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

Health Insurance Options in Scott County, Virginia

Scott County residents can choose from plans offered by 6 confirmed carriers in Rating Area 6 on Marketplace Virginia/HealthCare.gov for 2026.
Virginia Medicaid (FAMIS Plus) is available for adults with incomes up to 138% of the Federal Poverty Level.
On-exchange PPO, HMO, and EPO plans are available, providing diverse coverage choices in Scott County.
Subsidies significantly reduce monthly premiums for individuals and families earning up to 400% FPL, making coverage more affordable.
Scott County has an uninsured rate of 5.9%, lower than the state average, per U.S. Census Bureau ACS 2024 5-year estimates.

Finding affordable health insurance in Scott County, Virginia, involves understanding your options through Marketplace Virginia (which uses the federal HealthCare.gov platform), state-sponsored programs like Virginia Medicaid, and off-marketplace plans. For 2026, residents have access to a competitive market with 6 confirmed carriers offering a variety of plans, including HMO, PPO, and EPO options, many of which are eligible for significant subsidies. If your income falls within certain guidelines, you may qualify for premium tax credits that lower your monthly costs or even qualify for comprehensive, low-cost coverage through Virginia Medicaid or the state's FAMIS programs.

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What Are Your Health Insurance Options in Scott County, Virginia?

Residents of Scott County have several pathways to securing health insurance coverage, primarily through the Affordable Care Act (ACA) marketplace, Virginia's expanded Medicaid program, and direct-to-carrier plans.

Marketplace Virginia (HealthCare.gov): This is the primary avenue for individuals and families to purchase private health insurance plans. Plans purchased here may qualify for Advanced Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs), making coverage much more affordable. In Virginia, shoppers can choose from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, with PPOs being available on-exchange.

Virginia Medicaid and FAMIS: Virginia expanded its Medicaid program in 2019, significantly increasing eligibility. Adults with incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (FAMIS Plus). The state also offers robust programs for pregnant women (FAMIS Moms, up to 200% FPL) and children (FAMIS, up to 200% FPL), with FAMIS Select providing low-cost options for children up to 400% FPL.

Off-Marketplace Plans: You can also purchase health insurance directly from carriers outside of Marketplace Virginia. While these plans are ACA-compliant, they do not qualify for premium tax credits or cost-sharing reductions. These are typically chosen by individuals who do not qualify for subsidies or prefer specific plan options not available on the exchange.

Understanding Marketplace Plans and Subsidies in Scott County

The ACA marketplace in Virginia offers plans categorized into metal tiers: Bronze, Silver, Gold, and Platinum. These tiers indicate how you and your plan share the cost of healthcare:

Bronze Plans: Have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They cover 60% of costs on average, with you paying 40%. Best for those who expect minimal healthcare use.
Silver Plans: Offer moderate premiums and out-of-pocket costs, covering 70% of costs on average. These are the only plans eligible for Cost-Sharing Reductions (CSRs) for those with incomes up to 250% FPL, which significantly lowers deductibles and copays.
Gold Plans: Feature higher premiums but lower deductibles and out-of-pocket maximums, covering 80% of costs on average. Suitable for those who expect to use medical services frequently.
Platinum Plans: Have the highest premiums but the lowest deductibles and out-of-pocket costs, covering 90% of costs on average. Ideal for individuals with extensive healthcare needs.

Premium Tax Credits (Subsidies): For 2026, individuals and families in Scott County with household incomes between 100% and 400% of the Federal Poverty Level may qualify for Advanced Premium Tax Credits (APTCs). These subsidies directly reduce your monthly premium, making plans more affordable. The exact amount depends on your income, household size, and the cost of the benchmark Silver plan in your area.

Cost-Sharing Reductions (CSRs): If your income is below 250% FPL, you may also qualify for CSRs in addition to premium tax credits. CSRs reduce your deductibles, copayments, and out-of-pocket maximums, effectively making Silver plans offer better coverage than their standard 70% actuarial value. You must enroll in a Silver plan to receive CSRs.

2026 Health Insurance Carriers in Scott County, Virginia

Scott County is part of Virginia Rating Area 6. In 2026, 6 carriers offer marketplace plans in Rating Area 6, which covers Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, Washington, Wise counties. This robust selection ensures that residents have a variety of choices to meet their healthcare needs and budgets.

The confirmed carriers offering plans in Rating Area 6 for 2026 include:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

Each of these carriers provides a range of plan types across the metal tiers, including HMO, PPO, and EPO options. It is important to compare the specific benefits, provider networks, and costs of each plan to find the best fit for your situation.

