Sentara Health Insurance Plans in Washington County, Virginia

Sentara Health Plans is one of 6 carriers offering marketplace plans in Washington County's Rating Area 6 for 2026.
Virginia's marketplace, Marketplace Virginia / HealthCare.gov, offers HMO, PPO, and EPO plan types.
Adults in Virginia with incomes up to 138% FPL qualify for Virginia Medicaid (FAMIS Plus).
Washington County has a population of 53,926 and an uninsured rate of 6.7%, per U.S. Census Bureau ACS 2024 5-year estimates.

If you're looking for health insurance in Washington County, Virginia, Sentara Health Plans is a prominent option available through Marketplace Virginia, the state's official health insurance exchange on HealthCare.gov. Residents of Washington County, like those in neighboring Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, and Wise counties, are part of Virginia Rating Area 6. This means you have access to a competitive marketplace where six different carriers offer a range of plan types, including HMOs, PPOs, and EPOs, with potential subsidies to lower your monthly premiums. Understanding your income, health needs, and local provider networks is key to choosing the right plan.

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What Are Your Health Insurance Options in Washington County?

Residents of Washington County have several pathways to obtaining health coverage, primarily through the Affordable Care Act (ACA) marketplace, employer-sponsored plans, or Virginia's robust Medicaid program. For individuals and families seeking coverage on their own, the Marketplace Virginia / HealthCare.gov platform is the primary resource. On the marketplace, plans are categorized into metal tiers: Bronze, Silver, Gold, and Platinum. These tiers indicate how you and your plan share costs, not the quality of care.

Bronze plans: Offer the lowest monthly premiums but have the highest deductibles and out-of-pocket maximums. They cover 60% of costs on average, with you paying 40%.
Silver plans: Have moderate premiums and deductibles. They cover 70% of costs on average, with you paying 30%. Crucially, if you qualify for cost-sharing reductions (CSRs), Silver plans offer extra savings on deductibles, copayments, and coinsurance.
Gold plans: Feature higher monthly premiums but lower deductibles and out-of-pocket costs. They cover 80% of costs on average, with you paying 20%.

In Virginia, consumers shopping on the marketplace can choose from HMO, PPO, and EPO plan types. PPO plans are available on-exchange, providing more flexibility in choosing providers outside a specific network compared to HMOs, which typically require you to stay within a defined network.

Sentara Health Plans Availability in Washington County

Sentara Health Plans is one of the carriers actively participating in Virginia's health insurance marketplace for Washington County. As part of Rating Area 6, which covers Bristol, Buchanan, Dickenson, Lee, Norton, Russell, Scott, Tazewell, Washington, and Wise counties, Sentara Health Plans offers various options designed to meet different needs and budgets. When considering a Sentara Health Plan, it's important to review its specific network of doctors, specialists, and hospitals. In Washington County, Johnston Memorial Hospital in Abingdon is a key acute care facility that serves the local population of 53,926. Confirming that your preferred providers are in-network with your chosen Sentara plan is a crucial step to avoid unexpected out-of-pocket costs.

Virginia Medicaid and FAMIS Programs for Washington County Residents

Virginia expanded its Medicaid program in 2019, significantly increasing access to affordable healthcare for many residents. Adults with household incomes up to 138% of the Federal Poverty Level (FPL) are eligible for Virginia Medicaid, also known as FAMIS Plus. For a single individual, this income threshold is approximately $20,783 annually for the 2026 plan year. Beyond standard adult Medicaid, Virginia also offers specialized programs:

FAMIS Moms: Covers pregnant women with incomes up to 200% FPL, providing comprehensive prenatal, delivery, and 12 months of postpartum care. Applications can be submitted through commonhelp.virginia.gov.
FAMIS (Family Access to Medical Insurance Security): Provides low-cost health coverage for uninsured children in households with incomes up to 200% FPL.
FAMIS Select: Offers low-cost coverage for children in families earning between 200% and 400% FPL, bridging the gap for those who don't qualify for standard FAMIS but still need assistance.

If your income falls within these ranges, applying for Virginia Medicaid or FAMIS programs could provide you with comprehensive, low-cost, or free health coverage.

