Virginia Health Services

Virginia Health Care Services are available to qualifying state residents, including low-income, aged and/or disabled claimants. These Virginia health care programs include Medicaid and Medicare insurance as well as the Program of All-Inclusive Care for the Elderly (PACE). While PACE and Medicaid insurance benefits are available to residents through the state Department of Medical Assistance Services (DMAS), Medicare is available at the federal level. In addition to these affordable insurance plans in Virginia, qualifying uninsured pregnant women and children may apply for health care coverage under the Family Access to Medical Insurance Security (FAMIS) program. Through this type of insurance plan, uninsured pregnant women receive the medical attention they need throughout the entire term of their pregnancy and qualifying children receive services such as doctor and hospital visits. Under the Affordable Care Act (ACA) of 2010, low cost insurance in Virginia is also available through the federal Health Insurance Marketplace. To obtain these benefits, uninsured residents must apply for coverage online, in person, by mail or telephone. To learn more about these health care services in Virginia, review the information below.

Virginia Medicaid Insurance

Available Virginia Health Care Services include Medicaid insurance (or Medical Assistance) and FAMIS (also known as the Children’s Health Insurance Program or CHIP). These health care programs are available to certain eligible residents through the Virginia DMAS, whose mission is to provide qualifying state residents with high-quality and cost-effective medical services. With Medicaid insurance coverage, patients receive low-cost medical care, including emergency hospital and psychologist services, hospice care and physical therapy. In many cases, VA Medicaid insurance enrollees simply need to pay a copayment for the service they wish to receive, unless they are exempt from doing so. To obtain these low-cost insurance benefits, however, residents typically need to meet certain age, income and/or disability requirements. Furthermore, the FAMIS health care program is only available to qualifying children, while uninsured pregnant women who meet family income guidelines may be able to obtain FAMIS coverage under the varied programs offered under FAMIS.

Before enrolling in these Virginia health care programs, it is important to understand the differences between Medicaid and CHIP/FAMIS and the various services each of these programs provide. In many cases, Medicaid coverage includes vision services as well as dental care if recipients are pregnant or younger than 21 years of age. Additionally, residents who wish to obtain low cost insurance in Virginia must take the time to learn about the costs and fees associated with medical assistance in the state. To learn more about VA Medicaid insurance and how to apply, download our comprehensive guide.

Virginia Medicare Insurance

Medicare coverage is also available to qualifying Virginia residents. Medicare insurance coverage includes Part A, B, C and D. To obtain low cost insurance in Virginia through the Medicare program, claimants may apply online, in person or by telephone. To enroll in the Medicare health care program, however, residents must be at least 64 years and 9 months of age, qualify for a Special Enrollment Period (SEP), have End Stage Renal Disease or a qualifying disability. However, Medicare insurance applicants may file an appeal if their request for coverage is denied for any reason. Before obtaining Medicare health insurance, it is important for applicants to take the time to understand the various costs, co-pays and additional fees they may need to pay when receiving medical care.

In addition to Medicare health insurance coverage, eligible residents may enroll in the PACE program under the Virginia DMAS if they are at least 55 years of age and live with chronic medical needs or disabilities. To obtain these Virginia Health Care Services, residents must qualify for nursing home-level of care. To learn more about PACE and Medicare health insurance benefits, eligibility requirements, or how to apply for coverage, click here to download our useful guide.

The Affordable Care Act in Virginia

Residents may also obtain affordable insurance plans in Virginia under the ACA of 2010. Under the Affordable Care Act, all US residents must enroll in a medical insurance plan if they wish to avoid paying a penalty fee when they file their yearly taxes. As such, residents may obtain low cost insurance in Virginia by applying for coverage directly through the federal Marketplace if they do not qualify for an employer-sponsored plan. Furthermore, veterans may obtain an affordable health insurance plan through the federal Marketplace or they may apply for coverage directly through the US Department of Veterans Affairs (VA) if they are eligible to do so. If veterans obtain insurance through the VA, they automatically meet the requirements under the ACA of 2010. To obtain a plan through the federal marketplace, claimants must apply for coverage during the open enrollment period, unless they qualify for a SEP, Medicaid or CHIP (including FAMIS).

Before applying for low cost insurance in VA, however, it is important to understand the different types of available Marketplace plans and the various services they provide. To obtain an affordable plan through the Marketplace, it is also important to understand Affordable Care Act plan costs, benefits and eligibility requirements. To learn more about the ACA programs in Virginia and methods to apply for coverage, download our comprehensive guide.


Virginia Department of Social Services