Sentara Health Insurance Plans in Great Falls, 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 Great Falls, Virginia, for 2026.
Virginia operates Marketplace Virginia, which uses the federal platform HealthCare.gov for enrollment.
Marketplace shoppers in Great Falls can choose from HMO, PPO, and EPO plan structures in 2026.
Virginia expanded Medicaid, covering adults with income up to 138% of the Federal Poverty Level (FPL).

Navigating health insurance options in Great Falls, Virginia, often begins with identifying available carriers and their plan offerings. For 2026, Sentara Health Plans is a prominent option for residents of Great Falls, providing a range of health insurance solutions through Marketplace Virginia, which operates on HealthCare.gov. Understanding how Sentara Health Plans fits into the local market, alongside other carriers, is crucial for choosing the right coverage for your needs and budget. This article details Sentara's presence in Great Falls, outlines the broader marketplace landscape, and guides you through the enrollment process.

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Understanding Sentara Health Plans in Great Falls

Sentara Health Plans is a significant provider in Virginia's health insurance market, including Great Falls. As one of the six confirmed carriers in Virginia Rating Area 1 for the 2026 plan year, Sentara Health Plans offers Great Falls residents various plan options. These plans typically include different network structures such as Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, allowing individuals and families to select coverage that aligns with their preferred doctors and hospitals. Great Falls, located in Fairfax County, is part of Virginia Rating Area 1. This multi-county rating area also covers Alexandria, Arlington, Clarke, Culpeper, Falls Church, Fauquier, Frederick, Fredericksburg, Loudoun, Madison, Manassas, Manassas Park, Orange, Prince William, Rappahannock, and Warren counties. In 2026, the 15,228 residents of Great Falls, with a median age of 45.7 years and a low uninsured rate of 2.3% per U.S. Census Bureau ACS 2024 5-year estimates, have access to a competitive health insurance market.

Health Insurance Marketplace Options in Great Falls, Virginia

Residents of Great Falls seeking individual or family health insurance can access plans through Marketplace Virginia, the state's health insurance marketplace that utilizes the federal HealthCare.gov platform. This is the primary avenue for individuals to enroll in plans that may qualify for premium tax credits and cost-sharing reductions, making coverage more affordable. In Virginia, marketplace shoppers have a robust selection of plan types. Unlike some states, PPO plans ARE available on-exchange in Virginia, alongside HMO and EPO structures. This means consumers in Great Falls can choose a plan that offers more flexibility in provider choice if a PPO aligns with their needs. When evaluating plans, it's important to consider network size, deductible, out-of-pocket maximums, and prescription drug coverage. Virginia has expanded Medicaid, meaning adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for comprehensive, low-cost health coverage through Virginia Medicaid or FAMIS Plus. For pregnant women, Virginia Medicaid (FAMIS Moms) covers those with incomes up to 200% FPL, and FAMIS (Family Access to Medical Insurance Security) covers uninsured children up to 200% FPL.

Health Insurance Carriers in Great Falls

For the 2026 plan year, residents of Great Falls, Virginia, have a strong selection of carriers offering plans through Marketplace Virginia. In 2026, 6 carriers offer marketplace plans in Rating Area 1, which includes Great Falls. These carriers provide diverse options across different plan types and metal tiers (Bronze, Silver, Gold, Platinum):

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

Each carrier offers a range of plans, and it's advisable to compare their specific offerings, provider networks, and cost structures to find the best fit for your healthcare needs.

Hospitals and Healthcare Services in Fairfax County

Access to quality healthcare facilities is a key consideration when choosing a health plan. Great Falls is served by hospitals within Fairfax County. Fairfax County, with a population of 1,147,837 and a median income of $153,637 per U.S. Census Bureau ACS 2024 5-year estimates, is home to several major hospitals. These facilities provide a wide range of acute care and specialized medical services to residents across the county. The hospitals in Fairfax County include:

Fort Belvoir Community Hospital (Fort Belvoir)
Inova Fairfax Hospital (Falls Church)
Inova Fair Oaks Hospital (Fairfax)
Reston Hospital Center (Reston)
Inova Mount Vernon Hospital (Alexandria)

When selecting a Sentara Health Plan or any other plan, it is important to verify that your preferred doctors and any frequently used hospitals are within the plan's network.

Choosing the Right Health Plan in Great Falls

Selecting the ideal health plan in Great Falls involves more than just looking at the monthly premium. Consider your expected healthcare usage, preferred doctors, and financial situation.

If you expect high healthcare costs: A Gold or Platinum plan may be suitable, offering lower deductibles and out-of-pocket maximums in exchange for higher monthly premiums.
If you prefer a balance of costs: Silver plans are a popular choice, providing moderate premiums and out-of-pocket costs. If your income is below 250% FPL, you may also qualify for extra cost-sharing reductions on Silver plans, significantly lowering your out-of-pocket expenses.
If you are generally healthy: Bronze or Catastrophic plans (for those under 30 or with a hardship exemption) offer the lowest premiums but come with higher deductibles and out-of-pocket costs, primarily covering major medical emergencies.
If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus), which provides comprehensive coverage at little to no cost.

A licensed health insurance producer can provide personalized guidance, helping you compare plans from Sentara Health Plans and other carriers, understand subsidy eligibility, and navigate the enrollment process without any additional cost to you.

Frequently Asked Questions

Is Sentara Health Plans available in Great Falls, Virginia?

Yes, Sentara Health Plans is one of six confirmed carriers offering health insurance plans in Great Falls, Virginia, for the 2026 plan year. Great Falls is located in Virginia Rating Area 1, which Sentara Health Plans serves.

What types of plans does Sentara Health Plans offer in Virginia?

Sentara Health Plans typically offers a range of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans. The specific options available will vary by rating area and plan tier.

How do I enroll in a Sentara Health Plan in Great Falls?

You can enroll in a Sentara Health Plan through Marketplace Virginia, which uses HealthCare.gov. Enrollment typically occurs 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 agent can assist you for free.