Federal and state subsidies
To see if you qualify for a subsidy you must purchase your health plan through Virginia’s Insurance Marketplace. These subsidies could be tax credits or cost-sharing reductions to help you pay for your health care costs. How much help you get depends on how much money you make. Virginia’s Insurance Marketplace will determine your eligibility during open enrollment. Individuals can buy health insurance through other sources, but the only way to get a tax credit is through Virginia’s Insurance Marketplace. There are two subsidies available:
Advanced Premium Tax Credit (APTC): A federal tax credit individuals can use to lower their monthly insurance payment (called the “premium”). The tax credit is based on the individuals’ income estimate and household information on their Marketplace application.
Virginia Premium Savings: Beginning in 2027, a new program called Virginia Premium Savings (VaPS), may help eligible Virginians lower the cost of health coverage. Savings and qualifications are based on your individual income estimate and household information. Virginia Premium Savings will be applied in addition to any federal premium tax credits for which you qualify. This is available on a first, come first serve basis. So don’t delay!
Talk to a Personal Plan Advisor today: 1-855-460-5819 or Call me form
2026 Poverty Guidelines
Federal Poverty Guidelines (FPL) are a measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine member eligibility for certain programs and benefits, including savings on the Exchange, and Medicaid and CHIP coverage.
The 2026 poverty guidelines* for the 48 Contiguous States and the District of Columbia.
| Persons in family/household | Poverty Guideline |
| Persons in family/household 1 | Poverty Guideline$15,960 |
| Persons in family/household 2 | Poverty Guideline$21,640 |
| Persons in family/household 3 | Poverty Guideline$27,320 |
| Persons in family/household 4 | Poverty Guideline$33,000 |
| Persons in family/household 5 | Poverty Guideline$38,680 |
| Persons in family/household 6 | Poverty Guideline$44,360 |
| Persons in family/household 7 | Poverty Guideline$50,040 |
| Persons in family/household 8 | Poverty Guideline$55,720 |
*For families/households with more than 8 persons, add $5,680 for each additional person.
*Source: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines.
Understanding your Sentara Individual & Family Health Plans Options
Our plans offer a variety of price options. Individual & Family Health Plans are classified by metallic tiers: Platinum, Gold, Silver, and Bronze. Metallic tiers make it easier for you to compare plans based on price and coverage. While this chart is not comprehensive it may help determine which plan would work best for you.
| Platinum | Gold | Silver | Bronze | |
Monthly premium | Platinum$$$$ | Gold$$$ | Silver$$ | Bronze$ |
Percentage of healthcare cost covered | Platinum90% | Gold80% | Silver70% | Bronze60% |
Good for members who... | Platinumuse healthcare services often and want lower out-of-pocket costs | Goldprefer higher premiums in exchange for lower costs at the time of care | Silverneed a balance of premium and out-of-pocket costs | Bronzedon't plan to use a lot of healthcare services |
Things to consider
Sentara Health Plans offers Silver plans, exclusively available off-exchange, that can help members lower costs. These plans might be well suited for those who don’t qualify for a subsidy and for those who are a member for a CHOICE Arrangement plan (formerly known as ICHRA).
We also offer two Gold plans and one Platinum plan, exclusively off-exchange.