TSM Life & Health is an independent, licensed agency helping Virginia residents compare Medicare Advantage, ACA Marketplace, life insurance, final expense and annuity options in plain language. For 2026, CMS lists 49 Medicare Advantage (MA-PD) plans in Fairfax County, 31 in Virginia Beach and 32 in Henrico County (Richmond), with about 20 or more $0 monthly-premium plans in each. On the ACA side, Virginia runs its own marketplace — Virginia’s Insurance Marketplace — which lists 83 individual medical plans from 8 insurers for 2026, and many households qualify for a premium tax credit. We help you compare, at no cost and no pressure.
Snapshots we pulled live from the CMS 2026 Medicare Advantage landscape and Virginia’s 2026 individual marketplace plan file. Medicare Advantage availability is set county by county, so the three counties below are major-metro examples within Virginia, not statewide totals; the ACA figures are for Virginia’s individual market statewide.
Every figure below is for non-SNP Medicare Advantage plans with prescription drug coverage (MA-PD) in the named county for contract year 2026. Averages are computed across all MA-PD plans CMS lists in that county. Fairfax County uses ZIP 22030, Virginia Beach city ZIP 23462 and Henrico County (Richmond) ZIP 23228 as representative anchors within Virginia.
| County (metro) | MA-PD plans | $0-premium plans | Avg premium/mo | Avg in-network MOOP | Avg Part D deductible | Plans rated 4★+ |
|---|---|---|---|---|---|---|
| Fairfax County (Northern VA) | 49 | 21 | $32.32 | $7,542 | $385 | 23 of 49 (47%) |
| Virginia Beach (Hampton Roads) | 31 | 20 | $20.62 | $7,435 | $445 | 12 of 31 (39%) |
| Henrico / Richmond | 32 | 21 | $20.22 | $7,070 | $444 | 13 of 32 (41%) |
A $0 plan premium does not mean $0 cost — you still pay your Medicare Part B premium and any plan copays or coinsurance. The in-network maximum out-of-pocket (MOOP) is the most you would pay for covered Part A and Part B services in a year; once you reach it, the plan pays 100% for the rest of the year.
Virginia does not use HealthCare.gov. Since plan year 2024 the state runs its own exchange, Virginia’s Insurance Marketplace (marketplace.virginia.gov). For 2026, Virginia’s individual market lists 83 medical qualified health plans (QHPs) from 8 participating insurers. The metal-tier mix below is the count of distinct 2026 individual plans; the specific plans and premiums available to you depend on your county (rating area), and many households qualify for a premium tax credit based on income and household size.
| Metal tier | Distinct 2026 individual plans | What it means |
|---|---|---|
| Bronze & Expanded Bronze | 26 | Lowest premiums, highest deductibles |
| Silver | 24 | Mid-level; unlocks cost-sharing reductions if eligible |
| Gold | 28 | Higher premiums, lower out-of-pocket costs |
| Platinum | 1 | Highest premiums, lowest out-of-pocket costs |
| Catastrophic | 4 | Under-30 or hardship-exemption shoppers only |
| Total medical QHPs | 83 | Across 8 insurers, statewide |
Open Enrollment for 2026 coverage through Virginia’s Insurance Marketplace runs November 1, 2025 through January 15, 2026; a qualifying life event can open a Special Enrollment Period at other times. Tell us your county and household and we will help you compare the plans available where you live — this is guidance, not a quote or an offer of coverage.
TSM Life & Health is an independent, licensed insurance agency (founder Keith McLiverty, National Producer Number 3481853). We are licensed in Virginia and work with Virginia residents by phone and video, so you get the same plain-spoken, no-pressure guidance whether you are in Virginia Beach, Richmond, Arlington, Fairfax, Norfolk, Roanoke or anywhere else in the Commonwealth. Because we are independent, we help you compare options across carriers — we do not work for any one insurance company.
Yes. We are an independent, licensed insurance agency serving Virginia residents. We help you compare Medicare Advantage, ACA Marketplace, life insurance, final expense and annuity options by phone and video, at no cost to you.
Availability is set county by county. For 2026, CMS lists 49 MA-PD plans in Fairfax County, 31 in Virginia Beach city and 32 in Henrico County (Richmond), with about 20 or more $0 monthly-premium plans in each of those counties. Tell us your county and we will pull the current list for you.
No. Since plan year 2024, Virginia runs its own state marketplace, Virginia’s Insurance Marketplace, at marketplace.virginia.gov, instead of HealthCare.gov. For 2026 the state’s individual market lists 83 medical plans from 8 insurers, and many households qualify for a premium tax credit that lowers the monthly premium.
ACA Marketplace Open Enrollment for 2026 coverage runs November 1, 2025 to January 15, 2026 through Virginia’s Insurance Marketplace, with Special Enrollment Periods after qualifying life events. Medicare has an Annual Enrollment Period October 15 to December 7, plus Initial and Special Enrollment Periods. We can help you find the window that applies to you.
No. There is no cost to you to compare plans with us. We are compensated by the carriers when you enroll, and we present your options neutrally so you can choose what fits.
Sources. Medicare Advantage plan counts, premiums, in-network out-of-pocket maximums, Part D deductibles and CMS Overall Star Ratings come from the CMS Medicare Advantage / Part D Landscape for contract year 2026 (cms.gov), for Fairfax County, Virginia Beach city and Henrico County, VA, covering non-SNP MA-PD plans; averages are computed across the plans in each county. ACA Marketplace plan and insurer counts come from the Virginia’s Insurance Marketplace 2026 Public Use File (marketplace.virginia.gov), counting distinct individual medical qualified health plans statewide. Data accessed via The Brain (Ambrose) MCP on July 31, 2026. For all of your options, see medicare.gov or ssa.gov.
