Health Insurance in Montgomery County, Virginia: Your 2026 Guide

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

In 2026, 6 carriers offer marketplace health insurance plans in Virginia Rating Area 5, which includes Montgomery County.
Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level.
Montgomery County has a population of 99,101 and an uninsured rate of 4.8%, per U.S. Census Bureau ACS 2024 5-year estimates.
Marketplace Virginia offers a choice of HMO, PPO, and EPO plan structures for 2026 coverage in the county.
Pregnant women in Virginia may qualify for FAMIS Moms (Medicaid) with incomes up to 200% FPL.

Navigating health insurance options in Montgomery County, Virginia, involves understanding both state-specific programs and the plans available through Marketplace Virginia. For 2026 coverage, residents have access to a variety of plans from multiple carriers, with potential financial assistance to make coverage more affordable. Virginia's Medicaid expansion also provides a pathway to free or low-cost health coverage for many individuals and families based on income. This guide will help you explore your options, from understanding plan types and carriers to determining your eligibility for subsidies or Medicaid.

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Understanding Your Health Insurance Options in Montgomery County

Residents of Montgomery County primarily access individual and family health insurance through Marketplace Virginia, the state's health insurance exchange that utilizes the federal HealthCare.gov platform. This marketplace is designed to help individuals and families find comprehensive coverage, often with financial assistance.

Marketplace Plans and Subsidies

When you shop on Marketplace Virginia, you'll encounter a range of plan categories:

Bronze plans: Offer lower monthly premiums but higher deductibles and out-of-pocket costs. They cover 60% of costs on average.
Silver plans: Provide moderate premiums and out-of-pocket costs, covering about 70% of costs. These plans are particularly valuable if you qualify for Cost-Sharing Reductions (CSRs), which further lower deductibles, copayments, and coinsurance.
Gold plans: Feature higher monthly premiums but lower deductibles and out-of-pocket costs, covering about 80% of costs.
Platinum plans: Have the highest premiums but the lowest deductibles and out-of-pocket costs, covering about 90% of costs.

Many Montgomery County residents qualify for premium tax credits (subsidies) that reduce their monthly health insurance premiums. Eligibility for these subsidies depends on your household income relative to the Federal Poverty Level (FPL). Individuals and families with incomes between 100% and 400% FPL typically qualify for significant assistance. Cost-Sharing Reductions are available for those with incomes up to 250% FPL, making Silver plans exceptionally good value.

Available Plan Types in Virginia

Unlike some states, Virginia offers a broad range of plan types through Marketplace Virginia. In Montgomery County, you can choose from:

Health Maintenance Organization (HMO) plans: Typically require you to choose a primary care provider (PCP) within the plan's network and get referrals for specialists.
Preferred Provider Organization (PPO) plans: Offer more flexibility, allowing you to see any doctor or specialist without a referral, though you'll pay less if you use in-network providers. PPO plans ARE available on-exchange in Virginia.
Exclusive Provider Organization (EPO) plans: A hybrid, allowing you to see specialists without referrals but generally limiting coverage to providers within the plan's network, except in emergencies.

This variety ensures you can find a plan structure that best fits your healthcare preferences and needs.

Who Qualifies for Virginia Medicaid (FAMIS Plus)?

Virginia expanded its Medicaid program in 2019, significantly broadening eligibility for low-income adults. This program, often referred to as Virginia Medicaid Expansion or FAMIS Plus, provides comprehensive health coverage with no monthly premiums or deductibles for those who qualify. Adults in Montgomery County with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid. For 2024, this threshold is approximately $20,782 for an individual and $35,245 for a family of three. If your income falls within this range, Medicaid offers a robust and affordable healthcare solution.

Medicaid for Pregnant Women and Children

Virginia also offers specific programs for pregnant women and children:

FAMIS Moms: Covers pregnant women with household incomes up to 200% FPL. This program provides comprehensive prenatal care, labor and delivery services, and 12 months of postpartum care, extended under the American Rescue Plan.
FAMIS (Family Access to Medical Insurance Security): Provides coverage for uninsured children in households with incomes up to 200% FPL.
FAMIS Select: For children in families with incomes between 200% and 400% FPL, FAMIS Select offers low-cost health coverage options.

