Health Insurance Options in Loudoun County, Virginia

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

In 2026, residents of Loudoun County can choose from health plans offered by 6 carriers in Rating Area 1 via Marketplace Virginia / HealthCare.gov.
Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level (FPL).
Pregnant women and children in Virginia may qualify for FAMIS programs with income thresholds up to 200% FPL.
Loudoun County has a population of 432,998 and an uninsured rate of 5.4%, per U.S. Census Bureau ACS 2024 5-year estimates.

Navigating health insurance in Loudoun County, Virginia, offers a range of options designed to fit various needs and budgets. Whether you're looking for comprehensive coverage through the Affordable Care Act (ACA) marketplace, or seeking assistance programs like Virginia Medicaid or FAMIS, understanding your choices is the first step. Loudoun County residents can access plans with potential financial assistance, making quality healthcare more affordable. This guide will walk you through the specifics of health insurance availability in your area, including marketplace plans, eligibility for state programs, and the local healthcare landscape.

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What Are Your Health Insurance Options in Loudoun County?

Residents of Loudoun County have several pathways to securing health insurance coverage. The primary avenues include the ACA marketplace, Virginia Medicaid, and specific programs for children and pregnant women. Each option caters to different income levels and circumstances, ensuring that a broad spectrum of the population can find suitable coverage.

Loudoun County, with a population of 432,998 and an uninsured rate of 5.4%, is part of Virginia Rating Area 1. This rating area covers 18 counties, including Alexandria, Arlington, Clarke, Culpeper, Fairfax, Falls Church, Fauquier, Frederick, Fredericksburg, Madison, Manassas, Manassas Park, Orange, Prince William, Rappahannock, and Warren, and is served by two acute care hospitals within the county: Inova Loudoun Hospital and Stonesprings Hospital Center. This vibrant community, with a median income of $181,765, benefits from a competitive health insurance marketplace.

ACA Marketplace Plans

For most individuals and families who don't receive health insurance through an employer, the ACA marketplace (known as Marketplace Virginia / HealthCare.gov) is the main source of coverage. These plans are standardized by metal tiers (Bronze, Silver, Gold, Platinum) and may include subsidies to lower monthly premiums and out-of-pocket costs based on income.

Virginia Medicaid and FAMIS Programs

Virginia expanded its Medicaid program in 2019 (known as Virginia Medicaid Expansion or FAMIS Plus), offering coverage to adults with incomes up to 138% of the Federal Poverty Level (FPL). This expansion ensures that more low-income residents have access to essential healthcare services. Additionally, Virginia offers the Family Access to Medical Insurance Security (FAMIS) program for uninsured children, and FAMIS Moms for pregnant women, with higher income thresholds.

Understanding ACA Plan Types and Costs in Loudoun County

When shopping for health insurance on Marketplace Virginia / HealthCare.gov, Loudoun County residents will encounter various plan types and metal tiers. Understanding these can help you choose a plan that balances cost with access to care.

Available Plan Structures: HMO, PPO, and EPO

Unlike some states where marketplace options are limited, Loudoun County residents can choose from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans.

HMOs typically have lower premiums and restrict coverage to doctors and hospitals within the plan's network, requiring a primary care physician referral for specialists.
PPOs offer more flexibility, allowing you to see out-of-network providers (though at a higher cost) and generally not requiring a referral to see a specialist. PPO plans ARE available on-exchange in Virginia, including options from HealthKeepers Plus PPO, Cigna HMO and PPO, and United Healthcare HMO and PPO.
EPOs combine features of both, offering a network of providers like an HMO but usually without the need for referrals. Out-of-network care is generally not covered, except in emergencies.

Metal Tiers and Subsidies

ACA plans are categorized into metal tiers:

Bronze plans have the lowest premiums but the highest deductibles and out-of-pocket costs, covering about 60% of medical expenses. They are best for those who expect minimal healthcare use.
Silver plans cover about 70% of costs. Crucially, if your income is between 100% and 250% FPL, you may qualify for Cost-Sharing Reductions (CSRs) that significantly lower your deductibles, copayments, and out-of-pocket maximums, making Silver plans a strong value.
Gold plans cover about 80% of costs with higher premiums but lower deductibles and out-of-pocket maximums, suitable for those who anticipate more medical care.
Platinum plans cover about 90% of costs, offering the highest premiums but the lowest out-of-pocket expenses, ideal for individuals with significant ongoing medical needs.

Virginia Medicaid and FAMIS Eligibility in Loudoun County

Virginia's commitment to expanding healthcare access means that many low-income residents in Loudoun County can qualify for state-sponsored programs.