TSM Life & Health is an independent, licensed insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP) to get information on all of your options. We are not connected with or endorsed by the U.S. government, the federal Medicare program, or CMS. Figures are estimates for education only, not quotes or guarantees of coverage or savings. Verify current plan details with a licensed agent before enrolling.
Most Virginia residents build their coverage from three parts. Here is how they compare in plain language.
| Coverage path | What it is | Good to know |
|---|---|---|
| Original Medicare | Part A (hospital) and Part B (medical), run by the federal government. | Covers the essentials, but not everything — there is no built-in drug coverage and no yearly out-of-pocket cap. |
| Medicare Advantage (Part C) | Bundles Part A and Part B — and usually Part D drug coverage — through a private plan. | Often adds extra benefits and includes a yearly out-of-pocket cap; you use the plan’s provider network. |
| Medicare Part D | Prescription drug coverage offered by private plans. | Pairs with Original Medicare, or is already built into most Medicare Advantage plans. |
We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area.
Timing matters with Medicare. These are the main windows to know.
| Enrollment period | When | What it is for |
|---|---|---|
| Initial Enrollment Period (IEP) | The 7 months around your 65th birthday — the 3 months before, your birthday month, and the 3 months after. | Your first opportunity to enroll in Medicare. |
| General Enrollment Period (GEP) | January 1 – March 31 each year. | For those who missed their IEP; coverage starts the month after you sign up. |
| Annual Enrollment Period (AEP) | October 15 – December 7 each year. | Change your Medicare Advantage or Part D plan for the coming year. |
| Medicare Advantage Open Enrollment | January 1 – March 31 each year. | If you are already in a Medicare Advantage plan, make a one-time switch. |
A Special Enrollment Period (SEP) can also open after a qualifying event, such as losing employer coverage or moving.
You generally qualify for Medicare if you are:
Real figures for Virginia, pulled from CMS. Medicare Advantage plan availability is set county by county, so the statewide plan count below counts distinct 2026 plans offered somewhere in the Commonwealth.
Sources. Beneficiary counts from the CMS Medicare Monthly Enrollment dataset (2025 annual, Virginia total). Plan counts and the average premium are computed across the CMS Medicare Advantage / Part D Landscape for CY2026 (distinct non-SNP MA-PD plans, and stand-alone Virginia Part D plans). Accessed via The Brain (Ambrose) MCP on July 31, 2026. We do not offer every plan available in your area.
No pressure — just a clear path. When you are ready, we help you:
These free, official resources can help you compare all of your options:
Medicare is usually the reason people call, but it’s rarely the only thing on the kitchen table. We’re an independent agency, so we compare across carriers rather than representing one — and a fair number of these conversations end with us telling someone that what they already have is the right fit.
Not sure which of these applies to you? That’s a normal place to start. Book a free consultation or call 203-951-0339 and ask one question — that is allowed.
You will probably recognize yourself in one of these. Each one starts in a different place, so each one gets a different first conversation.
There are three shopping bags of mail on the table, every plan claims to be free, and you’d like to keep your cardiologist. We start with your doctors and your prescriptions, then look at the plans — not the other way around.
Start with MedicareYou’re the one reading small print at 11pm, wondering whether the postcard that looks like a Medicare card is a scam. Bring us the mail. We’ll tell you what’s real, and you can put us on speakerphone with your mother.
See how we workCOBRA quoted more than the mortgage payment and you’ve got a few years to get to Medicare. We help you think through the income estimate the Marketplace runs on, and set the calendar so you land on Medicare at 65 without a gap or a penalty.
Read the ACA guideSize it before you shop it — debt, income to replace, mortgage, education, minus what you already have. Then match the tool: term for the years with a mortgage and children in the house, a smaller permanent policy for what never expires.
See life insuranceNone of these are dramatic enough to notice in the mail. All three show up later — at the pharmacy counter, at the front desk, or in a monthly check that can’t be changed.
Working past 65 does not always let you delay Medicare. Whether you can wait depends on the size of your employer and whether the coverage counts as creditable. Nothing that arrives in the mail tells you which case you’re in, and the penalties for guessing wrong are added to your premium for as long as you hold the coverage. Here is how the enrollment windows actually work.
The higher earner’s Social Security decision is really the survivor’s decision. When one spouse dies, the survivor keeps the larger of the two checks — not both. So the higher earner’s claiming age sets the income the widow or widower lives on, potentially for decades. It’s the single most expensive thing to get wrong, and the easiest to miss. We walk through 62 versus 67 versus 70 here.
“Keep what I have” is one of the options being compared, not the default. Plans change every year — premiums, formularies, networks, the out-of-pocket maximum — and so does your life. Once a year we re-run your drug list and your doctors against the plans we offer in your area. If the plan you have is still the right one, that’s what we tell you, and it costs nothing either way. That yearly review is the part of the relationship that matters most.
Happy to look at any of this with you, at your pace. Our office is at 479 New Haven Avenue in Milford, Connecticut, and a real person answers the phone Monday to Friday 9–6 and Saturday 10–2. Get in touch.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP), to get information on all of your options. TSM Life & Health is a licensed independent insurance agency and is not connected with, affiliated with, or endorsed by the U.S. government, the federal Medicare program, the Social Security Administration, or the Centers for Medicare & Medicaid Services (CMS). This is a solicitation for insurance; a licensed insurance agent may contact you. Product availability and benefits vary by state and carrier, and all guarantees are backed solely by the claims-paying ability of the issuing insurance company. This page is general educational information only and is not insurance, tax, legal, or investment advice.
Tell us your county, your doctors and your prescriptions, and we will help you match a plan — at no cost and no pressure.