Sentara Health Plans in Tysons, Virginia
- Sentara Health Plans is one of 6 carriers offering individual and family health plans in Tysons, Virginia for the 2026 plan year.
- Marketplace Virginia (which uses HealthCare.gov) is where Tysons residents can compare and enroll in plans, potentially with subsidies.
- Virginia's Medicaid program covers adults with incomes up to 138% of the Federal Poverty Level and pregnant women up to 200% FPL.
- Tysons, located in Fairfax County, is part of Virginia Rating Area 1, which includes 17 other counties and cities.
Get Your Free Health Insurance Quote
A licensed agent can compare coverage options for you at no cost.
You're all set!
A licensed agent will reach out shortly.
What Are Your Health Insurance Options in Tysons, Virginia?
Residents of Tysons, Virginia, have several pathways to securing health insurance coverage, primarily through the Affordable Care Act (ACA) marketplace. Virginia operates a state-based marketplace using the federal platform, Marketplace Virginia, which allows individuals and families to compare plans and apply for financial assistance.For 2026, 6 carriers offer marketplace plans in Rating Area 1, which includes Tysons. These carriers provide a range of plan types, including HMO, PPO, and EPO options. Unlike some states, PPO plans are available on-exchange in Virginia, offering greater flexibility in provider choice. Depending on your household income, you may qualify for subsidies (Premium Tax Credits and Cost-Sharing Reductions) that significantly lower your monthly premiums and out-of-pocket costs.
Tysons, located in Fairfax County, is part of Virginia Rating Area 1. This rating area covers 18 counties and independent cities in total, including Alexandria, Arlington, Clarke, Culpeper, Fairfax, Falls Church, Fauquier, Frederick, Fredericksburg, Loudoun, Madison, Manassas, Manassas Park, Orange, Prince William, Rappahannock, and Warren counties. Inova Fairfax Hospital in Falls Church and Reston Hospital Center in Reston are among the major acute care facilities serving residents of Fairfax County and the broader Rating Area 1.
Sentara Health Plans and Other Carriers in Tysons
For the 2026 plan year, Tysons residents can choose from plans offered by 6 different health insurance carriers on Marketplace Virginia. Sentara Health Plans is one of these carriers, providing various options to meet different healthcare needs and budgets. It's important to compare plans not only by premium but also by deductible, out-of-pocket maximums, and provider networks to find the best fit for your situation.The confirmed carriers offering marketplace plans in Rating Area 1, which serves Tysons, Virginia, for 2026 are:
- CareFirst BlueChoice
- Cigna
- HealthKeepers
- Oscar Health
- Sentara Health Plans
- United Healthcare
When selecting a plan, consider whether your preferred doctors and hospitals, such as Inova Fairfax Hospital or Inova Fair Oaks Hospital, are in-network. Each carrier offers plans across different metal tiers (Bronze, Silver, Gold), with varying levels of coverage and cost-sharing. Bronze plans typically have lower premiums and higher deductibles, while Gold plans have higher premiums and lower out-of-pocket costs.
Understanding Financial Assistance and Virginia Medicaid
Affordable health insurance is within reach for many Tysons residents due to federal subsidies and Virginia's expanded Medicaid program.ACA Subsidies
Premium Tax Credits (PTCs) are available to individuals and families with household incomes between 100% and 400% of the Federal Poverty Level (FPL). These credits can be used to lower your monthly premium. For those with incomes between 100% and 250% FPL, Cost-Sharing Reductions (CSRs) may also be available on Silver plans, reducing deductibles, copayments, and coinsurance.Virginia Medicaid (FAMIS Plus)
Virginia expanded its Medicaid program in 2019, making coverage available to many more residents. Adults in Tysons with household incomes up to 138% of the FPL may qualify for Virginia Medicaid (also known as FAMIS Plus). This program offers comprehensive, low-cost or no-cost health coverage.For specific populations, Virginia also offers:
- FAMIS Moms: Covers pregnant women with household incomes up to 200% FPL, including prenatal care, labor, delivery, and 12 months of postpartum care. Applications can be submitted through commonhelp.virginia.gov.
- FAMIS (Children's Health Insurance Program - CHIP): Provides coverage for uninsured children in households with incomes up to 200% FPL.
- FAMIS Select: Offers low-cost coverage for children in families with incomes between 200% and 400% FPL.
Tysons, Virginia, has a population of 28,936 with a median household income of $129,818 and an uninsured rate of 5.0%, per U.S. Census Bureau ACS 2024 5-year estimates. Fairfax County, its parent county, serves a population of 1,147,837 and has a median income of $153,637. These figures highlight the diverse economic landscape and varying needs for affordable healthcare options in the region.
Choosing the Right Health Plan in Tysons
Selecting the best health plan involves considering several factors beyond just the carrier name, such as Sentara Health Plans. Here's how to approach your decision:- Assess Your Healthcare Needs: If you anticipate frequent doctor visits or have chronic conditions, a Gold plan with lower out-of-pocket costs might be more suitable, even with a higher premium. If you are generally healthy and prefer a lower monthly payment, a Bronze plan might work, but be prepared for higher costs if unexpected medical needs arise.
- Check Provider Networks: Ensure that your preferred doctors, specialists, and hospitals in Fairfax County, such as Fort Belvoir Community Hospital or Inova Mount Vernon Hospital, are part of the plan's network. This is especially crucial for HMO and EPO plans.
- Understand Costs: Compare premiums, deductibles, copayments, coinsurance, and annual out-of-pocket maximums. Remember that subsidies can significantly reduce your premium costs.
- Consider Plan Type: Decide between HMO, PPO, or EPO plans based on your preference for flexibility. PPO plans offer more freedom to see out-of-network providers (at a higher cost), while HMOs generally require referrals for specialists but often have lower overall costs.
A licensed health insurance producer can provide personalized guidance, helping you compare plans from Sentara Health Plans and other carriers, understand your subsidy eligibility, and enroll in a plan that meets your specific needs and budget. This assistance is typically provided at no cost to you.