Can contractors get health insurance through Marketplace Virginia?

Yes, independent contractors and self-employed individuals in Roanoke County can purchase health insurance plans through Marketplace Virginia, the state's official health insurance exchange. Depending on your income, you may qualify for subsidies (Premium Tax Credits and Cost-Sharing Reductions) to lower your monthly premiums and out-of-pocket costs.

What are the income limits for Virginia Medicaid in Roanoke County?

Virginia expanded Medicaid in 2019, making it available to adults with household incomes up to 138% of the Federal Poverty Level (FPL). For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL, and children (FAMIS) are covered up to 200% FPL as well. These programs provide comprehensive, low-cost or no-cost coverage.

Are PPO plans available for contractors on Marketplace Virginia?

Yes, unlike some other states, PPO plans are available on-exchange in Virginia through Marketplace Virginia. Contractors in Roanoke County can choose from HMO, PPO, and EPO plan structures, offering flexibility in how they access care and choose their providers.

Updated July 2026 · VirginiaPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Health Insurance for Contractors in Roanoke County, Virginia

Contractors in Roanoke County can access health insurance through Marketplace Virginia, with potential subsidies starting at 100% FPL.
Virginia Medicaid (FAMIS Plus) is available to adults with incomes up to 138% of the Federal Poverty Level.
In 2026, 6 carriers offer plans in Rating Area 5, including CareFirst BlueChoice, Cigna, and United Healthcare.
PPO plans are available on-exchange in Virginia, providing more network flexibility compared to some other states.

Navigating health insurance options as a contractor in Roanoke County, Virginia, offers several pathways to coverage, primarily through Marketplace Virginia or state Medicaid programs. Unlike traditional employees, contractors are responsible for securing their own health benefits, but they can often benefit from financial assistance based on household income. Marketplace Virginia, which uses HealthCare.gov, provides access to a range of plans, including HMO, PPO, and EPO options, with subsidies available to make premiums more affordable. Additionally, Virginia's expanded Medicaid program offers comprehensive coverage for eligible individuals and families with lower incomes.

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How Can Contractors Get Affordable Health Insurance in Roanoke County?

As a contractor in Roanoke County, your primary options for affordable health insurance are Marketplace Virginia (for subsidized private plans) and Virginia Medicaid (for low-income individuals). The best path depends on your household income and family size.

Roanoke County, with a population of 97,023 and a median income of $83,709, is part of Virginia Rating Area 5. This rating area also covers Alleghany, Bath, Bedford, Botetourt, Carroll, Covington, Craig, Floyd, Galax, Grayson, Highland, Montgomery, Pulaski, Radford, Roanoke, Salem, Smyth, and Wythe counties. The county's uninsured rate stands at 3.9%, which is lower than the national average, indicating good access to coverage options for residents.

Marketplace Virginia (HealthCare.gov)

This is the official health insurance exchange where individuals and families can purchase plans. As a contractor, you can enroll during the annual Open Enrollment Period (typically November 1 to January 15 in most years) or during a Special Enrollment Period if you experience a qualifying life event (e.g., marriage, birth of a child, loss of other coverage). Financial Assistance:

Premium Tax Credits (Subsidies): These reduce your monthly premium. Eligibility is based on household income relative to the Federal Poverty Level (FPL). For 2026, individuals and families with incomes between 100% and 400% FPL may qualify for significant subsidies.
Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs (deductibles, copayments, coinsurance). CSRs are only available with Silver-tier plans and are typically offered to those with incomes between 100% and 250% FPL.

Virginia Medicaid (FAMIS Plus)

Virginia expanded its Medicaid program in 2019 (known as Virginia Medicaid Expansion or FAMIS Plus). This means that adults with household incomes up to 138% of the Federal Poverty Level may qualify for comprehensive, low-cost or no-cost health coverage. If your income falls within this range, applying for Virginia Medicaid should be your first step.

2026 Federal Poverty Level (FPL) Guidelines for Virginia (Estimates)
Household Size	100% FPL	138% FPL (Medicaid)	250% FPL (Enhanced Silver)	400% FPL (Premium Tax Credits)
1	$15,060	$20,783	$37,650	$60,240
2	$20,440	$28,207	$51,100	$81,760
3	$25,820	$35,631	$64,550	$103,280
4	$31,200	$43,056	$78,000	$124,800
Figures are approximate and for illustration only. Actual FPL may vary.

What Types of Plans Are Available to Contractors in Roanoke County?

When you shop for health insurance on Marketplace Virginia, you'll encounter different plan categories and structures. Virginia offers a robust marketplace with various options.

