HealthKeepers Health Insurance Plans in Franklin, Virginia
- In 2026, HealthKeepers is one of 6 carriers offering health insurance plans through Marketplace Virginia in Franklin.
- Franklin residents may choose from HealthKeepers HMO and PPO plans, which are available on-exchange for subsidy eligibility.
- Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level (FPL).
- The average uninsured rate in Franklin is 2.9%, significantly lower than the national average, per U.S. Census Bureau ACS 2024 5-year estimates.
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What HealthKeepers Plans Are Available in Franklin, Virginia?
In Franklin, HealthKeepers offers a range of health insurance plans, primarily including Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) options. These plans are available through Marketplace Virginia, allowing eligible individuals and families to access premium tax credits and cost-sharing reductions. HMO Plans: HealthKeepers HMO plans typically require you to choose a primary care provider (PCP) within their network. This PCP then coordinates your care and provides referrals to specialists if needed. HMOs often have lower monthly premiums and out-of-pocket costs compared to PPOs, but with less flexibility in choosing providers outside the network. PPO Plans: HealthKeepers PPO plans offer more flexibility. While they have a network of preferred providers, you generally do not need a referral to see a specialist, and you can see out-of-network providers, though at a higher cost. PPO plans are available on-exchange in Virginia, meaning you can use subsidies to help pay for them. All HealthKeepers plans, like other marketplace plans, cover essential health benefits, including doctor visits, hospital care, prescription drugs, mental health services, and maternity care. The specific benefits and cost-sharing (deductibles, copayments, coinsurance) will vary depending on the metal tier (Bronze, Silver, Gold) of the plan you choose.Understanding Health Insurance Costs and Subsidies in Franklin
The cost of HealthKeepers health insurance in Franklin depends on several factors, including your age, household size, and income. However, many Franklin residents qualify for financial assistance through Marketplace Virginia to make coverage more affordable.Premium Tax Credits
Premium tax credits, also known as subsidies, are available to individuals and families whose household income falls between 100% and 400% of the Federal Poverty Level (FPL). These credits can significantly reduce your monthly health insurance premiums. For 2026, enhanced subsidies remain in effect, potentially allowing individuals with incomes above 400% FPL to also qualify if their benchmark Silver plan premium would exceed 8.5% of their household income.Cost-Sharing Reductions (CSRs)
If your income is below 250% FPL, you may also qualify for Cost-Sharing Reductions (CSRs). These are additional subsidies that lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are only available with Silver-tier plans, making them a highly valuable option for those who qualify.Virginia Medicaid (FAMIS Plus)
Virginia expanded Medicaid in 2019 (Virginia Medicaid Expansion / FAMIS Plus). Adults in Franklin with household incomes up to 138% FPL may qualify for free or low-cost health coverage through Virginia Medicaid. This program provides comprehensive benefits with minimal or no out-of-pocket costs. Additionally, Virginia Medicaid (FAMIS Moms) covers pregnant women with income up to 200% FPL, and FAMIS (Family Access to Medical Insurance Security) covers uninsured children in households up to 200% FPL. For children between 200% and 400% FPL, FAMIS Select offers low-cost coverage. You can apply for these programs through commonhelp.virginia.gov.Health Insurance Carriers in Franklin
Franklin, Virginia, is part of Virginia Rating Area 4, which covers Chesapeake, Franklin, Hampton, Isle of Wight, James City, Newport News, Norfolk, Northampton, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, and York counties. In 2026, 6 carriers offer marketplace plans in Rating Area 4. This ensures a competitive market with a variety of plan options for residents. The confirmed carriers offering marketplace plans in Franklin for 2026 include:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Choosing the Right HealthKeepers Plan in Franklin
Selecting the best HealthKeepers plan in Franklin requires evaluating your healthcare needs, budget, and preferred providers. Here's a structured approach to help you decide:Franklin, with a population of 8,250 and an uninsured rate of 2.9% per U.S. Census Bureau ACS 2024 5-year estimates, is served by Carilion Franklin Memorial Hospital in nearby Rocky Mount. This city is part of Virginia Rating Area 4, which ensures access to a competitive marketplace. The median income in Franklin is $63,245, indicating that many residents may qualify for significant financial assistance to lower their health insurance costs.
| Your Income | Recommendation | Action |
|---|---|---|
| Below 138% FPL (e.g., ~$20,120 for an individual) | Virginia Medicaid (FAMIS Plus) | Apply through commonhelp.virginia.gov for free or low-cost comprehensive coverage. |
| 138% - 250% FPL | Silver Plan with Cost-Sharing Reductions (CSRs) | Enroll in a Silver plan through Marketplace Virginia to get premium tax credits and reduced deductibles/copayments. |
| 250% - 400% FPL | Bronze, Silver, or Gold Plan with Premium Tax Credits | Compare plans on Marketplace Virginia. Premium tax credits will significantly lower your monthly premiums. Bronze plans have lower premiums but higher out-of-pocket costs, while Gold plans have higher premiums but lower out-of-pocket costs. |
| Above 400% FPL | Bronze, Silver, or Gold Plan (may still qualify for subsidies) | Check eligibility for premium tax credits on Marketplace Virginia, especially if benchmark plan premiums exceed 8.5% of your income. Consider your expected healthcare usage to choose the metal tier that balances premiums and out-of-pocket costs. |
Frequently Asked Questions
What types of HealthKeepers plans are available in Franklin, VA?
In Franklin, HealthKeepers typically offers HMO and PPO plans on Marketplace Virginia. These plans provide access to a network of doctors and hospitals, with PPO options often allowing out-of-network care at a higher cost.
Can I get a subsidy for a HealthKeepers plan in Franklin?
Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits to lower your monthly payments. Some individuals with income above 400% FPL may also qualify if their benchmark plan premium exceeds 8.5% of their household income. These subsidies are applied directly when you enroll through Marketplace Virginia.
How does Franklin's Rating Area 4 affect my plan choices?
Franklin is part of Virginia Rating Area 4, which includes 16 other counties and cities such as Chesapeake, Hampton, and Virginia Beach. All health insurance plans offered in this rating area have the same base premiums, regardless of the specific city or county within Rating Area 4. This means you have access to the same 6 carriers and their plans as residents in other parts of the rating area.
Where can I find doctors and hospitals covered by HealthKeepers in Franklin?
HealthKeepers provides online provider directories where you can search for in-network doctors, specialists, and hospitals, including Carilion Franklin Memorial Hospital, which serves Franklin County. It is always recommended to verify that your preferred providers are in-network for the specific HealthKeepers plan you choose before enrolling.