Health Insurance in Craig County, Virginia

Six carriers offer marketplace plans in Craig County for 2026, serving Virginia Rating Area 5.
Virginia expanded Medicaid (FAMIS Plus) to adults with incomes up to 138% of the Federal Poverty Level.
Craig County residents have access to HMO, PPO, and EPO plans through Marketplace Virginia (HealthCare.gov).
With a population of 4,856, Craig County's uninsured rate is 3.1% per U.S. Census Bureau ACS 2024 5-year estimates.
There are no acute care hospitals within Craig County; residents needing inpatient care travel to neighboring counties.

Navigating health insurance options in Craig County, Virginia, involves understanding both marketplace plans available through Marketplace Virginia (HealthCare.gov) and robust Medicaid programs. For 2026, residents can choose from six confirmed carriers offering a variety of plan types, including HMOs, PPOs, and EPOs. Virginia's Medicaid expansion also provides crucial coverage for adults with incomes up to 138% of the Federal Poverty Level, along with specialized programs for pregnant women and children. This guide provides an overview of your choices, eligibility, and how to find the right coverage for your household in Craig County.

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What Are My Health Insurance Options in Craig County, Virginia?

Residents of Craig County, Virginia, have several pathways to securing health coverage, primarily through the Affordable Care Act (ACA) marketplace, known as Marketplace Virginia, and state-specific Medicaid programs. Through Marketplace Virginia, which uses the federal HealthCare.gov platform, individuals and families can compare and enroll in private health plans. Virginia is an expansion state, meaning a wide range of plans are available, and many residents qualify for significant financial assistance. Unlike some states, Virginia offers PPO plans on-exchange, alongside HMO and EPO options, giving consumers more choice in how their care is managed. For those with lower incomes, Virginia's expanded Medicaid program, known as FAMIS Plus, offers comprehensive coverage at little to no cost. Special programs like FAMIS Moms and FAMIS ensure that pregnant women and children also have access to vital health services.

Understanding Marketplace Subsidies and Eligibility

The ACA marketplace offers financial assistance designed to make health insurance more affordable. These subsidies come in two main forms: Premium Tax Credits (PTCs) and Cost-Sharing Reductions (CSRs). Premium Tax Credits lower your monthly premium payments. Eligibility for PTCs typically extends to individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL) who do not have access to affordable, employer-sponsored coverage. The amount of your tax credit is based on a sliding scale, with lower incomes receiving larger subsidies. Cost-Sharing Reductions help lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are available to those with incomes between 100% and 250% of the FPL who enroll in a Silver-tier plan. These reductions effectively make Silver plans much more valuable for eligible individuals, as they offer the enhanced benefits of a Gold plan at a Silver plan's premium. To determine your eligibility for these subsidies, you will need to provide income and household information when applying through Marketplace Virginia at HealthCare.gov.

Health Insurance Carriers in Craig County

In 2026, six carriers offer marketplace plans in Virginia Rating Area 5, which covers Craig County and 18 other counties including Alleghany, Bath, Bedford, Botetourt, Carroll, Covington, Floyd, Galax, Grayson, Highland, Montgomery, Pulaski, Radford, Roanoke, Roanoke, Salem, Smyth, and Wythe. This robust selection provides residents with competitive choices for their health coverage. The confirmed carriers offering plans in Craig County for the 2026 plan year are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When choosing a plan, it's important to compare offerings from each of these carriers, considering factors such as network size, specific doctors and hospitals covered, prescription drug formularies, and overall out-of-pocket costs.

Craig County Health Landscape: What to Know

Craig County, Virginia, is a rural community with specific considerations for health care access. With a population of 4,856 and a median age of 46.3 years, the county's health infrastructure differs from more urban areas. Per U.S. Census Bureau ACS 2024 5-year estimates, Craig County has an uninsured rate of 3.1%, which is lower than the national average. Notably, Craig County has no acute care hospitals within its boundaries, meaning residents needing emergency services or inpatient care typically travel to neighboring counties. This factor emphasizes the importance of understanding your plan's network and out-of-county coverage options. The county is part of Virginia Rating Area 5, which covers a broad geographic region, ensuring a shared pool of plans and carriers across its 19 member counties.