Plan Categories (Metal Tiers)

Plans are categorized into "metal tiers" based on how they split costs with you:

Bronze Plans: Have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They cover about 60% of your medical costs, with you paying 40%. Best for those who expect minimal medical care and want protection against catastrophic costs.
Silver Plans: Offer moderate premiums and out-of-pocket costs. They cover about 70% of medical costs, with you paying 30%. These are the only plans eligible for Cost-Sharing Reductions (CSRs), making them a strong choice if you qualify for subsidies.
Gold Plans: Have higher monthly premiums but lower deductibles and out-of-pocket maximums. They cover about 80% of medical costs, with you paying 20%. Good for those who expect to use medical services frequently.
Platinum Plans: The highest premiums but the lowest out-of-pocket costs. They cover about 90% of medical costs, with you paying 10%. Suitable for those with chronic conditions or who prefer predictability in their medical spending.

Plan Structures

In Virginia, contractors can choose from a variety of plan structures, including HMO, PPO, and EPO options on-exchange.

Health Maintenance Organization (HMO): Typically requires you to choose a primary care provider (PCP) within the plan's network and get referrals for specialists. Generally has lower premiums.
Preferred Provider Organization (PPO): Offers more flexibility. You don't usually need a referral to see a specialist, and you can see out-of-network providers for a higher cost. PPO plans ARE available on-exchange in Virginia, offering greater choice for contractors.
Exclusive Provider Organization (EPO): A hybrid plan. You don't need a PCP referral for specialists, but you generally must stay within the plan's network for care (except in emergencies).

Health Insurance Carriers in Roanoke County

For 2026, 6 carriers offer marketplace plans in Rating Area 5, which includes Roanoke County. These carriers provide a range of plan types and networks, giving contractors multiple choices. The confirmed carriers offering plans in Roanoke County are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When choosing a plan, consider not only the premium but also the network of doctors and hospitals. Roanoke County is served by Carilion Medical Center, an acute care hospital in Roanoke. Ensure your preferred providers are in-network with the plan you select.

Making Your Health Insurance Decision as a Contractor

Choosing the right health insurance plan as an independent contractor in Roanoke County involves evaluating your income, health needs, and budget.

Decision Guide for Contractors in Roanoke County
Your Situation	Recommended Action	Key Benefits
Income < 138% FPL	Apply for Virginia Medicaid (FAMIS Plus)	Comprehensive, low-cost or no-cost coverage; extensive benefits.
Income 100-250% FPL	Shop for Silver plans on Marketplace Virginia	Eligible for both Premium Tax Credits and Cost-Sharing Reductions, significantly lowering both premiums and out-of-pocket costs.
Income 250-400% FPL	Shop for Bronze, Silver, or Gold plans on Marketplace Virginia	Eligible for Premium Tax Credits to reduce premiums; consider Silver for moderate costs or Gold for lower deductibles.
Income > 400% FPL	Shop for any metal tier plan on Marketplace Virginia or off-exchange	Not eligible for subsidies, but can still find competitive plans. Bronze plans offer catastrophic coverage at a lower premium.
Pregnant or have children (up to 200% FPL)	Apply for FAMIS Moms (pregnant women) or FAMIS (children)	Specialized, comprehensive coverage for pregnant women and children.

Consider your expected medical usage. If you anticipate frequent doctor visits or have ongoing prescriptions, a Gold or even a subsidized Silver plan might be more cost-effective in the long run due to lower deductibles and copays. If you're generally healthy and primarily want protection against emergencies, a Bronze plan with a Health Savings Account (HSA) option could be a good fit.

Frequently Asked Questions

Can contractors deduct health insurance premiums?

Yes, self-employed individuals and independent contractors can generally deduct health insurance premiums from their gross income, provided they are not eligible to participate in an employer-sponsored health plan (either their own or their spouse's). This deduction is taken as an adjustment to income, meaning you don't have to itemize to claim it. Consult a tax professional for specific advice.

What if I lose my existing health coverage as a contractor?

Losing minimum essential coverage, such as through a job change or COBRA expiration, is considered a Qualifying Life Event (QLE). This allows you to enroll in a new plan through Marketplace Virginia during a Special Enrollment Period (SEP), typically lasting 60 days from the date of the QLE. Do not delay, as missing the SEP could mean waiting until the next Open Enrollment Period.

Do I need to find a primary care provider (PCP) for my plan?

It depends on your plan type. If you choose an HMO plan, you will likely need to select a primary care provider within the network, and they will typically coordinate your care and provide referrals to specialists. PPO and EPO plans generally do not require a PCP referral for specialist visits, though staying within the network is usually necessary to receive the highest level of benefits.

What is the difference between on-exchange and off-exchange plans?

On-exchange plans are those purchased through Marketplace Virginia (HealthCare.gov). These are the only plans where you can receive Premium Tax Credits and Cost-Sharing Reductions to lower your costs. Off-exchange plans are purchased directly from an insurance carrier or through a private broker outside of the marketplace. While off-exchange plans may offer different networks or benefits, they do not qualify for federal subsidies. Most contractors will find better value through on-exchange plans due to potential financial assistance.