Health Insurance in King and Queen County, Virginia

Residents of King and Queen County, Virginia, can access comprehensive health insurance coverage primarily through Marketplace Virginia, which uses the federal HealthCare.gov platform. In 2026, marketplace shoppers in King and Queen County, which is part of Virginia Rating Area 8, have a choice of plans from 6 confirmed carriers, including HealthKeepers, Cigna, and United Healthcare. Virginia's expanded Medicaid program, known as FAMIS Plus, also provides no-cost coverage for adults with incomes up to 138% of the Federal Poverty Level, ensuring essential care for many residents. Understanding these options is key to securing affordable and suitable health coverage in the county.

Understanding Your Health Insurance Options in King and Queen County

For individuals and families in King and Queen County who do not receive health insurance through an employer, the primary avenue for coverage is Marketplace Virginia. This state-based marketplace operates on the federal HealthCare.gov platform, providing a centralized place to compare plans and determine eligibility for financial assistance. Shoppers can choose from various plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, which are all available on-exchange in Virginia.

The Affordable Care Act (ACA) marketplace offers subsidies in the form of Premium Tax Credits and Cost-Sharing Reductions. Premium Tax Credits can lower your monthly premium payments, while Cost-Sharing Reductions reduce your out-of-pocket costs like deductibles, copayments, and coinsurance. Eligibility for these subsidies is based on household income relative to the Federal Poverty Level (FPL). For example, individuals and families earning between 100% and 400% FPL may qualify for Premium Tax Credits, with enhanced subsidies available for those closer to the lower end of that range.

Virginia Medicaid and FAMIS Programs for King and Queen County Residents

Virginia expanded its Medicaid program in 2019, significantly broadening access to no-cost health coverage for many residents of King and Queen County. This program, often referred to as Virginia Medicaid or FAMIS Plus, provides comprehensive health benefits to adults aged 19-64 with household incomes up to 138% of the Federal Poverty Level. This expansion ensures that individuals who might otherwise fall into a "coverage gap" can receive essential medical care without premiums or significant out-of-pocket costs.

Beyond adult expansion, Virginia also offers robust programs for pregnant women and children:

• FAMIS Moms: This program covers pregnant women with household 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.
• FAMIS (Family Access to Medical Insurance Security): Uninsured children in households with incomes up to 200% FPL can qualify for FAMIS, which provides comprehensive health and dental coverage.
• FAMIS Select: For children whose household incomes are between 200% and 400% FPL, FAMIS Select offers low-cost health insurance options.

Residents interested in applying for Virginia Medicaid or FAMIS programs can do so online through the commonhelp.virginia.gov portal, or by contacting their local Department of Social Services.

Health Insurance Carriers in King and Queen County

In 2026, 6 carriers offer marketplace plans in Virginia Rating Area 8, which covers Accomack, Albemarle, Amelia, Amherst, Appomattox, Bland, Brunswick, Buckingham, Campbell, Caroline, Charlotte, Charlottesville, Cumberland, Danville, Emporia, Essex, Fluvanna, Giles, Gloucester, Greene, Greensville, Halifax, Henry, King William, King and Queen, Lancaster, Louisa, Lunenburg, Lynchburg, Martinsville, Mathews, Mecklenburg, Middlesex, Nelson, Northumberland, Nottoway, Patrick, Pittsylvania, Prince Edward, Prince George, Sussex, Westmoreland, Winchester counties. This selection provides residents of King and Queen County with a range of choices across different plan types and metal tiers (Bronze, Silver, Gold).

The confirmed carriers available in King and Queen County for the 2026 plan year are:

• CareFirst BlueChoice
• Cigna
• HealthKeepers
• Oscar Health
• Sentara Health Plans
• United Healthcare

When comparing plans, it is important to consider not only the monthly premium but also the deductible, copayments, coinsurance, and the out-of-pocket maximum. Additionally, verifying if your preferred doctors, specialists, and medical facilities are in-network for any prospective plan is crucial for continuity of care.

Local Healthcare Landscape in King and Queen County

King and Queen County, part of Virginia Rating Area 8, is a rural community with a population of 6,695 and an uninsured rate of 5.8%, which is lower than the state average. This county, however, has no acute care hospitals within its boundaries, meaning residents must travel to neighboring counties for emergency and inpatient medical services. Rating Area 8 is extensive, covering 43 counties including Accomack, Albemarle, and Gloucester, ensuring a broad network of providers, though local access to facilities varies. According to U.S. Census Bureau ACS 2024 5-year estimates, the median income in King and Queen County is $70,469, with a median age of 49.3 years.

Given the lack of local acute care facilities, residents should pay particular attention to the provider networks of any health plan they choose. It is advisable to select a plan whose network includes hospitals and specialists in nearby counties that are convenient and accessible for your family's needs. Understanding whether a plan's network extends to these areas can prevent unexpected out-of-pocket costs for essential services.

Choosing the Right Plan: Next Steps for King and Queen County Residents

Selecting the ideal health insurance plan in King and Queen County depends largely on your household income, health needs, and preference for providers. Here's a guide to help you navigate your options:

• If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus), which offers comprehensive, no-cost coverage. Apply through commonhelp.virginia.gov.
• If your income is between 100% and 400% FPL: You are likely eligible for significant Premium Tax Credits on Marketplace Virginia / HealthCare.gov. Consider Silver plans, especially if your income is closer to 100-250% FPL, as you may also qualify for Cost-Sharing Reductions that lower your deductibles and copays.
• If your income is above 400% FPL: You can still purchase plans through Marketplace Virginia or directly from carriers. While not eligible for subsidies, you can still benefit from the consumer protections of the ACA.

A licensed health insurance agent specializing in Virginia plans can provide personalized assistance at no cost to you. They can help you compare plans from CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare, explain the nuances of deductibles and networks, and ensure you enroll in a plan that best fits your budget and healthcare requirements.

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