Last Updated on October 31, 2025 by Paul Smith
The first time I really understood how our coastal location impacts health insurance was back in 2018, sitting across from a young couple who owned a surf shop on Atlantic Avenue. They were perfectly healthy, but their premiums had just spiked. The reason? Their plan wasn’t built for the unique mix of tourismdriven seasonal income and the yearround residents we have here. It was a lesson in finding the right fit for Virginia Beach life, not just a generic policy.
After more than a decade helping folks from Pungo to the Oceanfront navigate their coverage, I’ve learned that health insurance here isn’t a onesizefitsall situation. You have to account for the seasonal economy, the prevalence of military families with TRICARE, and honestly, our specific health risks that insurers definitely notice. Let’s break down what you can expect for 2025.
What Makes Virginia Beach Health Insurance Different
If you live here, you know we’re not just any city. We’re a massive military hub, a huge tourist destination, and a sprawling coastal community all rolled into one. That creates a unique insurance landscape.
For starters, we have a higherthanaverage number of younger, healthy people thanks to the military presence. But we also have an older population in neighborhoods like Sandbridge and Red Mill. This mix can sometimes help balance risk pools, but insurers also look at our local claim data. And they see a lot of allergyrelated claims (thanks, coastal flora), sports injuries from our active lifestyle, and unfortunately, the health impacts of seasonal stress in the hospitality industry.
You know what’s funny? I’ve had more than one client who works at the Oceanfront come to me because their plan’s network didn’t include doctors convenient to the resort area. They were stuck fighting traffic to get to an appointment in Kempsville during the summer, which is nearly impossible. So now, one of the first things I check is where the innetwork urgent cares and primary care docs are actually located. It seems simple, but it’s a real qualityoflife issue here.
2025 Cost Projections for Virginia Beach
Alright, let’s talk numbers. Based on the filings I’ve been reviewing and the trends we’re tracking, here’s what you can expect for 2025 in the Virginia Beach market.
For individual plans (the kind you buy on your own, not through an employer):
- Bronze Plans (High Deductible): Typically $350–$550/month for a 40yearold. These are your catastrophic coverage plans.
- Silver Plans (Most Common): Around $450–$700/month. This is where most people land, especially if you qualify for subsidies.
- Gold/Platinum Plans (Low OutofPocket): $600–$900+/month. You’ll pay more upfront for much better coverage when you need care.
For small business group plans (2–50 employees), which is a big part of our local economy:
- Employeeonly coverage: $500–$800/month per person
- Family coverage: $1,200–$2,200/month
Wait — actually, let me rephrase that more clearly. Those business numbers are what the employer typically pays, though many split the cost with employees. The employee’s portion is usually deducted from their paycheck.
And here’s an insider secret about costs in our area: Sometimes, a plan that seems more expensive on the monthly premium can actually save you money if you have a specific chronic condition. I had a teacher from the Princess Anne area who was paying $100 more per month for her plan, but her asthma medications were completely covered. Her previous, cheaper plan would have cost her $300/month in prescriptions alone. You have to look at the total picture.
The Main Types of Plans Available Here
We have the full spectrum of health insurance plans available in Virginia, but some are more popular than others in our specific market.
HMOs (Health Maintenance Organizations)
These require you to use a specific network of doctors and get referrals for specialists. They’re often the most affordable option. Sentara Health Plans has a strong HMO network here that includes Sentara Virginia Beach General Hospital and their numerous local clinics. If you don’t mind staying within one system and your primary doctor is part of it, this can be a costeffective choice.
PPOs (Preferred Provider Organizations)
These give you more flexibility to see specialists without referrals and use outofnetwork providers (for a higher cost). Cigna and Anthem Blue Cross Blue Shield have robust PPO networks in our area. This is what I typically recommend for military spouses who might need to see providers outside the TRICARE network or for small business owners who travel frequently to Norfolk or Chesapeake for work.
EPOs (Exclusive Provider Organizations)
A hybrid model—no referrals needed, but you must stay innetwork except for emergencies. UnitedHealthcare offers some good EPO options here. They can be a nice middle ground.
HighDeductible Health Plans (HDHPs) with HSAs
These are becoming increasingly popular, especially with younger, healthier residents in areas like the ViBe Creative District. You pay a lower premium but have a higher deductible. The key advantage is the Health Savings Account (HSA), which lets you save pretax money for medical expenses. It’s like a 401(k) for your health care.
To tell you the truth, I’ve made the mistake myself of recommending an HDHP to someone without fully explaining the HSA component. They ended up with a $3,000 medical bill they couldn’t pay because they hadn’t funded their account. That one still stings. So now I spend extra time making sure people understand the “savings” part is just as important as the “insurance” part with these plans.
Special Considerations for Virginia Beach Residents
Military Families & TRICARE
We have one of the largest concentrations of activeduty military and veterans in the country. If you have TRICARE, you’re generally in good shape. But here’s what many don’t realize: TRICARE often works alongside other insurance as a secondary payer. I’ve helped several dualmilitary families where both spouses have employer coverage plus TRICARE, and we’ve had to carefully coordinate benefits to maximize their coverage.
