Oscar Health Insurance Plans in Mathews County, Virginia
- Oscar Health is one of 6 carriers offering Marketplace plans in Mathews County, Virginia for 2026.
- Mathews County is part of Virginia Rating Area 8, which covers 43 counties across the state.
- Virginia Marketplace plans include HMO, PPO, and EPO options, with PPOs available on-exchange.
- Virginia Medicaid (FAMIS Plus) covers adults up to 138% FPL; pregnant women and children up to 200% FPL.
- Mathews County has a population of 8,540 and an uninsured rate of 6.8%, per U.S. Census Bureau ACS 2024 5-year estimates.
Get Your Free Health Insurance Quote
A licensed agent can compare coverage options for you at no cost.
You're all set!
A licensed agent will reach out shortly.
What Oscar Health Plans Are Available in Mathews County?
For the 2026 plan year, Oscar Health offers a range of health insurance plans to residents of Mathews County through Marketplace Virginia. Mathews County is part of Virginia Rating Area 8, where a total of 6 carriers provide marketplace options. Oscar Health's offerings typically include Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, and Exclusive Provider Organization (EPO) plans. Unlike some states, Virginia's marketplace allows consumers to choose from HMO, PPO, and EPO structures, providing flexibility in network access and referral requirements. When selecting an Oscar Health plan, you will encounter different metal tiers: Bronze, Silver, Gold, and Platinum. These tiers indicate how you and your plan share costs:- Bronze plans: Offer the lowest monthly premiums but have the highest deductibles and out-of-pocket costs. They are designed for those who want protection against catastrophic medical bills.
- Silver plans: Provide moderate premiums and out-of-pocket costs. They are a good choice for many, especially those who qualify for cost-sharing reductions, which significantly lower deductibles, copayments, and coinsurance.
- Gold plans: Feature higher monthly premiums but lower deductibles and out-of-pocket maximums. They are suitable for individuals who expect to use medical services frequently throughout the year.
Understanding Health Insurance Costs in Mathews County
The cost of an Oscar Health plan, or any other plan in Mathews County, depends on several factors, including your age, household income, plan tier (Bronze, Silver, Gold), and whether you smoke. Many Mathews County residents qualify for financial assistance, known as premium tax credits, which can significantly reduce monthly premiums. For example, a 40-year-old individual in Mathews County with an income of $35,000 (around 250% FPL) might pay a significantly lower premium for a Silver plan after subsidies, compared to the full price. Cost-sharing reductions are also available for those with incomes up to 250% FPL who enroll in a Silver plan, further lowering deductibles and out-of-pocket maximums. To illustrate potential costs, here's an example of estimated unsubsidized monthly premiums for an individual in Mathews County in 2026:| Metal Tier | Estimated Monthly Premium (Age 30, Unsubsidized) | Estimated Monthly Premium (Age 50, Unsubsidized) |
|---|---|---|
| Bronze | $350 - $450 | $500 - $650 |
| Silver | $400 - $550 | $600 - $800 |
| Gold | $500 - $700 | $750 - $1000 |
Note: These are illustrative estimates. Actual premiums vary by specific plan, age, tobacco use, and final subsidy eligibility.
Health Insurance Carriers in Mathews County
Mathews County is part of Virginia 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. In 2026, 6 carriers offer marketplace plans in Rating Area 8. Residents of Mathews County can choose from plans offered by these confirmed carriers:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
How to Choose the Right Plan in Mathews County
Choosing the best Oscar Health plan, or any other plan, involves evaluating your specific healthcare needs, budget, and preferred doctors. Consider the following:- Your healthcare usage: If you anticipate frequent doctor visits or need specific medications, a Gold or Silver plan with lower out-of-pocket costs after the deductible might be more cost-effective. If you rarely visit the doctor, a Bronze plan with a lower premium could be suitable.
- Provider network: Oscar Health plans, like all others, have specific networks of doctors, specialists, and facilities. Ensure your preferred providers are in-network. For HMO and EPO plans, you may need a referral for specialists, while PPO plans offer more flexibility.
- Medication coverage: Check the plan's formulary to ensure your prescription drugs are covered and understand their cost-sharing structure.
- Financial assistance: Determine if your household income qualifies you for premium tax credits or cost-sharing reductions. These subsidies can significantly impact your out-of-pocket expenses. Virginia expanded Medicaid in 2019 (Virginia Medicaid Expansion / FAMIS Plus), covering adults with incomes up to 138% of the Federal Poverty Level. Pregnant women and children in Virginia may qualify for Medicaid (FAMIS Moms and FAMIS) with household incomes up to 200% FPL.
Get Your Free Quote
Understanding your health insurance options in Mathews County doesn't have to be complicated. A licensed health insurance producer can help you compare Oscar Health plans with other available carriers, determine your eligibility for financial assistance, and guide you through the enrollment process on Marketplace Virginia. This service is provided at no cost to you.Frequently Asked Questions
Is Oscar Health insurance available in Mathews County, Virginia?
Yes, Oscar Health is one of six carriers offering health insurance plans on the Marketplace Virginia (HealthCare.gov) in Rating Area 8, which includes Mathews County, for the 2026 plan year.
What types of Oscar Health plans are available in Mathews County?
Oscar Health, like other carriers in Virginia, offers Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, and Exclusive Provider Organization (EPO) plans on the Marketplace. PPO plans are available on-exchange in Virginia.
Can I get a subsidy for an Oscar Health plan in Mathews County?
Yes, individuals and families in Mathews County with household incomes between 100% and 400% of the Federal Poverty Level (FPL) may qualify for premium tax credits to lower the cost of an Oscar Health plan through Marketplace Virginia. Those with incomes up to 138% FPL may qualify for Virginia Medicaid (FAMIS Plus).
Where can Mathews County residents access medical care with Oscar Health?
Mathews County does not have an acute care hospital within its boundaries. Oscar Health members in Mathews County typically travel to neighboring counties for hospital services. Oscar Health's network includes providers and facilities across Rating Area 8 and broader Virginia.