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Medicaid Unwinding after COVID-19: Return to Regular Enrollment 

Virginia Medicaid has started to return to regular enrollment processes. If you are a Medicaid-eligible Virginian, continue reading to see how you are able to keep receiving health care coverage.

Continuous Coverage Requirement

The continuous coverage requirement, which prevented state Medicaid agencies from reducing or ending Medicaid or FAMIS coverage regardless of changes in an individual’s circumstances, ended on March 31, 2023, due to the passage of the 2023 Consolidated Appropriations Act and associated omnibus bill that decoupled the continuous coverage requirement from the COVID-19 Public Health Emergency (PHE). Starting April 1, 2023, DMAS began conducting eligibility determinations and renewals for all Medicaid and FAMIS members. DMAS has 12 months to initiate eligibility determinations and renewals. An individual’s failure to respond to communications about their Medicaid or FAMIS eligibility could result in their coverage ending. Individuals can update their contact information by calling Cover Virginia at 1-855-242-8282, visiting commonhelp.virginia.gov, contacting their local Department of Social Services office, or by contacting their Medicaid/FAMIS Managed Care Organization (MCO). You can view the DMAS member factsheet, FAQs, toolkits, and other materials that are available in multiple languages at CoverVa.org. Read about emergency policies related to COVID-19 Medicaid Information Eligibility, Enrollment, and Appeals Here.

Making Updates to Member Information

Individuals can ensure they receive important paperwork, by confirming that their information is up-to-date on the Virginia Medicaid Program website. This includes member mailing addresses and phone numbers. Members can make updates:

 

If you do not qualify for full benefits through Medicaid or FAMIS, or you cannot afford Marketplace coverage, please know that people who are uninsured can get health care services at Virginia's Free and Charitable Health Clinics and Virginia's Community Health Centers.

Community Information and Updates

Frequently Asked Questions (FAQ)

What was the federal public health emergency (PHE) and how did it affect Medicaid members?

The federal government declared a public health emergency when the COVID-19 pandemic began. During the PHE, state agencies continued health care coverage for all medical assistance programs, even for people who were no longer eligible. Starting April 1, 2023, DMAS began conducting eligibility determinations and renewals for all Medicaid and FAMIS members. DMAS has 12 months to initiate eligibility determinations and renewals. An individual’s failure to respond to communications about their Medicaid or FAMIS eligibility could result in their coverage ending. Individuals can update their contact information by calling Cover Virginia at 1-855-242-8282, visiting commonhelp.virginia.gov, contacting their local Department of Social Services office, or by contacting their Medicaid/FAMIS Managed Care Organization (MCO). You can view the DMAS member factsheet, FAQs, toolkits, and other materials that are available in multiple languages at CoverVa.org. Read about emergency policies related to COVID-19 Medicaid Information Eligibility, Enrollment, and Appeals Here.

When will normal Medicaid processes begin again?

States have 12 months to make sure Medicaid members are still eligible for coverage. We will not cancel or reduce coverage for our members without asking them for updated information.

What if Medicaid members lose their coverage?

If a member no longer qualifies for health coverage from Virginia Medicaid, they will get: Notice of when the Medicaid coverage will end, Information on how to file an appeal if the member thinks the decision was incorrect, and A referral to the Federal Marketplace and information about buying other health care coverage.

What can Medicaid members do now?

Members can: Update their contact information by calling Cover Virginia at 1-855-242-8282 or online at commonhelp.virginia.gov. The most up-to-date contact information must be on file, such as a mailing address and phone number(s), so they are able to receive important notices and be reached if necessary. Watch for and respond quickly to notices about coverage. Sign up for email and text updates, and visit coverva.org.

What are the other health care coverage choices?

Virginians who do not qualify for Virginia Medicaid can buy health insurance through Enroll Virginia. Enroll Virginia has offices in communities across the state helping Virginians receive high-quality, affordable health coverage. Individuals can sign up for insurance on the Federal Marketplace on HealthCare.gov: Within 60 days of losing health coverage, or Anytime during the annual open enrollment period from November 1 through January 15. Virginians who do not qualify for health coverage from Medicaid may be able to get financial help to lower the cost of private health insurance through HealthCare.gov. The amount of financial aid is based on the cost of insurance where an applicant lives, how many people are in the household, and estimated yearly income. Learn more at enrollva.org or 888-392-5132: Get help from trained assisters, called navigators, to sign up for health coverage online or in person. Compare plans and cost with an easy, anonymous online tool. Find out how much financial help you may qualify to receive. Get enrolled!

How can I get more information?

Virginia Medicaid will keep members up to date through coverva.org, commonhelp.virginia.gov., emails, text messages, and social media.

Where can I send questions or share my views?

Medicaid members can reach out to covervirginia@dmas.virginia.gov.

COVID-19 Resources
 

The below fact sheet outlines the Medicaid policies to streamline application processing and maintain coverage for members during the COVID-19 pandemic.

[PDF] COVID-19 Medicaid Information Eligibility, Enrollment, and Appeals (Updated 06/29/2021)
 

Cover Virginia has an email inbox for verification (proof) returns. This lets customers send a proof by email in addition to fax or mail. Customers will be notified about this return method during calls for applications, status, and renewal submissions. It is also on the Verification Checklist (VCL) sent to customers seeking information.
 

The new inbox lets Virginians send a proof by email. You are still able to fax or U.S. mail your proof. Applicants and members who call will be given the email address. The new option is also on the Verification Checklist (VCL) that is sent to Virginians who ask for information. They can still use the email inbox after the emergency ends.

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