Can I get health insurance if I only work part-time in Highland County?

Yes, part-time workers in Highland County, Virginia, have several options for health insurance. The most common route is through the Affordable Care Act (ACA) marketplace, Marketplace Virginia, where you may qualify for subsidies based on your income. Virginia also offers expanded Medicaid coverage for eligible individuals.

What are the income limits for Medicaid in Virginia?

Virginia expanded Medicaid in 2019, covering adults with household incomes up to 138% of the Federal Poverty Level (FPL). For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL, and children are covered by FAMIS up to 200% FPL.

How do ACA subsidies work for part-time employees?

ACA subsidies, known as Premium Tax Credits, are available to individuals and families with household incomes between 100% and 400% of the Federal Poverty Level. These credits reduce your monthly premium, making coverage more affordable. The exact amount depends on your income, household size, and the cost of the benchmark plan in your area.

Part-Time Health Insurance Options in Highland County, Virginia

Q: What types of health plans are available on Marketplace Virginia?

In Highland County, and across Rating Area 5, you can choose from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans on Marketplace Virginia. PPO plans are available on-exchange in Virginia, offering more flexibility in choosing providers.

Part-time workers in Highland County can access ACA marketplace plans through Marketplace Virginia, potentially receiving subsidies if their income is between 100% and 400% FPL.
Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level.
Highland County is part of Virginia Rating Area 5, where 6 carriers offer a choice of HMO, PPO, and EPO plans in 2026.
Pregnant women in Virginia may qualify for FAMIS Moms Medicaid coverage with incomes up to 200% FPL, including 12 months of postpartum care.

Navigating health insurance options when you work part-time in Highland County, Virginia, can seem challenging, but robust solutions are available. The Affordable Care Act (ACA) marketplace, known as Marketplace Virginia, provides comprehensive health plans that may be significantly more affordable thanks to federal subsidies. For those with lower incomes, Virginia's expanded Medicaid program offers another vital pathway to coverage. This article will guide you through understanding your options, eligibility, and how to secure reliable health insurance as a part-time employee in Highland County.

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What Health Insurance Options Are Available for Part-Time Workers?

Part-time employment does not preclude you from obtaining quality health insurance. In Highland County, your primary options generally fall into two categories:

Marketplace Virginia Plans: These are private health insurance plans offered through the state-based marketplace that uses the federal platform (HealthCare.gov). Plans are categorized into metal tiers (Bronze, Silver, Gold, Platinum) based on how costs are shared between you and the insurer. Crucially, Premium Tax Credits (subsidies) can significantly lower your monthly premiums if your household income is between 100% and 400% of the Federal Poverty Level (FPL).
Virginia Medicaid (FAMIS Plus): Virginia expanded its Medicaid program in 2019. This means adults with household incomes up to 138% FPL may qualify for free or low-cost health coverage. This is a critical safety net, providing comprehensive benefits without the need for marketplace subsidies.
FAMIS Programs for Pregnant Women and Children: Virginia also offers specialized Medicaid and CHIP programs. FAMIS Moms covers pregnant women with incomes up to 200% FPL, including 12 months of postpartum care. FAMIS (Family Access to Medical Insurance Security) covers uninsured children in households up to 200% FPL, with FAMIS Select offering low-cost coverage for children between 200% and 400% FPL.

Unlike employer-sponsored plans, which often require full-time status, these options are tied to your income and household size, making them ideal for part-time workers, freelancers, or those who don't receive benefits from their employer.

Understanding ACA Plan Tiers and Subsidies in Highland County

When selecting a plan on Marketplace Virginia, you'll encounter different metal tiers, each indicating a different cost-sharing structure:

Metal Tier	Coverage Level (Insurer Pays)	Out-of-Pocket Costs	Best For
Bronze	~60%	Higher deductibles, lower premiums	Individuals who rarely use medical services and want catastrophic protection.
Silver	~70%	Moderate deductibles, moderate premiums	Good balance of premium and out-of-pocket costs. Eligible for Cost-Sharing Reductions (CSRs) if income is below 250% FPL.
Gold	~80%	Lower deductibles, higher premiums	Individuals who expect to use medical services frequently and prefer predictable costs.
Platinum	~90%	Very low deductibles, highest premiums	Individuals with chronic conditions or high anticipated medical needs.

