HealthKeepers Health Insurance in Bedford, Virginia
- HealthKeepers is one of 6 carriers offering health insurance plans on Marketplace Virginia in Rating Area 5, which includes Bedford.
- Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level.
- Bedford's uninsured rate is 8.2%, per U.S. Census Bureau ACS 2024 5-year estimates, slightly higher than Bedford County's 5.7%.
- Marketplace Virginia offers HMO, PPO, and EPO plan types, with PPO options available from HealthKeepers and other carriers.
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What HealthKeepers Plans Are Available in Bedford?
HealthKeepers offers a range of health insurance plans in Bedford through Marketplace Virginia, catering to different budgets and healthcare needs. These plans are categorized into metal tiers: Bronze, Silver, and Gold. Bronze plans typically have the lowest monthly premiums but the highest deductibles and out-of-pocket costs, making them suitable for individuals who expect minimal medical care or want catastrophic coverage. Silver plans offer a balance of moderate premiums and out-of-pocket costs, and they are the only plans eligible for Cost-Sharing Reductions (CSRs) for those with incomes between 150% and 250% of the Federal Poverty Level. Gold plans have higher premiums but lower deductibles and out-of-pocket costs, ideal for those who anticipate more frequent medical care. HealthKeepers provides both Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans in Bedford. HMO plans generally require you to choose a primary care provider (PCP) within the network and get referrals for specialists, offering lower costs but less flexibility. PPO plans offer more flexibility, allowing you to see out-of-network providers (though at a higher cost) and typically not requiring referrals for specialists. Virginia is one of the states where PPO plans are available on-exchange, providing more choice for marketplace shoppers.Understanding Health Insurance Costs and Subsidies in Bedford
The cost of HealthKeepers health insurance in Bedford is influenced by several factors, including your age, household size, income, and the specific plan you choose. Many Bedford residents qualify for financial assistance through Marketplace Virginia, which can make coverage significantly more affordable. Advanced Premium Tax Credits (APTCs) are available to individuals and families with household incomes between 100% and 400% of the Federal Poverty Level (FPL). These credits can be applied directly to your monthly premium, reducing the amount you pay out-of-pocket. For example, a single person in Bedford earning $40,000 annually may see their monthly premium for a Silver plan reduced by hundreds of dollars through APTCs. Additionally, if your income falls between 150% and 250% FPL, you may qualify for Cost-Sharing Reductions (CSRs) on Silver plans. CSRs lower your deductibles, copayments, coinsurance, and out-of-pocket maximums, providing extra financial protection when you need medical care. Bedford's population is 7,724, with a median income of $70,288 and a poverty rate of 12.2%, per U.S. Census Bureau ACS 2024 5-year estimates. The uninsured rate in Bedford is 8.2%. These figures highlight the importance of affordable health coverage options for many residents.| Household Income (FPL) | Individual (Age 40) | Couple (Age 40) | Family of 4 (2 Adults, 2 Kids) |
|---|---|---|---|
| 150% FPL ($21,870 Individual / $45,000 Family) | $20 - $50 | $40 - $90 | $60 - $120 |
| 250% FPL ($36,450 Individual / $75,000 Family) | $70 - $120 | $140 - $240 | $210 - $360 |
| 350% FPL ($51,030 Individual / $105,000 Family) | $150 - $250 | $300 - $500 | $450 - $750 |
| Note: These are estimates. Actual costs depend on specific plan, age, and exact income. Figures are illustrative for 2026 plan year. | |||
Virginia Medicaid and FAMIS Programs for Bedford Residents
Virginia expanded Medicaid in 2019, meaning more adults in Bedford and across the state can qualify for comprehensive, low-cost health coverage. Adults with household incomes up to 138% of the Federal Poverty Level (FPL) may be eligible for Virginia Medicaid (also known as FAMIS Plus). This program provides extensive benefits with no monthly premiums and minimal out-of-pocket costs. For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL. This coverage includes prenatal care, labor and delivery, and an extended 12 months of postpartum care, ensuring comprehensive support for new mothers. Children in families with incomes up to 200% FPL can qualify for FAMIS (Family Access to Medical Insurance Security), Virginia's Children's Health Insurance Program (CHIP). For children in families with incomes between 200% and 400% FPL, FAMIS Select offers low-cost coverage options. Residents can apply for these programs through commonhelp.virginia.gov.Health Insurance Carriers in Bedford
In 2026, 6 carriers offer marketplace plans in 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. For residents of Bedford, the confirmed carriers available through Marketplace Virginia include:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
How to Choose the Right HealthKeepers Plan in Bedford
Choosing the right HealthKeepers plan in Bedford involves evaluating your healthcare needs, budget, and preferred access to doctors and hospitals. Consider the following steps:- Assess Your Healthcare Needs: If you anticipate frequent doctor visits, prescription medications, or have chronic conditions, a Gold plan with lower out-of-pocket costs or a Silver plan with CSRs (if eligible) might be more cost-effective despite higher premiums. If you are generally healthy and primarily want protection against major medical events, a Bronze plan could be suitable.
- Understand Your Subsidy Eligibility: Use the Marketplace Virginia website or consult with a licensed agent to determine if you qualify for Advanced Premium Tax Credits or Cost-Sharing Reductions, as these can significantly impact your net costs.
- Review Network Coverage: Verify that your preferred doctors, specialists, and facilities, such as Centra Bedford Memorial Hospital, are in-network for any HealthKeepers plan you consider. This is especially important for HMO plans where out-of-network care is typically not covered.
- Compare Plan Types (HMO vs. PPO): Decide whether the flexibility of a PPO plan (often with higher premiums) or the potentially lower costs and coordinated care of an HMO plan aligns better with your preferences. Remember that PPO plans are available on-exchange in Virginia.
- Consider Deductibles and Out-of-Pocket Maximums: These figures represent how much you might have to pay before your insurance starts covering a larger share of costs.
Frequently Asked Questions
Is HealthKeepers a PPO or HMO in Bedford, Virginia?
In Bedford, Virginia, HealthKeepers offers both HMO and PPO plans on the Marketplace Virginia. PPO plans are available in Virginia, allowing consumers to choose from a variety of plan structures including HMO, PPO, and EPO options.
What is the average cost of HealthKeepers health insurance in Bedford?
The average cost of HealthKeepers health insurance in Bedford, Virginia, varies significantly based on factors such as your age, income, chosen plan tier (Bronze, Silver, Gold), and whether you qualify for subsidies. Many Bedford residents qualify for Advanced Premium Tax Credits, which can substantially reduce monthly premiums. For example, a 40-year-old earning $40,000 might pay under $100 per month for a Silver plan after subsidies.
Can I get a subsidy for HealthKeepers plans in Bedford?
Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for Advanced Premium Tax Credits (APTCs) to lower your monthly premiums for HealthKeepers plans purchased through Marketplace Virginia. Individuals and families with incomes between 150% and 250% FPL may also qualify for Cost-Sharing Reductions (CSRs) on Silver plans, which reduce out-of-pocket costs like deductibles and copays.
Does HealthKeepers cover Centra Bedford Memorial Hospital?
HealthKeepers, like other major carriers in Virginia's Rating Area 5, typically contracts with local hospital systems. Centra Bedford Memorial Hospital is the primary acute care facility in Bedford. It is highly probable that HealthKeepers plans would include Centra Bedford Memorial Hospital in their network, but it is crucial to verify network specifics for any plan you consider by checking the official plan documents or contacting HealthKeepers directly.