Oscar Health Insurance Plans in King and Queen County, Virginia
- Oscar Health is one of 6 health insurance carriers offering plans on HealthCare.gov in King and Queen County's Rating Area 8 for 2026.
- Virginia's marketplace offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, with PPOs available on-exchange.
- Residents of King and Queen County with incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid.
- Approximately 6,695 people reside in King and Queen County, which has a median age of 49.3 years and a 5.8% uninsured rate.
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Understanding Oscar Health Plans in King and Queen County
Oscar Health offers various health insurance plans designed to meet different needs and budgets. While specific plan details and availability can vary by rating area, King and Queen County residents can typically expect to find plans across the standard metal tiers: Bronze, Silver, Gold, and Platinum. Bronze plans generally have lower monthly premiums but higher deductibles and out-of-pocket costs, making them suitable for those who anticipate 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), which further lower deductibles and copayments for eligible individuals. Gold and Platinum plans feature higher premiums but lower out-of-pocket costs, providing more comprehensive coverage for those who expect to use medical services frequently. King and Queen County is part of Rating Area 8, which covers Accomack, Albemarle, Amelia, Amherst, Appomattox, Bland, Brunswick, Buckingham, Campbell, Caroline, Charlotte, Charlottesville, Cumberland, Danville, Emporia, Essex, Fluvanna, Giles, Gloucester, Greene, Greensville, Halifax, Henry, King William, King and Queen, Lancaster, Louisa, Lunenburg, Lynchburg, Martinsville, Mathews, Mecklenburg, Middlesex, Nelson, Northumberland, Nottoway, Patrick, Pittsylvania, Prince Edward, Prince George, Sussex, Westmoreland, Winchester counties. This broad rating area ensures that plan options and pricing for Oscar Health are consistent across this large geographic region.Eligibility for Financial Assistance in Virginia
Many King and Queen County residents qualify for financial assistance to help pay for their health insurance premiums and out-of-pocket costs. These subsidies are available through HealthCare.gov.Premium Tax Credits
Premium tax credits, or subsidies, lower your monthly health insurance premiums. Eligibility is based on your household income relative to the Federal Poverty Level (FPL). For 2026, individuals and families with incomes between 100% and 400% FPL may qualify. The amount of your tax credit depends on your income, household size, and the cost of the benchmark Silver plan in your area.Cost-Sharing Reductions (CSRs)
Cost-sharing reductions help lower your out-of-pocket expenses like deductibles, copayments, and coinsurance. These are available to individuals and families with incomes up to 250% FPL who enroll in a Silver-tier plan. CSRs enhance the value of Silver plans, making them significantly more robust for eligible individuals.Virginia Medicaid and FAMIS Programs
Virginia expanded Medicaid in 2019, meaning more adults qualify for coverage. If your household income is at or below 138% of the Federal Poverty Level, you may qualify for Virginia Medicaid (also known as FAMIS Plus). This program provides comprehensive health coverage 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, including prenatal care, labor, delivery, and 12 months of postpartum care. Children in households with incomes up to 200% FPL may qualify for FAMIS (Family Access to Medical Insurance Security) for uninsured children. 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 King and Queen County
In 2026, 6 carriers offer marketplace plans in Rating Area 8, which includes King and Queen County. Oscar Health is one of these confirmed carriers. It is important to compare plans from multiple providers to find the best fit for your healthcare needs and budget. The confirmed carriers for King and Queen County's Rating Area 8 are:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Choosing the Right Oscar Health Plan
When selecting an Oscar Health plan, consider your expected healthcare usage, preferred doctors, and budget. If you have a primary care physician or specialists you wish to continue seeing, verify if they are in Oscar Health's network for your chosen plan type.Considerations for Plan Selection:
- Network Type (HMO, PPO, EPO): HMOs generally require you to choose a primary care provider (PCP) and get referrals for specialists. PPOs offer more flexibility, allowing you to see out-of-network providers at a higher cost. EPOs are similar to HMOs but typically do not require a PCP referral for specialists, though they usually do not cover out-of-network care.
- Deductible: How much you pay out-of-pocket before your insurance begins to cover costs.
- Copayments and Coinsurance: Fixed fees or percentages you pay for specific services after your deductible is met.
- Out-of-Pocket Maximum: The maximum amount you will pay for covered services in a plan year. Once you reach this limit, your plan pays 100% of covered costs.
Next Steps for Enrollment in King and Queen County
To enroll in an Oscar Health plan or any other marketplace plan in King and Queen County, follow these steps:- Determine Eligibility: Use the HealthCare.gov website or consult with a licensed agent to estimate your income and household size to see if you qualify for premium tax credits or cost-sharing reductions.
- Compare Plans: Review the available plans from Oscar Health and other carriers in Rating Area 8. Pay close attention to premiums, deductibles, out-of-pocket maximums, and provider networks.
- Apply During Open Enrollment: The annual Open Enrollment Period is the main time to apply. If you experience a qualifying life event, such as losing other coverage, getting married, or having a baby, you may qualify for a Special Enrollment Period.
- Get Expert Assistance: A licensed health insurance agent can provide personalized guidance, help you understand your options, and assist with the application process at no additional cost to you.
Frequently Asked Questions
Can I get Oscar Health plans in King and Queen County?
Yes, Oscar Health is one of 6 carriers offering marketplace plans in King and Queen County's Rating Area 8 for the 2026 plan year. You can enroll through HealthCare.gov.
What types of Oscar Health plans are available in Virginia?
In Virginia, Oscar Health and other marketplace carriers offer Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. The specific plan types from Oscar Health will depend on their offerings in Rating Area 8.
How do I apply for an Oscar Health plan in King and Queen County?
You can apply for an Oscar Health plan, or any other marketplace plan, through HealthCare.gov during the annual Open Enrollment Period or if you qualify for a Special Enrollment Period. Licensed agents can also assist with your application at no cost.
What is the uninsured rate in King and Queen County?
King and Queen County has an uninsured rate of 5.8%, according to U.S. Census Bureau ACS 2024 5-year estimates. This is lower than the national average, indicating a high rate of coverage among residents.