Seasonal & Tourism Workers
If you work in hospitality, at the Oceanfront, or in any seasonal business, your income likely fluctuates. This is crucial when applying for subsidized plans through the Affordable Care Act marketplace. Your subsidy is based on your projected annual income. I lean back in my chair every time I have to explain this to a server or bartender—if you underestimate, you might owe money at tax time. If you overestimate, you leave savings on the table. We have to make our best educated guess based on your previous years and current situation.
Small Business Owners
Virginia Beach is powered by small businesses. The truth is, providing health insurance is one of the biggest expenses and administrative burdens for local business owners. But it’s also the number one benefit that helps retain good employees. The Small Business Health Options Program (SHOP) marketplace offers some tax advantages, but many of the businesses I work with find better rates and options through private exchanges or by working directly with carriers like Anthem or Cigna.
Local Provider Networks Who Actually Serves Our Area
When you’re evaluating health insurance plans in Virginia Beach, the network is everything. The best plan in the world is useless if your preferred doctors and hospitals aren’t innetwork.
Based on actual local presence, here are some established providers in Virginia Beach:
Sentara Health Plans — Serves the entire Virginia Beach area with a strong focus on local care.
Anthem Blue Cross Blue Shield — Widespread network throughout Hampton Roads.
UnitedHealthcare — Comprehensive coverage options across the city.
Cigna — Particularly strong in the Kempsville and Great Neck areas.
Anyway, the key is to verify that your specific doctors are innetwork, not just the hospital system. I can’t tell you how many times someone has assumed that because Sentara Virginia Beach General is innetwork, every doctor who practices there must be too. That’s not always the case. Doctors are often independent contractors with their own insurance agreements.
Navigating the Virginia Beach Insurance Landscape
Here’s my practical advice for finding the right coverage for 2025:
- Start early. Don’t wait until December. Begin researching in October so you have time to properly compare options.
- Check your medications. Formularies (the list of covered drugs) change annually. A medication covered this year might not be next year.
- Consider your life stage. Are you planning to start a family? Nearing retirement? These life changes dramatically impact what type of plan makes sense.
- Don’t just look at premiums. Factor in deductibles, copays, coinsurance, and outofpocket maximums. A plan with a $50 lower premium but a $2,000 higher deductible might not be the bargain it appears.
Funny thing is, I had a client last year—a fisherman who worked out of Rudee Inlet—who was convinced he needed the absolute cheapest plan available. He was healthy as a horse, never went to the doctor. But then he slipped on his boat and broke his wrist. The cheap plan had a $7,000 deductible and limited emergency coverage. That “bargain” ended up costing him thousands more than if he’d chosen a slightly more expensive Silver plan with better comprehensive coverage. Sometimes the math works counterintuitively.
Local Rules & Verification
All health insurance sold in Virginia Beach must comply with Virginia state insurance regulations. You can verify licenses and check for complaints through the Virginia State Corporation Commission (SCC), which oversees insurance in our state.
For Medicare plans (which many of our retirees in neighborhoods like Baylake Pines use), you’ll want to consult the official Medicare website and consider speaking with a Virginia Beachbased SHIP (State Health Insurance Assistance Program) counselor—they offer free, unbiased Medicare advice.
Common Questions from Virginia Beach Residents
When is open enrollment for 2025 plans?
For individual plans through the Affordable Care Act, it’s November 1, 2024, to January 15, 2025. For employer plans, it varies, but typically in the fall. Medicare Annual Enrollment is October 15 to December 7.
What if I experience a qualifying life event?
Things like getting married, having a baby, or losing other coverage trigger a Special Enrollment Period. You typically have 60 days to enroll in a new plan. The City of Virginia Beach employees I’ve worked with often need this when they first start their jobs or when they have life changes.
Are there any local resources to help me understand my options?
Yes! The Virginia Beach Community Development Corporation sometimes hosts health insurance literacy workshops. And many local insurance agents (like myself) offer free consultations to review your situation.
How does Virginia Beach compare to other cities in Hampton Roads?
Our rates are generally comparable to Norfolk and Chesapeake, but sometimes slightly higher than Portsmouth or Suffolk. This reflects our different hospital systems, provider concentrations, and local health statistics across the region.
Final Thoughts from a Local Perspective
After all these years, what still surprises me is how personal health insurance really is. What works for a retired couple in Chick’s Beach might be completely wrong for a young family in Salem Lakes. The “best” plan is the one that fits your health needs, your budget, and your life here in Virginia Beach.
If you’re looking at health insurance plans for 2025, start by making a list of what matters most to you—your current doctors, any regular medications, and your financial comfort zone. From there, the choice becomes much clearer. And honestly, don’t hesitate to ask for help. This is complicated stuff, and having a local guide who understands both insurance and our community can make all the difference.