Sentara Health Insurance Plans in Richmond County, VA
- Sentara Health Plans is one of six carriers offering Affordable Care Act (ACA) marketplace plans in Richmond County for 2026.
- Richmond County is part of Virginia Rating Area 3, which includes 12 other counties in the region.
- Virginia expanded Medicaid in 2019, covering adults with incomes up to 138% of the Federal Poverty Level (FPL).
- The uninsured rate in Richmond County is 5.2%, significantly lower than the national average.
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What Health Insurance Options Are Available in Richmond County?
Residents of Richmond County, Virginia, can choose from a range of health insurance options designed to fit various budgets and healthcare needs. The primary source for individual and family coverage is Marketplace Virginia, where plans are offered by private insurance companies and may be eligible for federal subsidies, known as Advance Premium Tax Credits (APTCs), to help reduce monthly premiums. Cost-sharing reductions (CSRs) are also available for those with lower incomes who enroll in Silver-tier plans. In Virginia, marketplace plans include Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) structures. This means consumers in Richmond County can select a plan that aligns with their preference for network flexibility and whether they need referrals to see specialists. The fact sheet indicates that PPO plans ARE available on-exchange in Virginia, providing more choice than in some other states. Richmond County itself is a rural area with a population of 9,095, per U.S. Census Bureau ACS 2024 5-year estimates. While the county itself does not host large medical centers, residents have access to acute care hospitals in the broader Richmond area, such as Medical College of Virginia Hospitals and Bon Secours St Marys Hospital. The county's median income is $66,304, and its uninsured rate stands at 5.2%, reflecting relatively good access to coverage compared to national figures.Sentara Health Plans in Richmond County
Sentara Health Plans is a prominent carrier offering health insurance options through Marketplace Virginia, serving residents of Richmond County and the surrounding region. For the 2026 plan year, Sentara Health Plans is one of six confirmed carriers participating in Rating Area 3, which encompasses Richmond County. This provides consumers with a competitive selection of plans, often including a variety of metal tiers (Bronze, Silver, Gold, and Platinum) and plan types like HMOs and PPOs. When considering Sentara Health Plans or any other carrier, it is important to evaluate the plan's specific network of doctors, hospitals, and specialists, as well as its formulary for prescription drugs. While Sentara Health Plans generally offers comprehensive coverage, individual plans within their offerings will vary in terms of deductibles, copayments, and out-of-pocket maximums.Other Health Insurance Carriers in Richmond County
In 2026, 6 carriers offer marketplace plans in Rating Area 3, which covers Charles City, Chesterfield, Colonial Heights, Dinwiddie, Goochland, Hanover, Henrico, Hopewell, New Kent, Petersburg, Powhatan, and Richmond counties. This ensures a competitive marketplace with multiple options for residents of Richmond County. The confirmed carriers for this rating area are:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Virginia Medicaid and FAMIS Programs
Virginia expanded its Medicaid program in 2019, making coverage available to more low-income adults. In Richmond County, adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid, also known as FAMIS Plus. This means that individuals earning between 100% and 138% FPL are eligible for Medicaid, rather than falling into a "coverage gap" as in non-expansion states. Beyond general adult coverage, Virginia offers specific programs for pregnant women and children:- FAMIS Moms: Virginia Medicaid covers pregnant women with household incomes up to 200% FPL. This comprehensive coverage includes prenatal care, labor and delivery, and 12 months of postpartum care, extended under the American Rescue Plan and adopted by Virginia. Applications can be submitted through commonhelp.virginia.gov.
- FAMIS (Family Access to Medical Insurance Security): This program provides health coverage for uninsured children in households with incomes up to 200% FPL. For children in families with incomes between 200% and 400% FPL, FAMIS Select offers low-cost coverage options.
How to Choose the Right Health Plan in Richmond County
Choosing a health plan requires careful consideration of your healthcare needs, financial situation, and preferred providers. Here’s a guide to help Richmond County residents make an informed decision:| Your Situation | Recommended Action | Key Considerations |
|---|---|---|
| Income below 138% FPL | Apply for Virginia Medicaid (FAMIS Plus) | Comprehensive coverage with no premiums or deductibles for eligible adults. Check eligibility at commonhelp.virginia.gov. |
| Income 138% - 250% FPL | Explore Silver plans with Cost-Sharing Reductions (CSRs) | You'll likely qualify for significant subsidies, reducing both premiums and out-of-pocket costs (deductibles, copays). Silver plans offer the best value. |
| Income 250% - 400% FPL | Consider Bronze or Silver plans with Premium Tax Credits | You'll qualify for premium subsidies. Balance lower premiums (Bronze) with better coverage (Silver). Look at deductibles and out-of-pocket maximums. |
| Income above 400% FPL | Evaluate all metal tiers (Bronze, Silver, Gold, Platinum) | You'll pay full price for premiums but can still benefit from ACA protections. Compare plans based on network, deductibles, and anticipated medical use. |
| Need specific doctors/hospitals | Verify network coverage before enrolling | Use the carrier's provider search tool (e.g., Sentara Health Plans' website) to ensure your preferred doctors and any local hospitals like Medical College of Virginia Hospitals are in-network. |
Frequently Asked Questions
Can I get Sentara Health Plans in Richmond County, VA?
Yes, Sentara Health Plans is one of six carriers offering marketplace health insurance plans in Rating Area 3, which includes Richmond County, for the 2026 plan year.
What types of plans does Sentara Health Plans offer in Virginia?
Sentara Health Plans, like other marketplace carriers in Virginia, typically offers a range of plan types including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, allowing consumers to choose based on their network and referral preferences.
What is the income limit for Virginia Medicaid in Richmond County?
Virginia expanded Medicaid in 2019, meaning adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify. For a single individual in 2026, this threshold is approximately $20,783 per year.
How do I apply for health insurance in Richmond County?
You can apply for marketplace health insurance plans, including those from Sentara Health Plans, through Marketplace Virginia, which uses the HealthCare.gov platform. Licensed agents are also available to assist you in comparing plans and enrolling at no cost.