Oscar Health Insurance Plans in Dumfries, Virginia
- Oscar Health is one of 6 carriers offering health insurance plans on the Marketplace Virginia exchange in Dumfries for 2026.
- Residents of Dumfries, part of Virginia Rating Area 1, can choose from HMO, PPO, and EPO plan types.
- Individuals and families with household incomes between 100% and 400% FPL may qualify for subsidies to reduce Oscar Health plan premiums.
- Virginia Medicaid (FAMIS Plus) covers adults up to 138% FPL, pregnant women up to 200% FPL, and children up to 200% FPL.
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What Oscar Health Plans Are Available in Dumfries, Virginia?
Oscar Health offers various health insurance plans through Marketplace Virginia / HealthCare.gov. As a resident of Dumfries, you are part of Virginia Rating Area 1, which covers Prince William County and 17 other counties including Alexandria, Arlington, Clarke, Culpeper, Fairfax, Falls Church, Fauquier, Frederick, Fredericksburg, Loudoun, Madison, Manassas, Manassas Park, Orange, Rappahannock, and Warren. For the 2026 plan year, shoppers in Rating Area 1 can select from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. Oscar Health typically offers HMO and EPO plans, which emphasize in-network care, while PPO plans offer more flexibility to see out-of-network providers for a higher cost. When considering an Oscar Health plan, it is important to review the specific benefits, deductibles, copayments, and out-of-pocket maximums for each metal tier (Bronze, Silver, Gold, Platinum). Bronze plans typically have the lowest premiums but highest out-of-pocket costs, while Gold and Platinum plans offer higher premiums with lower out-of-pocket expenses. Silver plans are unique because they are the only plans eligible for cost-sharing reductions (CSRs), which can further lower deductibles and copays for eligible individuals.Financial Assistance and Virginia Medicaid in Dumfries
Affordability is a major factor in choosing health insurance. Many Dumfries residents qualify for financial assistance programs through Marketplace Virginia.Advance Premium Tax Credits (APTCs)
If your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may be eligible for advance premium tax credits (subsidies). These credits directly reduce your monthly premium, making plans from Oscar Health and other carriers more affordable. The exact amount of your subsidy depends on your income, household size, and the cost of the benchmark Silver plan in your area.Cost-Sharing Reductions (CSRs)
For individuals and families with incomes up to 250% FPL, choosing a Silver plan may also qualify you for cost-sharing reductions. CSRs directly reduce your out-of-pocket costs, such as deductibles, copayments, and coinsurance, making healthcare more accessible when you need it.Virginia Medicaid Expansion (FAMIS Plus)
Virginia expanded its Medicaid program in 2019 (Virginia Medicaid Expansion / FAMIS Plus). This means that adults with household incomes up to 138% of the Federal Poverty Level can qualify for comprehensive health coverage. For a single individual, this threshold is approximately $20,782 per year in 2024. Virginia Medicaid covers a wide range of services with no or very low out-of-pocket costs. Applications can be submitted through commonhelp.virginia.gov.Medicaid for Pregnant Women and Children (FAMIS Moms and FAMIS)
Virginia also provides robust support for pregnant women and children. Virginia Medicaid (FAMIS Moms) covers pregnant women with incomes up to 200% FPL, including prenatal care, labor and delivery, and 12 months of postpartum care. The Family Access to Medical Insurance Security (FAMIS) program covers uninsured children in households up to 200% FPL. For children between 200% and 400% FPL, FAMIS Select offers low-cost coverage.Health Insurance Carriers in Dumfries
In 2026, 6 carriers offer marketplace plans in Virginia Rating Area 1, which serves Dumfries. These carriers provide a range of plan options, allowing residents to compare coverage and costs. The confirmed carriers for this rating area are:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Local Healthcare Resources in Prince William County
Dumfries, with a population of 5,816 and an uninsured rate of 17.2% per U.S. Census Bureau ACS 2024 5-year estimates, is situated in Prince William County. Prince William County's 488,880 residents have access to two acute care hospitals. These include Sentara Northern Virginia Medical Center in Woodbridge and Uva Health Haymarket Medical Center in Haymarket. These facilities provide essential medical services to the region, and it is important to ensure your chosen health plan, such as an Oscar Health plan, includes access to your preferred local providers and hospitals.Making Your Health Insurance Decision in Dumfries
Choosing the right health insurance plan requires evaluating your healthcare needs, budget, and local provider access. Here is a simplified guide to help Dumfries residents make an informed decision:| Your Household Income (as % FPL) | Recommended Action | Key Benefits |
|---|---|---|
| Below 138% FPL | Apply for Virginia Medicaid (FAMIS Plus) | Comprehensive coverage with no or low costs. |
| 138% - 250% FPL | Explore Silver plans on Marketplace Virginia | Eligible for both premium tax credits and cost-sharing reductions. |
| 250% - 400% FPL | Explore Bronze, Silver, or Gold plans on Marketplace Virginia | Eligible for premium tax credits to lower monthly costs. |
| Above 400% FPL | Compare plans on Marketplace Virginia or directly with carriers | Access to all plan types, though generally not eligible for subsidies. |
Frequently Asked Questions
Is Oscar Health insurance available in Dumfries, Virginia?
Yes, Oscar Health is one of 6 carriers offering marketplace plans in Virginia Rating Area 1, which includes Dumfries, for the 2026 plan year.
What types of Oscar Health plans can I get in Dumfries?
Oscar Health, along with other carriers in Virginia, offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans on the Marketplace Virginia exchange. You can choose the plan type that best fits your needs.
Can I get a subsidy for Oscar Health plans in Dumfries?
Yes, if your household income falls between 100% and 400% of the Federal Poverty Level, you may qualify for advance premium tax credits (subsidies) to lower your monthly premiums for Oscar Health or any other marketplace plan. Cost-sharing reductions are also available for those with incomes up to 250% FPL who choose a Silver plan.