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

Health Insurance in Lee County, Virginia

In Lee County, Virginia, residents can choose from HMO, PPO, and EPO plans through Marketplace Virginia / HealthCare.gov.
Virginia's Medicaid program (FAMIS Plus) covers adults with incomes up to 138% of the Federal Poverty Level.
For the 2026 plan year, 6 confirmed carriers offer marketplace plans in Rating Area 6, which includes Lee County.
Lee County has a poverty rate of 28.8% and an uninsured rate of 7.0%, per U.S. Census Bureau ACS 2024 estimates.
There are no acute care hospitals within Lee County, requiring residents to travel to neighboring counties for inpatient services.

Navigating health insurance options in Lee County, Virginia, involves understanding both federal and state programs available to residents. Whether you are looking for an affordable plan through the health insurance marketplace, qualify for expanded Medicaid, or need coverage for your family, Lee County offers various pathways to securing health coverage. Virginia's marketplace, known as Marketplace Virginia, operates on the federal platform (HealthCare.gov) and provides access to subsidized private plans, while the state's Medicaid program offers comprehensive coverage for eligible individuals and families.

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What Health Insurance Options Are Available in Lee County, Virginia?

Residents of Lee County have several key avenues for obtaining health insurance, primarily through the Affordable Care Act (ACA) marketplace or Virginia's robust Medicaid program. Understanding the eligibility requirements and benefits of each can help you choose the best fit for your needs and budget.

ACA Marketplace Plans

Through Marketplace Virginia / HealthCare.gov, individuals and families in Lee County can enroll in private health insurance plans. These plans are categorized into metal tiers: Bronze, Silver, Gold, and Platinum, reflecting the balance between monthly premiums and out-of-pocket costs. Importantly, Virginia offers a variety of plan types on-exchange, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. This means marketplace shoppers in Lee County have the flexibility to choose a plan structure that aligns with their preferences for provider networks and referrals. Many Lee County residents qualify for financial assistance, known as subsidies, to help make these plans more affordable.

Premium Tax Credits (PTC): These credits reduce your monthly premium payments and are available to individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL).
Cost-Sharing Reductions (CSRs): Available exclusively with Silver-tier plans for those with incomes up to 250% FPL, CSRs lower your deductibles, copayments, and out-of-pocket maximums, making healthcare more accessible when you need it.

Virginia Medicaid and FAMIS Programs

Virginia expanded its Medicaid program in 2019, significantly broadening eligibility for many residents.

Virginia Medicaid (FAMIS Plus): Adults in Lee County with household incomes up to 138% of the Federal Poverty Level may qualify for comprehensive, no-cost health coverage through FAMIS Plus.
FAMIS Moms: Pregnant women in Lee County with incomes up to 200% FPL are eligible for FAMIS Moms, which provides extensive prenatal care, labor and delivery coverage, and 12 months of postpartum care. You can apply for this program through commonhelp.virginia.gov.
FAMIS (Family Access to Medical Insurance Security): Uninsured children in households up to 200% FPL can receive low-cost or free coverage through FAMIS. For children between 200% and 400% FPL, FAMIS Select offers additional affordable coverage options.

Health Insurance Carriers in Lee County

For the 2026 plan year, Lee County residents can choose from a competitive selection of health insurance carriers offering plans through Marketplace Virginia / HealthCare.gov. In 2026, 6 confirmed carriers offer marketplace plans in Rating Area 6, which covers Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, Washington, and Wise counties. The carriers confirmed to offer plans in Lee County's Rating Area 6 include:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When selecting a plan, it is important to compare the specific networks, drug formularies, and benefits offered by each carrier to ensure they meet your healthcare needs and include your preferred doctors and facilities.

