Health Insurance in Bedford County, Virginia: Your 2026 Guide
- Bedford County residents can choose from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans on Marketplace Virginia / HealthCare.gov.
- In 2026, 6 health insurance carriers offer marketplace plans in Rating Area 5, which includes Bedford County.
- Virginia Medicaid is available to adults with income up to 138% of the Federal Poverty Level (FPL), and pregnant women up to 200% FPL.
- The average uninsured rate in Bedford County is 5.7%, significantly below the national average.
Navigating health insurance options in Bedford County, Virginia, for 2026 involves understanding your choices through Marketplace Virginia / HealthCare.gov, the state-based marketplace using the federal platform, as well as state-specific Medicaid programs. Residents can access a variety of plan types, including HMO, PPO, and EPO plans, from 6 confirmed carriers in Rating Area 5. Financial assistance is widely available to make coverage more affordable, with subsidies for those earning between 100% and 400% FPL, and Virginia Medicaid expanding eligibility to adults earning up to 138% FPL. This guide details your options, eligibility for financial aid, and local healthcare resources to help you find the best plan for your needs.
Get Your Free Health Insurance Quote
A licensed agent can compare coverage options for you at no cost.
You're all set!
A licensed agent will reach out shortly.
What Health Insurance Options Are Available in Bedford County?
For 2026, Bedford County residents primarily access health insurance through Marketplace Virginia / HealthCare.gov. This exchange offers a range of Affordable Care Act (ACA) compliant plans, categorized by metal tiers: Bronze, Silver, Gold, and Platinum. These tiers indicate the percentage of healthcare costs the plan is expected to cover, with Bronze plans covering about 60% and Platinum plans covering about 90%.
Unlike some states, Virginia offers a full spectrum of plan types on-exchange, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. This means you have flexibility in choosing a plan that balances network restrictions with cost. For instance, PPO plans from carriers like HealthKeepers Plus PPO, Cigna, and United Healthcare are available, providing more choice than states limited to HMOs and EPOs only. Catastrophic plans are also available for individuals under 30 or those with a hardship exemption, offering very low premiums but high deductibles.
Who Qualifies for Financial Assistance and Medicaid in Virginia?
Many Bedford County residents can receive financial help to make health insurance more affordable. The ACA provides two main types of subsidies through Marketplace Virginia / HealthCare.gov:
- Premium Tax Credits: These credits reduce your monthly premium. Eligibility is generally for individuals and families with household incomes between 100% and 400% of the Federal Poverty Level (FPL).
- Cost-Sharing Reductions (CSRs): Available only with Silver-tier plans, CSRs lower your out-of-pocket costs like deductibles, copayments, and coinsurance. You must have an income between 100% and 250% FPL to qualify. Enhanced Silver plans are particularly beneficial for those who qualify for CSRs, providing better coverage for the same premium as a standard Silver plan.
Virginia Medicaid and FAMIS Programs
Virginia expanded its Medicaid program in 2019, significantly broadening eligibility. Adults in Bedford County with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid, also known as FAMIS Plus. This program provides comprehensive health coverage with no monthly premiums and minimal or no out-of-pocket costs.
Beyond adult expansion, Virginia offers specific programs for pregnant women and children:
- FAMIS Moms: This program covers pregnant women with incomes up to 200% FPL. Coverage includes prenatal care, labor and delivery, and 12 months of postpartum care, extended under the American Rescue Plan and adopted by Virginia. Applications can be submitted through commonhelp.virginia.gov.
- FAMIS (Family Access to Medical Insurance Security): Uninsured children in households with incomes up to 200% FPL are eligible for this program.
- FAMIS Select: For children with household incomes between 200% and 400% FPL, FAMIS Select offers low-cost health coverage options.