Understanding Subsidies and Cost Savings

Many Washington County residents qualify for financial assistance to make health insurance more affordable. These subsidies, officially known as premium tax credits, are available to individuals and families with household incomes between 100% and 400% (or even higher, depending on household size and location) of the Federal Poverty Level. Premium tax credits reduce your monthly premium, making plans from carriers like Sentara Health Plans more accessible. You must purchase your plan through Marketplace Virginia / HealthCare.gov to receive these subsidies. In addition to premium tax credits, some individuals may qualify for Cost-Sharing Reductions (CSRs). CSRs lower the amount you have to pay for deductibles, copayments, and coinsurance. To be eligible for CSRs, your income must be between 100% and 250% FPL, and you must enroll in a Silver-tier plan. These plans are enhanced to provide more coverage for the same premium as a standard Silver plan. Washington County, with a population of 53,926, a median income of $64,552, and an uninsured rate of 6.7% (per U.S. Census Bureau ACS 2024 5-year estimates), reflects a community where access to affordable health coverage is important. Many residents will find that subsidies significantly reduce the financial burden of health insurance.

Health Insurance Carriers in Washington County

In 2026, 6 carriers offer marketplace plans in Rating Area 6, which includes Washington County. This competitive environment provides a variety of choices for residents seeking individual and family health insurance. The confirmed carriers for this area are:

CareFirst BlueChoice
Cigna
HealthKeepers
Oscar Health
Sentara Health Plans
United Healthcare

When comparing plans, look beyond just the premium. Consider the plan's network, especially if you have preferred doctors or need to access specific facilities like Johnston Memorial Hospital. Also, evaluate the deductibles, copayments, and out-of-pocket maximums to understand your total potential costs.

Making the Right Choice for Your Washington County Health Plan

Choosing the best health insurance plan in Washington County involves evaluating your household income, anticipated healthcare needs, and preferred providers.

If your income is below 138% FPL: You likely qualify for Virginia Medicaid (FAMIS Plus), which offers comprehensive coverage with minimal or no cost.
If your income is between 100% and 250% FPL: You may qualify for both premium tax credits and Cost-Sharing Reductions (CSRs). Opting for a Silver-tier plan is generally the most cost-effective choice in this range, as CSRs enhance its value.
If your income is above 250% FPL: You may still qualify for premium tax credits. Compare Bronze, Silver, and Gold plans based on your expected healthcare usage. Bronze plans suit those who anticipate minimal medical needs and want low monthly premiums, while Gold plans are better for those who expect more frequent care and prefer lower out-of-pocket costs when they use services.

A licensed health insurance producer can provide personalized guidance, helping you compare plans from Sentara Health Plans and other carriers, verify provider networks, and estimate your potential subsidies. Their assistance is free and can simplify the enrollment process.

Frequently Asked Questions

Can I get Sentara Health Plans through HealthCare.gov in Washington County?

Yes, Sentara Health Plans is one of six confirmed carriers offering plans on the Marketplace Virginia / HealthCare.gov platform in Rating Area 6, which includes Washington County, for the 2026 plan year.

What types of health insurance plans does Sentara Health Plans offer in Washington County?

In Virginia, marketplace shoppers can typically choose from HMO, PPO, and EPO plan structures. Sentara Health Plans, like other carriers, offers a variety of these plan types with different network structures and cost-sharing arrangements. Specific plan details vary by plan year and metal tier.

What is the income limit for Virginia Medicaid (FAMIS Plus) in Washington County?

Virginia expanded Medicaid in 2019, allowing adults with incomes up to 138% of the Federal Poverty Level (FPL) to qualify for coverage. For a single individual in 2026, this threshold is approximately $20,783 per year.

Are there subsidies available for Sentara Health Plans in Washington County?

Yes, if your household income is between 100% and 400% (or more) of the Federal Poverty Level, you may qualify for premium tax credits (subsidies) to help lower your monthly premiums for plans purchased through Marketplace Virginia / HealthCare.gov, including those from Sentara Health Plans.

Does Washington County have a local hospital?

Yes, Johnston Memorial Hospital in Abingdon is an acute care hospital serving Washington County. It's important to verify if this hospital and your preferred doctors are in-network with any plan you consider, including those from Sentara Health Plans.