Understanding Plan Costs and Subsidies in Lee County

The actual cost of health insurance in Lee County varies significantly based on your income, age, household size, and the plan tier you choose. However, the availability of subsidies can drastically reduce these costs for eligible individuals. Consider these general cost ranges for a single 40-year-old in Lee County before subsidies, based on national averages for 2026:

Metal Tier	Average Monthly Premium (before subsidies)	Typical Deductible Range
Bronze	$350 - $450	$7,000 - $9,000+
Silver	$450 - $600	$3,000 - $7,000
Gold	$550 - $750	$0 - $2,500

Note: These are illustrative ranges. Your exact premium will depend on your specific circumstances and the plan you select. For those with lower incomes, Cost-Sharing Reductions (CSRs) on Silver plans are particularly valuable. A Silver plan with CSRs can offer the benefits of a Gold plan (or even better) at a much lower out-of-pocket cost, making it an excellent value for those who qualify.

Healthcare Access in Lee County

Lee County, with a population of 21,900 and a poverty rate of 28.8% per U.S. Census Bureau ACS 2024 estimates, is part of Virginia Rating Area 6. This multi-county rating area also includes Bristol, Buchanan, Dickenson, Norton, Russell, Scott, Tazewell, Washington, and Wise counties. Notably, Lee County has no acute care hospitals within its boundaries, meaning residents often travel to a neighboring county for inpatient medical services. When choosing a health plan, it's crucial to confirm that the plan's network includes accessible hospitals and specialists in adjacent areas that you would use.

Enrollment Periods and How to Apply

Most people enroll in health insurance during the annual Open Enrollment Period, which typically runs from November 1st to January 15th each year. However, certain life events may qualify you for a Special Enrollment Period (SEP) outside of this window. Qualifying life events for an SEP include:

Losing existing health coverage (e.g., due to job loss, COBRA ending)
Getting married or divorced
Having a baby, adopting a child, or placing a child for foster care
Moving to a new area that offers different health plans
Changes in income that affect your eligibility for subsidies or Medicaid

To apply for marketplace plans or check your eligibility for subsidies, visit Marketplace Virginia / HealthCare.gov. If you believe you may qualify for Virginia Medicaid or FAMIS programs, you can apply directly through commonhelp.virginia.gov.

Making the Right Choice for Your Health Coverage

Choosing the right health insurance plan in Lee County depends on several factors, including your income, health needs, preferred doctors, and tolerance for out-of-pocket costs.

Your Situation	Recommended Action
Income below 138% FPL	Apply for Virginia Medicaid (FAMIS Plus) at commonhelp.virginia.gov.
Income 100% - 250% FPL	Explore Silver plans on Marketplace Virginia / HealthCare.gov to maximize Cost-Sharing Reductions.
Income above 250% FPL (up to 400% FPL)	Compare Bronze, Silver, and Gold plans on Marketplace Virginia / HealthCare.gov. Premium Tax Credits can still lower your monthly costs.
No subsidies, seeking lowest premium	Consider a Bronze plan on Marketplace Virginia / HealthCare.gov, but be aware of higher deductibles.
Pregnant or have children	Check eligibility for FAMIS Moms (up to 200% FPL) or FAMIS for children (up to 200% FPL) via commonhelp.virginia.gov.

A licensed health insurance agent can provide personalized guidance, helping you compare plans, understand subsidy eligibility, and enroll in a plan that best meets your needs, all at no cost to you.

Frequently Asked Questions

What types of health insurance plans are available in Lee County, Virginia?

In Lee County, residents can access Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans through Marketplace Virginia / HealthCare.gov. These plans are offered by multiple carriers, providing a range of network and cost options.

Do I qualify for Medicaid in Lee County, Virginia?

Virginia expanded Medicaid in 2019. Adults in Lee County with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (FAMIS Plus). Pregnant women (FAMIS Moms) and children (FAMIS) can qualify with incomes up to 200% FPL. You can apply through commonhelp.virginia.gov.

How many health insurance carriers offer plans in Lee County?

For the 2026 plan year, 6 confirmed carriers offer marketplace health insurance plans in Rating Area 6, which includes Lee County. These carriers are CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare.

Are there hospitals located directly within Lee County, Virginia?

No, Lee County does not have any acute care hospitals within its boundaries. Residents needing inpatient medical services or emergency care typically travel to neighboring counties for these services.