Sentara Health Insurance Plans in Franklin County, Virginia

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

Sentara Health Plans is one of 6 confirmed carriers offering marketplace plans in Franklin County for 2026.
Franklin County is part of Virginia Rating Area 4, which includes 16 other counties across the region.
Virginia Medicaid (FAMIS Plus) covers adults up to 138% of the Federal Poverty Level (FPL) and pregnant women up to 200% FPL.
The uninsured rate in Franklin County is 6.8%, according to U.S. Census Bureau ACS 2024 5-year estimates.
You can choose from HMO, PPO, and EPO plans on Virginia's marketplace, including options from Sentara and other carriers.

Navigating health insurance options in Franklin County, Virginia, includes understanding plans from carriers like Sentara Health Plans, which offers coverage through Virginia's official health insurance marketplace. As a resident of Franklin County, you have access to a variety of plans, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) structures, with financial assistance available based on your household income. This article will guide you through your options for securing health coverage in Franklin County, focusing on Sentara Health Plans and other available marketplace choices.

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What Are My Health Insurance Options in Franklin County, VA?

Residents of Franklin County, Virginia, primarily access health insurance through the Affordable Care Act (ACA) marketplace, also known as HealthCare.gov or Marketplace Virginia. This platform allows individuals and families to compare plans, apply for subsidies to lower monthly premiums and out-of-pocket costs, and enroll in coverage. In 2026, Franklin County is served by 6 confirmed carriers offering marketplace plans. Virginia's marketplace is robust, offering a choice of HMO, PPO, and EPO plans. This means you are not limited to managed care networks and can often find plans that allow for out-of-network care, depending on the specific plan's structure and your preferences. For individuals and families with lower incomes, Virginia's Medicaid expansion provides a critical safety net. Adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (FAMIS Plus), which offers comprehensive health coverage with no premiums. Pregnant women and children also have specific Medicaid and CHIP programs with higher income thresholds, up to 200% FPL, ensuring access to essential care.

Sentara Health Plans and Other Marketplace Carriers in Franklin County

Franklin County is part of Virginia Rating Area 4, which covers Chesapeake, Franklin, Franklin, Hampton, Isle of Wight, James City, Newport News, Norfolk, Northampton, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York counties. In 2026, 6 carriers offer marketplace plans in Rating Area 4, including Sentara Health Plans. The confirmed carriers for Franklin County's Rating Area 4 are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

Each of these carriers offers a range of plans across different metal tiers (Bronze, Silver, Gold), allowing you to choose a plan that balances monthly premiums with out-of-pocket costs like deductibles, copayments, and coinsurance. Sentara Health Plans provides various options designed to meet diverse healthcare needs, from basic coverage to more comprehensive plans. Franklin County's Carilion Franklin Memorial Hospital in Rocky Mount is an acute care facility serving the community. When selecting a plan, it is crucial to verify that your preferred doctors and any necessary specialists are included in the plan's network, especially if you have existing relationships with providers at Carilion Franklin Memorial Hospital or other facilities.

Understanding Financial Assistance and Eligibility

The ACA marketplace offers subsidies to make health insurance more affordable. These subsidies come in two main forms:

Premium Tax Credits (PTC): These reduce your monthly premium payments. Eligibility is based on household income relative to the Federal Poverty Level (FPL). You may qualify if your income is between 100% and 400% FPL.
Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs like deductibles, copayments, and coinsurance. CSRs are available only with Silver-tier plans and are for individuals with incomes between 100% and 250% FPL.

For those with incomes below 138% FPL, Virginia Medicaid (FAMIS Plus) offers comprehensive coverage. Pregnant women in Virginia can access FAMIS Moms if their income is up to 200% FPL, and children are covered by FAMIS or FAMIS Select up to 200% FPL and 400% FPL respectively. You can apply for these programs through commonhelp.virginia.gov. Franklin County has a population of 55,130 with a median household income of $68,849 and a poverty rate of 12.7%, per U.S. Census Bureau ACS 2024 5-year estimates. The uninsured rate is 6.8%, which is below the national average. These statistics highlight the importance of accessible and affordable health insurance options for the county's diverse residents.

Choosing the Right Plan: What to Consider

When selecting a health insurance plan in Franklin County, consider these factors:

Network: Check if your preferred doctors, specialists, and hospitals (like Carilion Franklin Memorial Hospital) are in the plan's network. HMOs and EPOs typically have more restricted networks than PPOs.
Metal Tier: Bronze plans have low premiums but high deductibles. Silver plans offer a balance and are the only tier eligible for Cost-Sharing Reductions. Gold plans have higher premiums but lower out-of-pocket costs.
Prescription Drug Coverage: Review the plan's formulary to ensure your necessary medications are covered and understand their cost-sharing structure.
Out-of-Pocket Maximum: This is the most you will pay for covered services in a plan year. A lower out-of-pocket maximum can provide greater financial protection in case of serious illness or injury.

A licensed health insurance producer can help you compare plans from Sentara Health Plans and other carriers, explain subsidy eligibility, and guide you through the enrollment process at no cost to you.

Frequently Asked Questions

Can I get Sentara Health Plans through HealthCare.gov in Franklin County?

Yes, Sentara Health Plans is one of 6 carriers offering marketplace plans in Virginia Rating Area 4, which includes Franklin County, for the 2026 plan year. You can enroll in Sentara plans and other options through HealthCare.gov.

What types of plans does Sentara Health Plans offer in Franklin County?

Sentara Health Plans, like other carriers in Virginia's marketplace, typically offers a range of plan types including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. The specific availability and structure depend on the individual plan offerings for your ZIP code.

What income qualifies for Medicaid in Virginia?

Virginia expanded Medicaid in 2019. Adults with household income up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid, also known as FAMIS Plus. For example, in 2024, 138% FPL for an individual was approximately $20,783 annually.

Are PPO plans available on Virginia's marketplace?

Yes, unlike some states, PPO plans are available on-exchange through Virginia's marketplace. In Rating Area 4, which covers Franklin County, carriers like Cigna, HealthKeepers Plus, and United Healthcare offer PPO options alongside HMO and EPO plans.