Medicaid for Adults (Virginia Medicaid Expansion / FAMIS Plus)

Since 2019, Virginia has expanded Medicaid eligibility. Adults in Loudoun County with a household income up to 138% of the Federal Poverty Level (FPL) may be eligible for comprehensive health coverage through Virginia Medicaid or FAMIS Plus. This program provides essential health benefits with no or very low out-of-pocket costs.

FAMIS for Children and Pregnant Women

Virginia also offers programs tailored for specific vulnerable populations:

FAMIS (Family Access to Medical Insurance Security) covers uninsured children in households with incomes up to 200% FPL. For children between 200% and 400% FPL, FAMIS Select offers low-cost coverage.
FAMIS Moms provides coverage for pregnant women with household incomes up to 200% FPL. This includes comprehensive prenatal care, labor and delivery services, and 12 months of postpartum care (extended under the ARP). Applications for these programs can be made through commonhelp.virginia.gov.

Health Insurance Carriers in Loudoun County

For the 2026 plan year, Loudoun County residents in Rating Area 1 have a competitive marketplace with multiple carriers offering plans through Marketplace Virginia / HealthCare.gov. In 2026, 6 carriers offer marketplace plans in Rating Area 1. The confirmed local carriers are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

These carriers provide a variety of plan options across the HMO, PPO, and EPO structures, allowing residents to compare benefits, networks, and costs to find the best fit for their needs.

Hospitals and Healthcare Facilities Serving Loudoun County

Loudoun County is served by two acute care hospitals, ensuring residents have access to essential medical services close to home. These facilities are integral to the local healthcare infrastructure. The hospitals in Loudoun County include:

Inova Loudoun Hospital (located in Leesburg)
Stonesprings Hospital Center (located in Dulles)

These hospitals provide a range of acute care services, supporting the health and well-being of the county's population. When selecting a health plan, it is important to verify that your preferred doctors and hospitals, including Inova Loudoun Hospital and Stonesprings Hospital Center, are within the plan's network.

Making the Right Choice: Next Steps for Loudoun County Residents

Choosing the right health insurance plan depends on your income, health needs, and preferences for doctors and hospitals. Here’s a guide to help you make an informed decision:

If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus). Apply through commonhelp.virginia.gov to determine your eligibility for free or very low-cost comprehensive coverage.
If your income is 100% to 400% FPL: You are eligible for premium tax credits on Marketplace Virginia / HealthCare.gov, which can significantly reduce your monthly premiums. If your income is between 100% and 250% FPL, explore Silver plans, as you may also qualify for Cost-Sharing Reductions (CSRs) to lower your out-of-pocket expenses.
If your income is above 400% FPL: You can still purchase plans through Marketplace Virginia / HealthCare.gov at full price, or explore off-exchange options directly from carriers. Focus on finding a plan that offers the best network and benefits for your healthcare needs.
For children and pregnant women: Check eligibility for FAMIS and FAMIS Moms programs, which offer robust coverage with generous income limits (up to 200% FPL for pregnant women and children, and up to 400% FPL for FAMIS Select for children).

Working with a licensed health insurance producer can simplify this process. They can help you compare plans, understand subsidies, and enroll in coverage that meets your specific requirements, all at no cost to you.

Frequently Asked Questions

What health insurance plans are available in Loudoun County, Virginia?

In Loudoun County, you can access health insurance through the Affordable Care Act (ACA) marketplace, Marketplace Virginia / HealthCare.gov. Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs). Additionally, Virginia Medicaid and the Family Access to Medical Insurance Security (FAMIS) programs offer coverage for eligible low-income individuals and families.

Can I get a PPO plan on the ACA marketplace in Loudoun County?

Yes, unlike some other states, PPO plans are available on-exchange through Marketplace Virginia / HealthCare.gov for residents of Loudoun County. You can choose from HMO, PPO, and EPO plan structures, allowing for greater flexibility in provider choice compared to states that primarily offer HMOs and EPOs on their marketplaces.

What are the income limits for Virginia Medicaid in Loudoun County?

Virginia expanded Medicaid in 2019 (known as Virginia Medicaid Expansion or FAMIS Plus). Adults in Loudoun County with incomes up to 138% of the Federal Poverty Level (FPL) may qualify for comprehensive, low-cost health coverage. For pregnant women, the income limit is 200% FPL, and for children, FAMIS covers those up to 200% FPL, with FAMIS Select available up to 400% FPL.

How many health insurance carriers offer plans in Loudoun County for 2026?

For the 2026 plan year, 6 carriers offer marketplace health insurance plans in Loudoun County's Rating Area 1. These include CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare.

Are there local hospitals in Loudoun County, Virginia?

Yes, Loudoun County is home to two acute care hospitals: Inova Loudoun Hospital in Leesburg and Stonesprings Hospital Center in Dulles. These facilities provide critical healthcare services to residents throughout the county.