For part-time workers, subsidies are often the key to making these plans affordable. Premium Tax Credits directly reduce your monthly premium payment. If your income is below 250% FPL, you may also qualify for Cost-Sharing Reductions (CSRs) on Silver plans. CSRs lower your deductibles, copayments, and out-of-pocket maximums, making a Silver plan much more comprehensive and affordable than its standard tier might suggest. This effectively creates "Enhanced Silver" plans, which offer Gold-level coverage for Silver-level premiums. Highland County, part of Virginia Rating Area 5, is one of the state's most rural counties, with a population of 2,296 and an uninsured rate of 3.9% per U.S. Census Bureau ACS 2024 5-year estimates. Residents needing acute care travel to neighboring counties, as Highland County has no acute care hospitals within its boundaries. The median income here is $65,625, with a median age of 56.5 years.

Health Insurance Carriers in Highland County

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. This provides a robust selection of plans for residents of Highland County. The confirmed local carriers for Highland County in 2026 are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

These carriers offer a variety of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) structures. PPO plans ARE available on-exchange in Virginia, providing marketplace shoppers in Highland County with more flexibility in choosing healthcare providers. When comparing plans, it's important to review the specific network of doctors and hospitals for each plan to ensure your preferred providers are included, especially given the need to travel for acute care in Highland County.

Making Your Decision: How to Choose the Right Plan

Your best health insurance option depends largely on your income, health needs, and household situation. Here’s a general guide for part-time workers in Highland County:

If your income is below 138% FPL: You will likely qualify for Virginia Medicaid (FAMIS Plus). This offers comprehensive coverage with no premiums and minimal out-of-pocket costs. Apply through commonhelp.virginia.gov.
If your income is between 138% and 250% FPL: Focus on Silver plans on Marketplace Virginia. You'll qualify for both Premium Tax Credits to lower your monthly payments and Cost-Sharing Reductions (CSRs) to reduce your deductibles, copays, and out-of-pocket maximums. An Enhanced Silver plan often provides the best value in this income range.
If your income is between 250% and 400% FPL: You will qualify for Premium Tax Credits to lower your monthly premiums on Marketplace Virginia plans. Consider a Bronze plan if you want the lowest premium and don't anticipate many medical expenses, or a Gold plan if you prefer lower out-of-pocket costs when you do need care.
If your income is above 400% FPL: While you won't qualify for subsidies, you can still purchase a plan through Marketplace Virginia at full price. Compare Bronze, Silver, and Gold plans based on your expected healthcare usage and budget.

Remember that Open Enrollment is the primary time to enroll in an ACA plan, typically from November 1 to January 15 each year. However, certain life events, such as getting married, having a baby, or losing other coverage, can trigger a Special Enrollment Period (SEP), allowing you to enroll outside of Open Enrollment.

Frequently Asked Questions

What is the difference between an HMO, PPO, and EPO plan in Virginia?

Health Maintenance Organization (HMO) plans require you to choose a primary care provider (PCP) within the network and get referrals for specialists. Preferred Provider Organization (PPO) plans offer more flexibility, allowing you to see out-of-network providers for a higher cost and typically without a referral. Exclusive Provider Organization (EPO) plans are similar to HMOs in that they cover in-network care only, but often don't require a PCP referral for specialists. PPO plans are available on Marketplace Virginia in Highland County.

Can I apply for Virginia Medicaid online?

Yes, you can apply for Virginia Medicaid, including FAMIS Plus and FAMIS Moms, online through commonhelp.virginia.gov. This portal allows you to apply for various social services and benefits, including healthcare.

What if my income changes after I enroll in a marketplace plan?

It is crucial to report any changes in your income or household size to Marketplace Virginia as soon as possible. Changes can affect your eligibility for Premium Tax Credits and Cost-Sharing Reductions. Adjusting your information will ensure you receive the correct amount of financial assistance and avoid issues at tax time.

Are dental and vision plans included with ACA health insurance?

While all ACA-compliant plans cover pediatric dental and vision benefits as Essential Health Benefits, adult dental and vision coverage is not typically included in standard health plans. You can often purchase separate standalone dental and vision plans through Marketplace Virginia or directly from insurance carriers.