Virginia Medicaid and FAMIS Programs in Scott County

Virginia's commitment to expanding healthcare access means that many Scott County residents may qualify for low-cost or free health coverage through Medicaid and the Family Access to Medical Insurance Security (FAMIS) programs.

Virginia Medicaid (FAMIS Plus): Since its expansion in 2019, Virginia Medicaid now covers adults with household incomes up to 138% of the Federal Poverty Level. This includes comprehensive benefits such as doctor visits, hospital stays, prescription drugs, mental health services, and more. There is no premium for Virginia Medicaid.

FAMIS Moms (Pregnant Women): Pregnant women in Scott County can access comprehensive coverage through FAMIS Moms if their household income is up to 200% FPL. This program covers prenatal care, labor and delivery, and an extended 12 months of postpartum care, ensuring continuous support for new mothers and their babies. Applications can be made through commonhelp.virginia.gov.

FAMIS (Children): Uninsured children in households with incomes up to 200% FPL are eligible for FAMIS, which provides comprehensive health and dental coverage. For children in families earning between 200% and 400% FPL, FAMIS Select offers affordable, low-cost coverage options.

Navigating Healthcare in Scott County: Hospitals and Services

Scott County, with a population of 21,479 and an uninsured rate of 5.9% per U.S. Census Bureau ACS 2024 5-year estimates, is part of Virginia Rating Area 6. This rating area covers a total of 10 counties, including Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, Washington, and Wise. While Scott County itself does not have acute care hospitals within its boundaries, residents typically access medical facilities in neighboring counties within this rating area for their acute care needs. It is important for residents to verify the specific provider networks of their chosen health plan to ensure access to preferred doctors and hospitals in nearby areas.

How to Enroll in a Health Plan in Scott County

Enrolling in a health insurance plan in Scott County depends on your eligibility and income. Here's a general guide to help you get started:

1. Determine Your Eligibility for Financial Assistance:

If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus). Apply directly through commonhelp.virginia.gov.
If your income is between 100% and 400% FPL: You are likely eligible for premium tax credits on Marketplace Virginia (HealthCare.gov). You may also qualify for Cost-Sharing Reductions if your income is below 250% FPL and you choose a Silver plan.
If your income is above 400% FPL: You can still purchase plans through Marketplace Virginia or directly from a carrier, but you will not qualify for subsidies.

2. Choose the Right Enrollment Period:

Open Enrollment Period: This is the standard time each year (typically November 1 - January 15) when anyone can enroll in or change a marketplace plan.
Special Enrollment Period (SEP): If you experience a qualifying life event outside of Open Enrollment, such as losing other coverage, getting married, having a baby, or moving, you may be eligible for an SEP.

3. Compare Plans: Whether you're applying through Marketplace Virginia or directly with a carrier, carefully compare the plan's monthly premium, deductible, copayments, out-of-pocket maximums, and provider network. Consider your expected healthcare needs for the year.

Navigating these choices can be complex. A licensed health insurance agent can provide free, unbiased assistance, helping you understand your options, compare plans, and enroll in the coverage that best fits your needs and budget. Their expertise ensures you maximize any available subsidies and select a plan with a suitable provider network.

Frequently Asked Questions

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

In Scott County, Virginia, you can find a variety of health insurance plan types on Marketplace Virginia (HealthCare.gov), including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. PPO plans are available on-exchange, offering more flexibility in choosing healthcare providers.

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

Virginia expanded Medicaid in 2019. Adults in Scott County may qualify for Virginia Medicaid (FAMIS Plus) if their household income is up to 138% of the Federal Poverty Level. Pregnant women (FAMIS Moms) can qualify with incomes up to 200% FPL, and children (FAMIS) are covered up to 200% FPL. For children between 200% and 400% FPL, FAMIS Select offers low-cost coverage.

How many health insurance carriers offer plans in Scott County, Virginia for 2026?

For the 2026 plan year, residents of Scott County, Virginia, can choose from marketplace plans offered by 6 confirmed carriers in Rating Area 6. These carriers include CareFirst BlueChoice, Cigna, HealthKeepers, Oscar Health, Sentara Health Plans, and United Healthcare.

Is pregnancy considered a qualifying life event for special enrollment in Virginia?

No, pregnancy alone is not a qualifying life event for a Special Enrollment Period (SEP) to enroll in an ACA health plan. However, the birth of a baby is a qualifying life event, which allows you to enroll yourself and your new child in a new health plan or add them to an existing one. You typically have 60 days from the date of birth to enroll.