Applications for these programs can be submitted online through commonhelp.virginia.gov.

Health Insurance Carriers in Montgomery County

In 2026, 6 carriers offer marketplace health insurance plans in Virginia Rating Area 5, which covers Alleghany, Bath, Bedford, Botetourt, Carroll, Covington, Craig, Floyd, Galax, Grayson, Highland, Montgomery, Pulaski, Radford, Roanoke, Roanoke, Salem, Smyth, Wythe counties. This robust competition provides residents with a strong selection of plans and price points. The confirmed local carriers offering plans in Montgomery County for the 2026 plan year include:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When selecting a plan, it is important to verify that your preferred doctors, specialists, and hospitals are in-network with the specific plan you choose.

Local Healthcare Providers and Services

Montgomery County is served by two acute care hospitals, ensuring residents have access to essential medical services. Carilion New River Valley Medical Center in Christiansburg and Lewisgale Hospital Montgomery in Blacksburg provide a range of inpatient and outpatient care. These facilities are integral to the local healthcare landscape and should be considered when selecting a health insurance plan, particularly regarding in-network provider lists. Montgomery County's population of 99,101 and an uninsured rate of 4.8% (per U.S. Census Bureau ACS 2024 5-year estimates) highlight the importance of accessible and affordable health coverage for its diverse community.

Making the Right Health Plan Decision for Your Needs

Choosing the best health insurance plan in Montgomery County depends on your specific financial situation, health needs, and preferences for accessing care.

If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus), offering comprehensive, low-cost coverage. Pregnant women and children have higher income thresholds for FAMIS programs.
If your income is between 100% and 400% FPL: You are likely eligible for significant premium tax credits on Marketplace Virginia, making a private plan more affordable. Explore Silver plans for potential Cost-Sharing Reductions.
If your income is above 400% FPL: You can still purchase plans through Marketplace Virginia or directly from carriers, though without subsidies. Focus on finding a plan that balances premium costs with your expected out-of-pocket expenses.

Consider your anticipated healthcare usage, whether you prefer the flexibility of a PPO or the lower costs often associated with HMOs, and if your current doctors are in-network with your chosen plan. A licensed health insurance producer can provide personalized guidance and help you compare plans and determine your eligibility for financial assistance at no cost to you.

Frequently Asked Questions

Can I get a PPO health insurance plan on Marketplace Virginia in Montgomery County?

Yes, PPO (Preferred Provider Organization) plans are available on Marketplace Virginia for residents of Montgomery County. In Virginia, marketplace shoppers can choose from HMO, PPO, and EPO plan structures, offering flexibility in how you access care. Be sure to check which local doctors and hospitals are in-network for any plan you consider.

What are the income limits for Virginia Medicaid (FAMIS Plus) in Montgomery County?

Virginia expanded Medicaid in 2019, covering adults with household incomes up to 138% of the Federal Poverty Level (FPL). For 2024, this is approximately $20,782 for an individual or $35,245 for a family of three. Pregnant women (FAMIS Moms) are covered up to 200% FPL, and children (FAMIS) are covered up to 200% FPL, with FAMIS Select offering low-cost options for children between 200% and 400% FPL.

Is pregnancy considered a Qualifying Life Event for a Special Enrollment Period?

No, pregnancy alone is not a Qualifying Life Event (QLE) that triggers a Special Enrollment Period (SEP) to enroll in a new health plan. However, the birth of a baby IS a QLE. This means you can enroll yourself and your newborn in a new plan within 60 days of the baby's birth. If you are pregnant, you can enroll during the annual Open Enrollment Period or explore Virginia Medicaid options (FAMIS Moms) if you meet income requirements.

How do I apply for health insurance in Montgomery County, Virginia?

Residents of Montgomery County can apply for health insurance through Marketplace Virginia (HealthCare.gov) during the annual Open Enrollment Period or if they qualify for a Special Enrollment Period. For Virginia Medicaid (FAMIS Plus or FAMIS Moms/Children), applications can be submitted online through commonhelp.virginia.gov. A licensed health insurance producer can also assist you with the application process for free.