Self-Employed Health Insurance in King and Queen County, Virginia

Updated July 2026 · VirginiaPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Self-employed individuals in King and Queen County can purchase health insurance through Marketplace Virginia / HealthCare.gov.
Virginia expanded Medicaid in 2019, covering adults with income up to 138% of the Federal Poverty Level (FPL).
Marketplace plans in King and Queen County include HMO, PPO, and EPO options, with 6 confirmed carriers for 2026.
Financial assistance (subsidies) is available to lower monthly premiums for those earning between 100% and 400% FPL.

For self-employed individuals in King and Queen County, Virginia, securing affordable health insurance is crucial, and fortunately, several robust options exist. The primary avenue for coverage is the Marketplace Virginia / HealthCare.gov, which offers a range of plans from private insurers with potential financial assistance. Virginia's expanded Medicaid program also provides a safety net for those with lower incomes, ensuring that essential healthcare is accessible. Understanding your income, health needs, and the types of plans available will help you navigate your choices effectively.

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What Are My Health Insurance Options as a Self-Employed Individual?

As a self-employed resident of King and Queen County, your main pathways to health insurance include the Affordable Care Act (ACA) marketplace, Medicaid, and potentially off-marketplace plans.

The ACA marketplace (Marketplace Virginia / HealthCare.gov) is designed to make health insurance more accessible and affordable. Plans purchased here are eligible for premium tax credits (subsidies) and cost-sharing reductions, which can significantly lower your monthly premiums and out-of-pocket costs. King and Queen County, 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, offers a variety of plan types, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs).

For individuals and families with lower incomes, Virginia Medicaid (also known as FAMIS Plus) is a critical resource. Virginia expanded Medicaid in 2019, meaning adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for comprehensive, low-cost or no-cost health coverage. This program is distinct from marketplace subsidies and offers a different path to care.

Understanding ACA Marketplace Plans and Subsidies

The ACA marketplace categorizes plans by "metal tiers" — Bronze, Silver, Gold, and Platinum — indicating the balance between monthly premiums and out-of-pocket costs.

Bronze Plans: These plans have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They are ideal if you anticipate minimal healthcare needs or want protection against catastrophic medical events.
Silver Plans: Offering moderate premiums and moderate out-of-pocket costs, Silver plans are a popular choice. Crucially, if your income is below 250% FPL, you may qualify for "cost-sharing reductions" (CSRs) that lower your deductibles, copayments, and out-of-pocket maximums, making Silver plans particularly valuable.
Gold Plans: With higher monthly premiums, Gold plans generally have lower deductibles and copayments. They are suitable if you expect to use healthcare services frequently and prefer predictable costs.

How Subsidies Work

Financial assistance through the ACA marketplace comes in two forms:

Premium Tax Credits (APTCs): These subsidies lower your monthly premium payments. Eligibility is based on household income, generally between 100% and 400% FPL. For 2026, enhanced subsidies remain in effect, making coverage more affordable across income levels.
Cost-Sharing Reductions (CSRs): Available only with Silver plans, CSRs reduce the amount you pay for deductibles, copayments, and coinsurance. You must earn between 100% and 250% FPL to qualify.

For example, a self-employed individual in King and Queen County earning $40,000 annually (approximately 267% FPL for an individual) would likely qualify for significant premium tax credits, reducing their monthly premium burden.

Virginia Medicaid and FAMIS Programs

Virginia's commitment to expanding access to healthcare is evident in its Medicaid and FAMIS programs.

Virginia Medicaid Expansion (FAMIS Plus): Since 2019, Virginia has expanded Medicaid to cover adults aged 19-64 with household incomes up to 138% FPL. This means a self-employed individual in King and Queen County earning up to approximately $20,783 (for 2026) could qualify for comprehensive health coverage with minimal or no out-of-pocket costs.
FAMIS (Family Access to Medical Insurance Security): This program provides low-cost health coverage for uninsured children up to 200% FPL. For children between 200% and 400% FPL, FAMIS Select offers low-cost coverage.
FAMIS Moms: Pregnant women in Virginia with household incomes up to 200% FPL are covered by Virginia Medicaid (FAMIS Moms). This includes prenatal care, labor and delivery, and 12 months of postpartum care. Applications can be submitted through commonhelp.virginia.gov.

These programs are vital for ensuring that low-income self-employed individuals and their families in King and Queen County have access to necessary medical care.

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. These carriers provide a range of plans across the metal tiers (Bronze, Silver, Gold) and plan types (HMO, PPO, EPO). The confirmed carriers for King and Queen County's Rating Area 8 are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When selecting a plan, it's important to review the network of each carrier to ensure your preferred doctors and any necessary specialists are included. King and Queen County, with a population of 6,695 per U.S. Census Bureau ACS 2024 5-year estimates, has no acute care hospitals within its boundaries, so residents typically travel to neighboring counties for acute care. This makes carrier network coverage and out-of-county access particularly important for residents.

Making Your Decision: Next Steps for Self-Employed Coverage

Choosing the right health insurance plan as a self-employed individual involves evaluating your income, health needs, and budget. Here's a general guide:

Household Income (as % FPL)	Recommended Action	Key Benefit
Below 138% FPL	Apply for Virginia Medicaid / FAMIS Plus	Comprehensive, low-cost or no-cost coverage
100% - 250% FPL	Consider Enhanced Silver plans on Marketplace Virginia / HealthCare.gov	Significant premium tax credits and cost-sharing reductions (lower deductibles/copays)
250% - 400% FPL	Explore Bronze, Silver, or Gold plans with premium tax credits on Marketplace Virginia / HealthCare.gov	Premium tax credits help lower monthly costs, allowing choice between cost/coverage levels
Above 400% FPL	Compare all metal tiers on Marketplace Virginia / HealthCare.gov or off-marketplace	Access to plans, but likely without premium subsidies

King and Queen County has a median income of $70,469 and an uninsured rate of 5.8%, per U.S. Census Bureau ACS 2024 5-year estimates. While this uninsured rate is relatively low, it highlights that many residents successfully navigate their health insurance choices. A licensed health insurance agent can provide personalized guidance, helping you compare plans, understand subsidy eligibility, and enroll in coverage that best fits your specific situation. Their services are typically free to you.

Frequently Asked Questions

Can I get health insurance if I'm self-employed in King and Queen County?

Yes, self-employed individuals in King and Queen County, Virginia, can purchase health insurance through the Marketplace Virginia / HealthCare.gov. You may qualify for subsidies to lower your monthly premiums based on your household income. Plans are available in HMO, PPO, and EPO structures.

What income level qualifies for Medicaid in Virginia?

Virginia expanded Medicaid in 2019. Adults in King and Queen County with a household income up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid or FAMIS Plus. For 2026, this threshold is approximately $20,783 for an individual.

How do I choose the best plan for self-employed health insurance?

When choosing a self-employed health insurance plan, consider your anticipated healthcare needs, budget, and preferred doctors. Bronze plans offer lower premiums but higher out-of-pocket costs, while Gold plans have higher premiums but lower deductibles and copays. Enhanced Silver plans provide additional savings if your income is below 250% FPL. A licensed agent can help you compare options.

Are PPO plans available on the Virginia health insurance marketplace?

Yes, PPO plans are available on the Marketplace Virginia / HealthCare.gov for residents of King and Queen County. In addition to PPO options, you can also choose from HMO and EPO plan structures, offering flexibility in how you access care.