Health Insurance Carriers in Bedford County
In 2026, 6 carriers offer marketplace plans in Rating Area 5, which covers Alleghany, Bath, Bedford, Botetourt, Carroll, Covington, Craig, Floyd, Galax, Grayson, Highland, Montgomery, Pulaski, Radford, Roanoke, Roanoke, Salem, Smyth, and Wythe counties. Bedford County residents can choose from the following confirmed health insurance providers:
- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
When comparing plans, consider each carrier's specific network of doctors and hospitals, drug formularies, and customer service reputation. While all plans on the marketplace must cover essential health benefits, the specific providers and cost-sharing structures will vary by plan and carrier.
Local Healthcare Resources in Bedford County
Bedford County, part of Virginia Rating Area 5, serves a population of 80,894 with an uninsured rate of 5.7%, which is notably lower than the state average. The median household income for the county is $78,937, and the median age is 47.2 years, per U.S. Census Bureau ACS 2024 5-year estimates. The county is served by Centra Bedford Memorial Hospital, an acute care facility located in Bedford.
When selecting a health plan, it's important to verify that your preferred doctors and any local facilities, such as Centra Bedford Memorial Hospital, are in the plan's network. This is especially crucial for HMO and EPO plans, which typically have more restricted networks than PPO plans.
Making the Right Health Insurance Decision in Bedford County
Choosing the right health insurance plan depends on your individual health needs, financial situation, and preferences for provider networks. Here's a quick guide to help you navigate your options:
- If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus), offering comprehensive, low-cost coverage. Apply through commonhelp.virginia.gov.
- If your income is between 100% and 400% FPL: You are eligible for premium tax credits through Marketplace Virginia / HealthCare.gov to lower your monthly premiums. Consider a Silver plan if your income is also below 250% FPL, as you may qualify for valuable Cost-Sharing Reductions.
- If your income is above 400% FPL: You can still purchase a plan through Marketplace Virginia / HealthCare.gov at full price, or explore off-marketplace options directly from carriers. Focus on finding a plan with a network that includes your preferred providers and a deductible/out-of-pocket maximum that aligns with your risk tolerance.
- For pregnant women: If your income is up to 200% FPL, explore FAMIS Moms for comprehensive maternity and postpartum care.
- For children: FAMIS covers children up to 200% FPL, and FAMIS Select offers low-cost options for those between 200% and 400% FPL.
A licensed health insurance producer can provide personalized guidance, helping you compare plans, understand subsidies, and enroll in coverage that best fits your situation, all at no cost to you.
Frequently Asked Questions
Can I get health insurance subsidies in Bedford County, Virginia?
Yes, if your household income is between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits and cost-sharing reductions through Marketplace Virginia / HealthCare.gov. These subsidies can significantly lower your monthly premiums and out-of-pocket costs, making coverage more affordable.
What types of health plans are available in Bedford County?
In Bedford County, consumers can choose from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans through Marketplace Virginia / HealthCare.gov. PPO plans, such as those offered by HealthKeepers Plus PPO, Cigna, and United Healthcare, are available on the exchange, providing more flexibility in provider choice.
Who qualifies for Medicaid in Virginia?
Virginia expanded Medicaid in 2019, meaning adults with household income up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (also known as FAMIS Plus). Pregnant women with income up to 200% FPL are covered under FAMIS Moms, and children up to 200% FPL qualify for FAMIS. You can apply for these programs through commonhelp.virginia.gov.
Is pregnancy a qualifying life event for special enrollment?
No, pregnancy itself is not considered a qualifying life event (QLE) for a Special Enrollment Period (SEP) to get health insurance through Marketplace Virginia / HealthCare.gov. However, the birth of a baby IS a QLE, allowing you to enroll or change plans within 60 days of the birth. If you are pregnant and uninsured, check your eligibility for Virginia Medicaid's FAMIS Moms program, which covers pregnant women up to 200% FPL.
How can I compare health plans in Bedford County?
To compare plans, visit Marketplace Virginia / HealthCare.gov and enter your ZIP code and household income information. You can filter plans by metal tier, plan type (HMO, PPO, EPO), and carrier. Pay close attention to premiums, deductibles, out-of-pocket maximums, and the provider network to ensure your preferred doctors and Centra Bedford Memorial Hospital are covered. A licensed agent can also help you compare options at no cost.