CareFirst BlueChoice Health Insurance in Franklin County, Virginia
- CareFirst BlueChoice is one of 6 carriers offering marketplace plans in Virginia's Rating Area 4, including Franklin County, for 2026.
- Marketplace Virginia (HealthCare.gov) offers HMO, PPO, and EPO plans, with PPOs available on-exchange in Franklin County.
- Virginia Medicaid (FAMIS Plus) covers adults up to 138% of the Federal Poverty Level (FPL), with higher thresholds for pregnant women (200% FPL) and children (200% FPL).
- Franklin County has a population of 55,130 and an uninsured rate of 6.8%, per U.S. Census Bureau ACS 2024 5-year estimates.
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What CareFirst BlueChoice Plans Are Available in Franklin County?
CareFirst BlueChoice offers a variety of health insurance plans to residents of Franklin County through Marketplace Virginia. These plans typically fall into different metal tiers—Bronze, Silver, and Gold—each designed to balance monthly premiums with out-of-pocket costs.Bronze plans generally have the lowest monthly premiums but higher deductibles and copayments, making them suitable for individuals who primarily want coverage for catastrophic events or who anticipate minimal healthcare use.
Silver plans offer a moderate balance of premiums and out-of-pocket costs. They are particularly valuable for individuals and families who qualify for Cost-Sharing Reductions (CSRs), as these subsidies significantly lower deductibles, copayments, and out-of-pocket maximums, making Silver plans much more comprehensive.
Gold plans feature higher monthly premiums but lower deductibles and out-of-pocket costs. These plans are ideal for those who expect to use healthcare services frequently and prefer to pay more upfront to have predictable costs when receiving care.
CareFirst BlueChoice plans in Virginia, like those from other carriers, utilize various network structures, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) options. It is important to verify which specific plan types and networks are available in your particular ZIP code within Franklin County when comparing options.
Understanding Financial Assistance and Virginia Medicaid
Affordability is a key factor in choosing health insurance, and Virginia residents have several avenues for financial assistance.Premium Tax Credits: If your household income is between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits. These credits reduce your monthly premium payment, making marketplace plans more affordable. The exact amount of your subsidy depends on your income, household size, and the cost of the benchmark Silver plan in your area.
Cost-Sharing Reductions (CSRs): Available exclusively with Silver plans, CSRs are for individuals and families with incomes up to 250% FPL. These subsidies reduce your deductibles, copayments, and out-of-pocket maximums, significantly enhancing the value of a Silver plan. You must enroll in a Silver plan through Marketplace Virginia to receive these benefits.
Virginia Medicaid (FAMIS Plus): Virginia expanded its Medicaid program in 2019, extending eligibility to adults with household incomes up to 138% of the Federal Poverty Level. This program, known as Virginia Medicaid or FAMIS Plus, provides comprehensive health coverage with no monthly premiums and minimal out-of-pocket costs. For instance, a single individual earning up to approximately $20,782 per year (for 2026 FPL figures) could qualify.
FAMIS for Pregnant Women and Children: Virginia also offers robust programs for pregnant women and children. Virginia Medicaid (FAMIS Moms) covers pregnant women with incomes up to 200% FPL, including prenatal care, labor, delivery, and 12 months of postpartum care. The Family Access to Medical Insurance Security (FAMIS) program covers uninsured children in households up to 200% FPL, with FAMIS Select offering low-cost coverage for children between 200% and 400% FPL. Applications for these programs can be submitted through commonhelp.virginia.gov.
Health Insurance Carriers in Franklin County
Franklin County is part of Virginia Rating Area 4, which also covers Chesapeake, Hampton, Isle of Wight, James City, Newport News, Norfolk, Northampton, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, and York counties. In 2026, 6 carriers offer marketplace plans in Rating Area 4, providing a competitive selection for residents.- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Franklin County, with a population of 55,130 and an uninsured rate of 6.8% per U.S. Census Bureau ACS 2024 5-year estimates, is served by Carilion Franklin Memorial Hospital in Rocky Mount for acute care needs. The county's median age is 48.4 years, and its median income is $68,849. These local factors influence healthcare needs and plan choices for residents.
Making Your Health Plan Decision in Franklin County
Choosing the right health insurance plan, whether from CareFirst BlueChoice or another carrier, requires careful consideration of your specific circumstances.| Your Situation | Recommended Action | Key Consideration |
|---|---|---|
| Income < 138% FPL | Apply for Virginia Medicaid (FAMIS Plus) | Comprehensive coverage with no premiums; apply via commonhelp.virginia.gov. |
| Income 100-250% FPL | Explore Silver plans with Cost-Sharing Reductions | Significant savings on premiums, deductibles, copays, and out-of-pocket maximums. |
| Income 100-400% FPL | Compare Bronze, Silver, and Gold plans with Premium Tax Credits | Tax credits lower monthly premiums; balance premium vs. expected healthcare use. |
| Income > 400% FPL | Compare Bronze, Silver, and Gold plans without subsidies | Focus on network, deductible, and out-of-pocket maximums. |
| Pregnant or have children | Check FAMIS Moms (up to 200% FPL) or FAMIS (up to 200% FPL) | Specialized, low-cost or free coverage for specific populations. |
A licensed health insurance producer can provide personalized guidance, helping you compare plans from CareFirst BlueChoice and other carriers in Franklin County, understand your subsidy eligibility, and enroll in a plan that meets your needs. Their services are free to you.