Health Insurance in Henrico County, Virginia: Your 2026 Coverage Guide
- In 2026, 6 carriers offer marketplace plans in Henrico County's Rating Area 3, including CareFirst BlueChoice and Cigna.
- Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level.
- Residents can choose from HMO, PPO, and EPO plans through Marketplace Virginia, with PPOs available on-exchange.
- Henrico County has a population of 335,744 and an uninsured rate of 6.3%, per U.S. Census Bureau ACS 2024 5-year estimates.
Navigating health insurance options in Henrico County, Virginia, for 2026 involves understanding both state-specific programs and the federal marketplace. Residents of Henrico County have access to a robust selection of plans through Marketplace Virginia, the state-based marketplace that uses the federal platform. Crucially, Virginia offers a variety of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, with PPOs being available on-exchange for those seeking broader network flexibility. Financial assistance, in the form of premium tax credits and cost-sharing reductions, is available to eligible individuals and families, making coverage more affordable.
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For those with lower incomes, Virginia's expanded Medicaid program provides comprehensive health coverage. Virginia expanded Medicaid in 2019, allowing adults with household incomes up to 138% of the Federal Poverty Level (FPL) to qualify. This guide will detail your options, outline local carriers, explain financial assistance, and help you make an informed decision about your health coverage in Henrico County.
What Are Your Health Insurance Options in Henrico County?
Residents of Henrico County primarily access health insurance through Marketplace Virginia, which operates via HealthCare.gov. This marketplace is the place to find plans that comply with the Affordable Care Act (ACA) and to apply for financial assistance. In Virginia, you have a choice of plan structures, including:
- Health Maintenance Organization (HMO): These plans typically require you to choose a primary care provider (PCP) within the network and get referrals for specialists.
- Preferred Provider Organization (PPO): Unlike some other states, PPO plans are available on-exchange in Virginia. These plans offer more flexibility, allowing you to see out-of-network providers, though at a higher cost. Referrals are generally not required.
- Exclusive Provider Organization (EPO): EPO plans combine features of HMOs and PPOs. You typically don't need a referral to see a specialist, but you must stay within the plan's network for care to be covered (except in emergencies).
All plans offered on Marketplace Virginia cover essential health benefits, including doctor visits, prescription drugs, emergency care, maternity care, and mental health services. You can enroll during the annual Open Enrollment Period or through a Special Enrollment Period if you experience a qualifying life event, such as getting married, having a baby, or losing other health coverage.
2026 Health Insurance Carriers in Henrico County
For the 2026 plan year, residents of Henrico County will find a competitive marketplace. In 2026, 6 carriers offer marketplace plans in Virginia Rating Area 3, which covers Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, Powhatan, Richmond, Richmond counties. These confirmed carriers provide a range of options:
- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
When selecting a plan, it is important to verify that your preferred doctors and hospitals are in-network with the plan you choose. While all these carriers offer plans in Rating Area 3, specific plan offerings (HMO, PPO, EPO) can vary by carrier.
Understanding Costs and Financial Assistance in Henrico County
The cost of health insurance in Henrico County can vary significantly based on your income, age, and the plan's metal tier (Bronze, Silver, Gold, Platinum). However, many individuals and families qualify for financial assistance to help reduce these costs.
Premium Tax Credits and Cost-Sharing Reductions
If your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may be eligible for Advanced Premium Tax Credits (APTCs). These credits can be applied directly to your monthly premiums, lowering your out-of-pocket cost. Individuals with incomes between 100% and 250% FPL may also qualify for Cost-Sharing Reductions (CSRs) when they enroll in a Silver plan. CSRs reduce your deductibles, copayments, and out-of-pocket maximums, making healthcare more affordable when you need it.
Virginia Medicaid and FAMIS Programs
Virginia expanded its Medicaid program in 2019. This means that adults in Henrico County with household incomes up to 138% FPL may qualify for Virginia Medicaid or FAMIS Plus, providing comprehensive, low-cost or no-cost health coverage. For families, Virginia also offers:
- FAMIS Moms: Covers pregnant women with incomes up to 200% FPL, including prenatal care, delivery, and 12 months of postpartum care.
- FAMIS (Children's Health Insurance Program - CHIP): Provides coverage for uninsured children in households up to 200% FPL.
- FAMIS Select: Offers low-cost coverage for children in households with incomes between 200% and 400% FPL.
You can apply for these programs through commonhelp.virginia.gov or during your Marketplace Virginia application process.
Example Monthly Premiums by Metal Tier (Approximate, 2026)
To give you an idea of potential costs, here's a hypothetical look at average monthly premiums for a 40-year-old in Henrico County, before any subsidies. Actual costs will vary based on your specific plan, age, and whether you qualify for financial assistance.
| Metal Tier | Average Monthly Premium (Before Subsidies) | Typical Coverage |
|---|---|---|
| Bronze | $350 - $450 | Lowest premiums, highest deductibles. Best for healthy individuals who want protection against catastrophic costs. |
| Silver | $450 - $600 | Moderate premiums, moderate deductibles. Best value if you qualify for Cost-Sharing Reductions. |
| Gold | $550 - $750 | Higher premiums, lower deductibles. Good for those who expect to use medical services regularly. |
| Platinum | $700+ | Highest premiums, very low deductibles. Covers a large share of medical costs. |
Local Healthcare Resources in Henrico County
Henrico County, with a population of 335,744 and an uninsured rate of 6.3% (per U.S. Census Bureau ACS 2024 5-year estimates), is served by Henrico Doctors' Hospital (Richmond) for acute care. The county is part of Virginia Rating Area 3, which covers Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, Powhatan, Richmond, Richmond counties. While Henrico Doctors' Hospital is a key local facility, residents in this multi-county rating area also have access to a broader network of providers and specialists within the greater Richmond metropolitan area.
How to Enroll and Get Personalized Advice
Choosing the right health insurance plan in Henrico County depends on your specific needs, budget, and health status. Here's a general guide to help you:
- If your income is below 138% FPL: You likely qualify for Virginia Medicaid or FAMIS Plus. Apply directly through commonhelp.virginia.gov or via Marketplace Virginia.
- If your income is between 100% and 400% FPL: You are eligible for significant premium tax credits. Consider a Silver plan, especially if your income is below 250% FPL, to benefit from Cost-Sharing Reductions.
- If your income is above 400% FPL: You can still purchase plans through Marketplace Virginia, but you will not qualify for subsidies. Explore all metal tiers to find a balance between premium cost and out-of-pocket expenses.
Navigating the various plan options, understanding networks, and applying for financial assistance can be complex. A licensed health insurance agent specializing in Virginia plans can provide free, unbiased advice tailored to your situation. They can help you compare plans, verify doctor networks, and guide you through the enrollment process to ensure you get the best coverage for your needs.