Navigating Medicaid and CHIP in Virginia

Virginia has expanded its Medicaid program, making coverage accessible to more residents of Craig County. This expansion, enacted in 2019, means that adults with incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid, known as FAMIS Plus. This program offers comprehensive health benefits with no monthly premiums and minimal out-of-pocket costs. For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL. This includes extensive prenatal care, labor and delivery services, and 12 months of postpartum care, an extension adopted by Virginia under the American Rescue Plan. Children in households with incomes up to 200% FPL can qualify for FAMIS (Family Access to Medical Insurance Security), Virginia's Children's Health Insurance Program (CHIP). For children in families with incomes between 200% and 400% FPL, FAMIS Select offers low-cost coverage options. Applications for Virginia Medicaid and FAMIS programs can be submitted online through commonhelp.virginia.gov. It's important to apply if you believe you or your family members meet the income requirements, as these programs provide essential health services.

Choosing the Right Plan in Craig County

Selecting the best health insurance plan in Craig County involves evaluating your health needs, financial situation, and preferred access to care. Consider these factors when making your decision:

Metal Tiers: Marketplace plans are categorized into Bronze, Silver, Gold, and Platinum tiers. Bronze plans have lower premiums but higher deductibles and out-of-pocket maximums, suitable for those who expect minimal medical care. Gold and Platinum plans have higher premiums but lower out-of-pocket costs, ideal for individuals with chronic conditions or who anticipate frequent medical needs. Silver plans are a popular choice, especially for those eligible for Cost-Sharing Reductions, as they offer a balance of moderate premiums and out-of-pocket costs.
Plan Type: In Craig County, you can choose between HMO, PPO, and EPO plans. HMOs typically require you to choose a primary care provider (PCP) and get referrals for specialists, often with lower premiums. PPOs offer more flexibility to see out-of-network providers (though at a higher cost) and usually don't require referrals. EPOs are similar to HMOs but don't require a PCP or referrals, though they generally don't cover out-of-network care except in emergencies.
Network and Coverage Area: Given that Craig County does not have an acute care hospital, it is crucial to verify that any plan you consider covers hospitals and specialists in neighboring counties you would typically access for care. Review the plan's provider directory carefully.
Prescription Drug Coverage: Check the plan's formulary to ensure your essential medications are covered and understand their cost-sharing structure.

A licensed health insurance agent can provide personalized guidance, helping you compare plans from CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare to find one that best fits your specific circumstances.

Next Steps for Health Coverage in Craig County

Your path to health insurance in Craig County depends largely on your income and household situation.

If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus). Apply directly through commonhelp.virginia.gov for comprehensive, low-cost coverage.
If your income is between 100% and 400% FPL: You are eligible for Premium Tax Credits to lower your monthly premiums on Marketplace Virginia (HealthCare.gov). If your income is also below 250% FPL, strongly consider a Silver plan to benefit from Cost-Sharing Reductions.
If your income is above 400% FPL: You can still enroll in a private health plan through Marketplace Virginia, but you will pay the full premium without federal subsidies.

The best way to ensure you're making an informed decision is to speak with a licensed health insurance agent. They can help you navigate the marketplace, understand your subsidy eligibility, and compare plans from all available carriers in Craig County, all at no cost to you.

Frequently Asked Questions

Can I get a PPO plan through the marketplace in Craig County, Virginia?

Yes, PPO plans are available on-exchange through Marketplace Virginia (HealthCare.gov) in Craig County. You can choose from HMO, PPO, and EPO plan structures, with options from carriers like Cigna and United Healthcare.

What is the income limit for Virginia Medicaid (FAMIS Plus) in Craig County?

Virginia expanded Medicaid (FAMIS Plus) to adults with incomes up to 138% of the Federal Poverty Level (FPL). For a single individual, this means qualifying with an annual income around $20,782 in 2026, though exact FPL thresholds are updated annually.

Does Craig County, Virginia have any acute care hospitals?

No, Craig County does not have any acute care hospitals within its boundaries. Residents needing acute medical care typically travel to neighboring counties for hospital services.

When can I enroll in a health insurance plan in Craig County?

The primary time to enroll is during Open Enrollment, which typically runs from November 1 to January 15 each year for coverage starting the following year. Outside of Open Enrollment, you may qualify for a Special Enrollment Period if you experience a Qualifying Life Event, such as marriage, birth of a child, or loss of other coverage.

How can a licensed agent help me find health insurance in Craig County?

A licensed health insurance agent can help you understand your options, compare plans from all available carriers in Craig County, determine your eligibility for subsidies, and guide you through the enrollment process. Their services are free to you, as they are compensated by the insurance carriers.