Medicaid in Virginia Introduction

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Virginia Medicaid is a state and federal medical assistance program available to qualifying residents who meet financial, age and residency requirements. To obtain Medicaid in Virginia, applicants must be pregnant, younger than 21 years of age and in foster care, caring for a child younger than 19 years of age or they must have a qualifying disability. Furthermore, Medicaid insurance is also available to qualifying applicants who are 65 years of age or older and those who meet household income restrictions. Since eligibility information about Medicaid often varies depending on the specific situation, it is important to do plenty of research before applying for coverage. After gathering information about medical assistance, claimants may apply for coverage online, in person, by mail or telephone.

“What is Medicaid in Virginia and what does it cover?” is a question many state residents may ask when researching affordable health care services. With Medicaid insurance coverage, financially needy residents and their families receive low-cost health care through the Virginia Department of Medical Assistance Services (DMAS). Medicaid coverage can provide qualifying residents with services such as vision and dental care, family planning, inpatient hospital services and emergency-room care. If residents are eligible for medical assistance in VA, they are not responsible for paying monthly premiums or enrollment fees. However, Virginia Medicaid recipients may need to pay low copayments before receiving certain types of services. Furthermore, many medical assistance services do not have copayments, including emergency-room services, dialysis, family planning or pregnant-related care.

In addition to obtaining information about Medicaid, it is important to understand the differences between medical assistance and the state Children’s Health Insurance Program (CHIP). ( Like Medicaid, eligible residents may enroll in the Family Access to Medical Insurance Security Program (FAMIS) if they wish to obtain free or low-cost health care. Also known as CHIP, FAMIS is available to qualifying children while FAMIS MOMS is available to uninsured pregnant women. In addition to these medical assistance programs, FAMIS Plus is available to families with little or no income. Known as Medicaid coverage for children, copayments are not required under the FAMIS Plus program. obtain additional Medicaid information and to learn how to apply for coverage, download our comprehensive guide here. For additional information about Medicaid in Virginia, review the sections below.

CHIP in Virginia

The Children’s Health Insurance Program (CHIP) in Virginia is available to qualifying families with children and uninsured pregnant women through the state Department of Medical Assistance Services (DMAS). The Virginia DMAS administers Medicaid for children and pregnant women as well as the state’s CHIP program. With CHIP and Medicaid enrollment, claimants receive free or low-cost medical assistance, including inpatient and outpatient healthcare, tests, X-rays and mental health services. In Virginia, the Children’s Health Insurance Program is also known as the Family Access to Medical Insurance Security Program (or FAMIS, FAMIS Plus and FAMIS MOMS). Moreover, Children’s Medicaid is also known as FAMIS Plus and is available to low-income families who wish to obtain affordable medical care for their qualifying dependents. However, Virginia CHIP and Medicaid are not the same programs, as FAMIS has a higher income limit than the Virginia Medicaid or medical assistance programs. To learn more about the requirements of Medicaid eligibility children and uninsured pregnant women, download our comprehensive guide. Read More.

Eligibility for Medicaid in Virginia

Some residents may wonder, “What are the requirements for Medicaid in Virginia?” when reviewing affordable health care programs. To meet Medicaid benefits eligibility requirements and obtain medical assistance, applicants must be financially needy and meet residency, income, age or disability requirements. However, Medicaid eligibility requirements and income limits often vary by household size. Furthermore, Medicaid eligibility is not based solely on an applicant’s need for medical care or current state of health. If applicants do not meet these medical assistance eligibility requirements due to income restrictions, they may apply for coverage under the Children’s Health Insurance Program (CHIP) if they are uninsured and pregnant or younger than 19 years of age. To meet CHIP medical assistance requirements, however, applicants must also meet income restrictions. However, these income restrictions are higher than that of Medicaid. Learning how to qualify for Medicaid insurance helps all potential applicants complete the Medicaid application process correctly and easily. Read More.

How to Apply for Medicaid in Virginia

The process of how to apply for Medicaid in Virginia varies depending on whether qualifying claimants wish to apply online, in person, by mail or telephone. If claimants wish to apply for Medicaid online, they simply need to input their personal information before submitting the application electronically. If submitting a Medicaid application form in person, however, applicants must visit a local branch of the Virginia Department of Social Services (DSS). To submit a Medicaid application in person at a branch of the DSS, claimants must visit an office for the city or county in which they live. Alternately, applicants may mail medical assistance applications to their local DSS office if they prefer paper applications. Additionally, claimants may complete the initial enrollment process by telephone. For additional information on how to apply for Virginia Medicaid, download our comprehensive guide. Read More.

Medicaid Costs and Coverage in Virginia

“How much is Medicaid in Virginia and what does it cover?” is a frequent question asked by Virginia residents in need of medical coverage. While Medicaid cost estimates often vary depending on several factors, many services are available to qualifying recipients at no charge. However, Medicaid coverage, also known as medical assistance in Virginia, may require a small copayment for certain types of services. Since medical assistance coverage is only available to low- or very-low income Virginia claimants who fall under a specific covered category, Medicaid costs are typically very affordable. Furthermore, various types of Medicaid insurance policies cover different types of medical services. For instance, Medicaid insurance for pregnant women includes prenatal and dental care during the term of the pregnancy, while coverage for aged, blind or disabled groups include benefits such as hospital, doctor and pharmacy services. To learn more about what services are covered by Medicaid and to obtain medical assistance cost estimates, potential enrollees can download our comprehensive guide. Read More.

Medicaid Dental Insurance in Virginia

Medicaid dental insurance in Virginia is available to qualifying applicants who meet income, age and covered group restrictions. However, comprehensive Virginia Medicaid dental insurance is not available to all qualifying beneficiaries. Instead, comprehensive Medicaid dental coverage is only available to low-income children who are 21 years of age and younger and qualifying pregnant women. While Medicaid dental benefits are available to older beneficiaries as well, these services are limited to medically necessary procedures. To enroll in VA Medicaid dental insurance, claimants must apply for benefits through Smiles for Children, a program under the Commonwealth of Virginia. Anyone who is eligible for dental insurance in Virginia obtains their benefits through the Smiles for Children program, even if claimants are 21 years of age or older. To learn more about Medicaid dental insurance eligibility requirements and the enrollment procedures, applicants can download our comprehensive guide here. Read More.

Medicaid Vision Insurance in Virginia

Medicaid vision insurance in Virginia is available to qualifying applicants who are eligible to receive medical assistance in the state. Virginia Medicaid vision care, also known as medical assistance, is an available benefit under the Department of Medical Assistance Services (DMAS) and the Commonwealth of Virginia. However, Virginia Medicaid vision benefits only include eye examinations once every two years. Additionally, the plan only includes eyeglasses if covered members are 21 years of age or younger. To enroll in VA Medicaid Vision Insurance, qualifying residents simply need to apply for medical assistance by completing an application online, in person, by mail or telephone. Residents who meet Medicaid vision insurance eligibility requirements do not need to complete a separate application for obtaining these benefits. To learn more about the requirements for vision insurance, download our comprehensive guide. Read More.