licensed insurance agent · NPN 20765405 · Lyons Life LLC · Virginia Private Health

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