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

Sentara Health Insurance Plans in Augusta County, Virginia

Sentara Health Plans is one of 6 carriers offering marketplace plans in Augusta County's Rating Area 7 for 2026.
Augusta County residents can choose from HMO, PPO, and EPO plan types on Marketplace Virginia (HealthCare.gov).
Individuals and families with incomes up to 400% FPL may qualify for subsidies to reduce Sentara Health Plans premiums.
Virginia Medicaid (FAMIS Plus) covers adults up to 138% FPL, and pregnant women up to 200% FPL, providing comprehensive, low-cost options.

Navigating health insurance options in Augusta County, Virginia, involves understanding the plans available through Marketplace Virginia (HealthCare.gov). Sentara Health Plans is a prominent carrier offering coverage in this region, providing a range of choices for individuals and families. This article focuses on Sentara's offerings, how they fit into the broader Virginia marketplace, and what Augusta County residents need to know to secure coverage for 2026.

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 Sentara Health Plans Are Available in Augusta County for 2026?

In Augusta County, Sentara Health Plans participates in Rating Area 7, offering various health insurance options through Marketplace Virginia (HealthCare.gov). For 2026, Augusta County residents, along with those in Buena Vista, Harrisonburg, Lexington, Page, Rockbridge, Rockingham, Shenandoah, Staunton, and Waynesboro counties, have access to plans from Sentara Health Plans. Typically, Sentara Health Plans offers a mix of Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. PPO plans are available on-exchange in Virginia, giving consumers more flexibility in provider choice compared to states where only HMO/EPO options are subsidized. When selecting a Sentara Health Plan, it is essential to review the specific plan's network to ensure your preferred doctors and hospitals, such as Augusta Health in Fishersville, are included.

Augusta County's 78,033 residents, with a median age of 45.1 years, face an uninsured rate of 6.6% per U.S. Census Bureau ACS 2024 5-year estimates. This rate is identical to the county's poverty rate, highlighting the importance of accessible and affordable health insurance options like those offered by Sentara Health Plans. Augusta Health, the county's single acute care hospital in Fishersville, serves as a critical healthcare hub for the region.

How Do Subsidies Affect Sentara Health Plan Costs in Augusta County?

Affordability is a key factor when choosing health insurance, and federal subsidies can significantly reduce the cost of Sentara Health Plans purchased through Marketplace Virginia. These subsidies come in two main forms:

Advanced Premium Tax Credits (APTCs): These reduce your monthly premium. Eligibility is based on household income relative to the Federal Poverty Level (FPL). In Virginia, individuals and families with incomes between 100% and 400% FPL typically qualify for APTCs.
Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs like deductibles, copayments, and coinsurance. CSRs are available for those with incomes up to 250% FPL who enroll in a Silver-tier plan.

For example, a single person in Augusta County earning $35,000 per year (well within the subsidy range) would likely qualify for substantial premium tax credits, making a Sentara Health Plan much more affordable than the sticker price. It's important to accurately report your income during the application process to receive the correct amount of financial assistance.

Virginia Medicaid and CHIP Eligibility

Virginia expanded Medicaid in 2019 (Virginia Medicaid Expansion / FAMIS Plus). Adults with income up to 138% FPL may qualify for comprehensive, low-cost health coverage. Unlike non-expansion states, Virginia does not have a "coverage gap" for those below 100% FPL. Additionally, Virginia Medicaid (FAMIS Moms) covers pregnant women with income up to 200% FPL, including prenatal, 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. These programs provide vital safety nets for vulnerable populations in Augusta County.

Health Insurance Carriers in Augusta County

Augusta County is part of Virginia Rating Area 7. In 2026, 6 carriers offer marketplace plans in Rating Area 7, providing a competitive landscape for consumers. These carriers include:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

This selection allows Augusta County residents to compare plans from multiple providers, considering factors like network, benefits, and costs, to find the best fit for their healthcare needs. A licensed health insurance producer can help you compare plans and understand the differences between carriers.

Choosing the Right Sentara Health Plan in Augusta County

Selecting a Sentara Health Plan, or any other plan, requires considering your healthcare needs, budget, and preferred providers. Here's a decision-making framework:

Assess your healthcare usage: If you expect frequent doctor visits or need specific prescriptions, a plan with lower deductibles and copays (like a Gold or Silver plan with CSRs) might be more cost-effective, even with a higher premium. If you only anticipate preventive care, a Bronze or Catastrophic plan might suffice, especially if you qualify for subsidies.
Verify network compatibility: Ensure that your current doctors, specialists, and the local Augusta Health hospital are in-network with the Sentara Health Plan you are considering. Out-of-network care can be significantly more expensive.
Consider your income and subsidies: Use the Marketplace Virginia (HealthCare.gov) tool or consult with an agent to accurately estimate your subsidies. Your eligibility for APTCs and CSRs will heavily influence the true cost of your plan.
Understand plan types (HMO, PPO, EPO): HMOs typically require a primary care physician and referrals for specialists. PPOs offer more flexibility to see out-of-network providers (at a higher cost) and usually don't require referrals. EPOs are similar to HMOs but don't require referrals, though out-of-network care is generally not covered.

A licensed health insurance producer can provide personalized guidance, helping you compare Sentara Health Plans and other options available in Augusta County to find the coverage that best meets your needs and budget. This service is free for consumers.

Frequently Asked Questions

What types of Sentara Health Plans are available in Augusta County?

Sentara Health Plans typically offers a range of plan types, including HMO and PPO options, on the Marketplace Virginia (HealthCare.gov) in Augusta County. Specific plan availability can vary by year and rating area, but these structures are commonly available.

Can I get a subsidy for Sentara Health Plans in Augusta County?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for Advanced Premium Tax Credits (APTCs) to lower your monthly premiums for Sentara Health Plans purchased through Marketplace Virginia. Cost-sharing reductions (CSRs) may also be available for those with incomes up to 250% FPL who choose Silver plans.

How do I enroll in a Sentara Health Plan in Augusta County, Virginia?

Enrollment for Sentara Health Plans in Augusta County is primarily done through Marketplace Virginia, which uses HealthCare.gov. You can apply during the annual Open Enrollment Period or if you qualify for a Special Enrollment Period due to a life event like marriage, birth, or loss of other coverage. A licensed health insurance producer can assist you with the application process at no cost.

Does Sentara Health Plans cover Augusta Health in Fishersville?

Network coverage varies by specific plan. When selecting a Sentara Health Plan, it is crucial to verify that your preferred providers, including Augusta Health in Fishersville, are in-network. You can check the plan's provider directory or confirm with Sentara Health Plans directly before enrolling.