Sentara Health Insurance Plans in Tazewell County, Virginia
- In 2026, Sentara Health Plans is one of 6 carriers offering Marketplace plans in Virginia Rating Area 6, which includes Tazewell County.
- Tazewell County residents may choose from HMO, PPO, and EPO plan types on Marketplace Virginia / HealthCare.gov.
- Individuals with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Virginia Medicaid (FAMIS Plus).
- Tazewell County's population is 39,624, with an uninsured rate of 4.1% per U.S. Census Bureau ACS 2024 5-year estimates.
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What Sentara Health Plan Options Are Available in Tazewell County?
Sentara Health Plans provides various health insurance options for residents of Tazewell County, Virginia, through the state's health insurance marketplace. As part of Virginia Rating Area 6, which covers Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, Washington, and Wise counties, Sentara Health Plans offers a selection of plan types. These include Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans, allowing consumers to choose based on their preferences for network flexibility and cost structure. When selecting a plan, it is crucial to consider the provider network, which includes primary care physicians, specialists, and hospitals. Tazewell County is served by Clinch Valley Medical Center in Richlands and Carilion Tazewell Community Hospital in Tazewell. Sentara Health Plans' network will include a specific set of local providers; checking that your preferred doctors and these local hospitals are in-network is a critical step before enrolling.Can You Get Financial Help for Sentara Health Plans in Tazewell County?
Many Tazewell County residents qualify for financial assistance to lower the cost of their health insurance premiums and out-of-pocket expenses. Virginia has an expanded Medicaid program, and subsidies are available on the Marketplace for those who qualify.Advance Premium Tax Credits (APTCs)
Advance Premium Tax Credits (APTCs) are government subsidies that reduce your monthly health insurance premiums. Eligibility is based on your household income relative to the Federal Poverty Level (FPL). In Virginia, if your income falls between 100% and 400% FPL, you are likely to qualify for APTCs. These credits can be applied directly to your premium each month, making plans from Sentara Health Plans and other carriers significantly more affordable.Cost-Sharing Reductions (CSRs)
For individuals and families with incomes up to 250% FPL, Cost-Sharing Reductions (CSRs) are available. These subsidies reduce the amount you pay for deductibles, copayments, and coinsurance. CSRs are only available on Silver-tier plans, making these plans a particularly strong value for eligible individuals, as they offer enhanced benefits beyond standard Silver plans.Virginia Medicaid (FAMIS Plus and FAMIS Moms)
Virginia expanded its Medicaid program in 2019, meaning adults with household incomes up to 138% FPL may qualify for comprehensive, low-cost or no-cost health coverage through Virginia Medicaid, also known as FAMIS Plus. This program provides extensive benefits, including doctor visits, hospital stays, prescription drugs, and mental health services. Additionally, pregnant women in Virginia with incomes up to 200% FPL can qualify for Virginia Medicaid (FAMIS Moms), which covers prenatal care, labor and delivery, and 12 months of postpartum care. Children in households up to 200% FPL are covered by FAMIS (Family Access to Medical Insurance Security), with FAMIS Select offering low-cost coverage for children between 200% and 400% FPL. Applications for these programs can be submitted through commonhelp.virginia.gov.Health Insurance Carriers in Tazewell County
Tazewell County, with a population of 39,624 and an uninsured rate of 4.1% per U.S. Census Bureau ACS 2024 5-year estimates, is part of Virginia Rating Area 6. This rating area ensures that residents across Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, Washington, and Wise counties have access to competitive health insurance options. In 2026, 6 carriers offer marketplace plans in Rating Area 6. These carriers provide a range of plans, including HMO, PPO, and EPO options, allowing consumers to compare benefits, networks, and costs. The confirmed carriers for Tazewell County are:- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
Making the Right Choice for Your Health Coverage in Tazewell County
Choosing the best health insurance plan involves evaluating your specific health needs, financial situation, and preferred access to care. Here's a decision-making guide for Tazewell County residents:| Your Situation | Recommended Action | Key Consideration |
|---|---|---|
| Income up to 138% FPL (e.g., ~$20,120 for an individual in 2026) | Apply for Virginia Medicaid (FAMIS Plus) through commonhelp.virginia.gov. | Comprehensive coverage with minimal or no premiums and out-of-pocket costs. |
| Income 100% - 400% FPL (e.g., ~$20,120 - ~$80,480 for an individual in 2026) | Explore plans on Marketplace Virginia / HealthCare.gov; utilize Advance Premium Tax Credits. | APTCs significantly lower monthly premiums. Consider Silver plans for potential Cost-Sharing Reductions if income is below 250% FPL. |
| Income above 400% FPL | Compare plans on Marketplace Virginia / HealthCare.gov or explore off-exchange options. | You will pay the full premium, but can still benefit from the consumer protections of the Affordable Care Act (ACA). |
| Pregnant or have children | Check eligibility for FAMIS Moms (up to 200% FPL for pregnant women) or FAMIS/FAMIS Select (up to 400% FPL for children). | Virginia offers robust programs for maternal and child health coverage. |
| Need specific doctors or hospitals | Verify network inclusion for Clinch Valley Medical Center, Carilion Tazewell Community Hospital, and your preferred providers. | Ensure your chosen Sentara Health Plan or other carrier includes your essential providers. |
Frequently Asked Questions
What types of Sentara Health Plans are available in Tazewell County?
Sentara Health Plans offers a variety of health insurance options in Tazewell County, Virginia, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) plans through the Marketplace Virginia / HealthCare.gov. The specific plan designs and networks vary by year and rating area.
Can I get a subsidy for Sentara Health Plans in Tazewell County?
Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for Advance Premium Tax Credits (APTCs) to lower your monthly premiums for Sentara Health Plans or other carriers available on Marketplace Virginia / HealthCare.gov. Individuals and families with incomes up to 150% FPL may also qualify for Cost-Sharing Reductions (CSRs) on Silver plans, further reducing out-of-pocket costs.
How do I enroll in a Sentara Health Plan in Tazewell County?
Enrollment in Sentara Health Plans for Tazewell County typically occurs during the annual Open Enrollment Period (OEP) via Marketplace Virginia / HealthCare.gov. If you experience a Qualifying Life Event (QLE) outside of OEP, such as losing other coverage, marriage, or having a baby, you may be eligible for a Special Enrollment Period (SEP). A licensed health insurance producer can assist you with understanding your options and completing the enrollment process at no cost.
What hospitals are in Tazewell County for Sentara Health Plan members?
Tazewell County is served by two acute care hospitals: Clinch Valley Medical Center in Richlands and Carilion Tazewell Community Hospital in Tazewell. When selecting a Sentara Health Plan, it is important to verify that your preferred doctors and hospitals are within the plan's network to ensure covered care.