Virginia's health insurance market is almost entirely HMO-based. Of the five carriers on the 2026 marketplace, only Blue Cross Blue Shield sells PPO coverage, and it charges 40-year-olds more than double what Kaiser Permanente charges for Silver-tier plans, $528 more a month. For most Virginia residents without out-of-state care needs, an HMO costs a fraction of what a PPO costs.
The more consequential comparison is within the HMO tier. Kaiser Permanente tops our rankings with a MoneyGeek score of 4.6 out of 5, but Sentara Health Plans costs $27 less a month at the Silver tier. That gap flips at Gold: Sentara's Gold plans cost $472 a month, $6 less than its own Silver plans. Anyone expecting regular medical expenses in 2026 should compare Sentara's Gold and Silver costs before choosing.











