Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Virginia program

A private plan through Virginia’s Insurance Marketplace

Virginia’s Marketplace sells private health plans and checks whether you can get help with the premium.

What it is

Virginia’s Marketplace sells private health plans and checks whether you can get help with the premium.

A coverage loss can open a special enrollment window. A navigator can compare plans with your child’s treatment team and medicines. The cheapest premium may not mean the lowest treatment costs.

Eligibility rules
  • Virginia residency is required. The 2026 premium-help income range is 100% to 400% of poverty, subject to the other eligibility rules.
  • The normal loss-of-coverage window is 60 days around a qualifying loss. Virginia allows 90 days after Medicaid ends.
What you get
  • A private health plan, with premium help for eligible households.
What the rules cover
  • In every area at least one gold plan caps a month's supply of a prescription at $200; ask the navigator which one.
If you decide to apply
  1. Ask a certified navigator or the Marketplace help center to compare your options.
  2. Bring the coverage-end notice, expected income and your child’s hospital, doctor and medicine list.

Virginia's Insurance Marketplace · Official page ↗

If you decide to apply
  • The consumer assistance center is 888-687-1501. A navigator can help at no charge.
Good to know

The enrollment clock follows the coverage-end date. The exact oncology network matters as much as the premium.

Other details
  • The end of a job and the end of its health coverage may be different dates. The coverage notice establishes the relevant date.
  • If you already have a Marketplace plan, a change in expected annual household income may change premium help. A navigator can help you update that estimate without treating a work change as a loss of coverage.

Federal background: Marketplace special enrollment

Official sources
Ask your social worker

“If our coverage ends, which Marketplace plans cover our cancer team and medicines? Could you help compare costs and confirm when new coverage would start?”

Why I’m asking: I want to avoid a treatment gap when insurance changes.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Apply within the window and check the network before you pick.

Your social worker

A certified navigator or the consumer assistance centre will walk through plans free of charge.

The care team

Records and letters when the application asks for them.

Who decides
Virginia's Insurance Marketplace
Ask your social worker
“We are losing cover. Which Marketplace plans have our hospital and oncology group in network, and what is our deadline?”

How to apply

First step: Go to marketplace.virginia.gov or call 888-687-1501 the same week cover ends.

  1. A Marketplace navigator can review a coverage-loss date, enrollment window and treatment access before any change.
  2. Check the hospital and the oncology group are in the network before choosing.

Official application / program page ↗

Where it starts: Apply at marketplace.virginia.gov or call the consumer assistance centre on 888-687-1501.

What to gather

  • The letter saying cover is ending and the date
  • Expected household income for the year
  • The names of the hospital and the oncology group

How long: Cover usually starts the first of the following month once you enrol.

Clock: Sixty days from the day job coverage ends to pick a Marketplace plan.

Clock: Ninety days from the day Medicaid ends to apply and enrol.

What a yes looks like

An enrolment confirmation with a start date and a premium after help.

What a no looks like, and the next move

If the window has passed, ask about another qualifying change; a move, a birth or another cover loss opens a new one.

Watch out

  • The clock starts the day cover ends, not the day you notice.
  • Check the oncology team is in network before price.
  • The homepage prints a second phone number; the help centre number 888-687-1501 is the verified one.

Dates that change this

2027-01-01: Virginia Premium Savings, the state top-up on premiums, starts in plan year 2027, not 2026, and applies to premiums only.

2026-01-01: The larger federal premium help has expired, so in 2026 only incomes between one and four times the poverty line get help with the premium.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

A private plan bought through the state, with 60 days after job cover ends and 90 days after Medicaid ends.

  • $60 — Days to enrol after losing job coverage
  • $90 — Days to enrol after Medicaid ends
  • $200 — Thirty-day prescription cap on at least one gold plan in each area

Covers: Individual and family health plans · Help with the premium between one and four times the poverty line

Legal protection: A guaranteed enrolment window after a qualifying loss of cover

What it costs the family: A monthly premium, reduced by federal help within the income range.

The eligibility facts, as published

Residency
Virginia
Enrolment window
60 days around a loss of qualifying coverage; 90 days after Medicaid ends
Premium help
incomes between 100% and 400% of the poverty line in 2026

The trap: The generic page says 60 days. The state's own flyer for people losing Medicaid says 90 days. Use 90 only for a Medicaid ending; use 60 for a job ending, and do not wait either way.

Where I read this

← Back to your options