Sentara Health Insurance Plans in Montgomery County, Virginia

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

Sentara Health Plans is one of 6 carriers offering Marketplace Virginia plans in Rating Area 5 for 2026.
Montgomery County residents may choose from HMO, PPO, and EPO plan structures available on-exchange.
Individuals with incomes between 100% and 400% of the Federal Poverty Level (FPL) may qualify for significant premium subsidies.
Virginia Medicaid (FAMIS Plus) covers adults up to 138% FPL, with pregnant women covered up to 200% FPL (FAMIS Moms).

Navigating health insurance options in Montgomery County, Virginia, can be simplified by understanding the local market, especially for specific carriers like Sentara Health Plans. For 2026, Sentara Health Plans is among the six health insurance carriers providing coverage through Marketplace Virginia (HealthCare.gov) in Rating Area 5, which includes Montgomery County. Residents have access to a variety of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, allowing for flexibility in network choice. Financial assistance, such as premium tax credits and cost-sharing reductions, is widely available to eligible individuals and families, making comprehensive coverage more affordable.

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What Sentara Health Plan Options Are Available in Montgomery County?

Sentara Health Plans offers a range of health insurance plans designed to meet diverse needs in Montgomery County. When you shop for a Sentara Health Plan on Marketplace Virginia, you will typically find plans categorized by metal tiers: Bronze, Silver, Gold, and Platinum. Each tier represents a different balance between monthly premiums and out-of-pocket costs, such as deductibles, copayments, and coinsurance. Bronze Plans: These plans have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They are suitable for individuals who expect to use healthcare services infrequently and want protection against catastrophic medical costs. Silver Plans: Offering a moderate balance of premiums and out-of-pocket costs, Silver plans are particularly valuable for individuals and families who qualify for cost-sharing reductions. These subsidies can significantly lower deductibles, copayments, and coinsurance, making Silver plans the best value for many. Gold Plans: With higher monthly premiums than Bronze or Silver, Gold plans come with lower deductibles and out-of-pocket costs. They are a good choice for those who anticipate needing regular medical care and prefer to pay more upfront for more predictable costs throughout the year. Catastrophic Plans: Available to individuals under 30 or those with a hardship exemption, these plans have very high deductibles and are primarily for emergency coverage, offering basic protection. Montgomery County, part of Virginia 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, has a population of 99,101 and an uninsured rate of 4.8% per U.S. Census Bureau ACS 2024 5-year estimates. This county context highlights the importance of accessible and affordable health insurance options like those offered by Sentara Health Plans.

Understanding Financial Assistance for Sentara Health Plans

The Affordable Care Act (ACA) provides significant financial assistance to make health insurance affordable. In Montgomery County, residents can access these subsidies through Marketplace Virginia.

Premium Tax Credits

Premium tax credits, also known as subsidies, reduce your monthly premium payment. Eligibility is based on your household income relative to the Federal Poverty Level (FPL).

Household Income (as % of FPL)	Assistance Type	Benefit
Below 138% FPL	Virginia Medicaid (FAMIS Plus)	Comprehensive, low-cost or no-cost coverage.
100% - 400% FPL	Premium Tax Credits	Reduces monthly health insurance premiums.
Above 400% FPL	No automatic subsidies	May still find affordable plans; subsidies cap removed for 2021-2025.

For a family of four in 2026, 138% FPL is approximately $43,060, while 400% FPL is roughly $124,800. These figures are subject to annual adjustments.

Cost-Sharing Reductions (CSRs)

Cost-sharing reductions help lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. These are only available with Silver-tier plans and are tied to income.

Household Income (as % of FPL)	CSR Level	Benefit
100% - 150% FPL	Highest CSRs	Significant reduction in deductibles, copayments, and out-of-pocket maximums.
150% - 200% FPL	Moderate CSRs	Substantial reduction in out-of-pocket costs.
200% - 250% FPL	Lower CSRs	Modest reduction in out-of-pocket costs.

If your income falls into these ranges, choosing a Silver plan from Sentara Health Plans will provide the most comprehensive financial protection.

Health Insurance Carriers in Montgomery County

In 2026, 6 carriers offer marketplace plans in Rating Area 5, which includes Montgomery County. Sentara Health Plans is one of these options, providing competitive health insurance coverage to local residents. The full list of confirmed carriers for this rating area includes:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When selecting a Sentara Health Plan or any other carrier, it is important to review the specific plan details, network of providers, and prescription drug coverage to ensure it aligns with your healthcare needs. Montgomery County's two acute care hospitals, Carilion New River Valley Medical Center in Christiansburg and Lewisgale Hospital Montgomery in Blacksburg, are critical facilities for local healthcare. It is advisable to confirm their in-network status with any plan you consider.

Choosing the Right Sentara Health Plan in Montgomery County

Deciding on the best Sentara Health Plan involves considering your specific health needs, financial situation, and preferred doctors and facilities.

Assess Your Healthcare Needs: If you anticipate frequent doctor visits, ongoing prescriptions, or specific medical conditions, a Gold or enhanced Silver plan might offer better value despite higher premiums. If you are generally healthy and primarily need coverage for emergencies, a Bronze plan could be more cost-effective.
Check Provider Networks: Ensure that your preferred doctors, specialists, and local hospitals, such as Carilion New River Valley Medical Center and Lewisgale Hospital Montgomery, are included in the Sentara Health Plan's network. This is especially important for HMO and EPO plans, which have more restricted networks than PPO plans.
Evaluate Total Costs: Look beyond just the monthly premium. Consider the deductible, copayments, coinsurance, and the out-of-pocket maximum. The lowest premium doesn't always mean the lowest total cost if you use medical services frequently.
Utilize Subsidies: If your household income is between 100% and 400% FPL, apply for premium tax credits. If your income is below 250% FPL, strongly consider a Silver plan to benefit from cost-sharing reductions, which significantly reduce your out-of-pocket expenses.

For Montgomery County residents whose income is below 138% FPL, Virginia Medicaid (FAMIS Plus) offers a robust and often no-cost healthcare option. Pregnant women are covered up to 200% FPL through FAMIS Moms, and children up to 200% FPL through FAMIS.

Frequently Asked Questions

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

Sentara Health Plans typically offer a range of plan types, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans in Virginia. These plans are available on the Marketplace Virginia, allowing you to choose the network structure that best fits your healthcare needs.

Can I get financial assistance for Sentara Health Plans in Montgomery County?

Yes, individuals and families in Montgomery County may qualify for premium tax credits and cost-sharing reductions when enrolling in a Sentara Health Plan through Marketplace Virginia. Eligibility for these subsidies is based on household income relative to the Federal Poverty Level (FPL), with subsidies available for incomes between 100% and 400% FPL.

Does Sentara Health Plans cover services at local Montgomery County hospitals?

Coverage for services at local hospitals like Carilion New River Valley Medical Center and Lewisgale Hospital Montgomery depends on your specific Sentara Health Plan's network. It is crucial to verify if these facilities and your preferred doctors are in-network with the Sentara plan you select before enrolling to ensure seamless access to care.

What is the enrollment period for Sentara Health Plans in Montgomery County?

Open Enrollment for 2026 plans typically runs from November 1st to January 15th each year. Outside of this period, you may qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event, such as losing other coverage, getting married, having a baby, or moving to Montgomery County.