Home > Health Insurance Options Guide

Medicaid

Medicaid

Medicaid and coverage for children under FAMIS Plus are programs that help pay for medical care. To be eligible for Medicaid or FAMIS Plus you must have limited income and resources and you must be in one of the groups of people covered by Medicaid. Some groups covered by Medicaid are: pregnant women, children, people with disabilities and people age 65 and older.

Medicaid and FAMIS Plus are programs funded by the state and Federal governments. Not everyone with high medical bills qualifies. The eligibility rules may be different for children, adults and people in nursing facilities, but all people within a group are treated the same.

In Virginia, the Department of Medical Assistance Services (DMAS) administers the Medicaid program. The Department of Social Services (DSS) has responsibility for taking applications and determining eligibility.

Medicaid has three levels of benefits:

  • Full coverage – Provides the full range of benefits including doctor, hospital and pharmacy services for those individuals not enrolled in Medicare
  • Time-limited coverage – Includes people who meet a spenddown or for women who receive 24 months of family planning services after their Medicaid coverage expires following a pregnancy
  • Medicare-related coverage – Provides Medicaid payment of Medicare premiums; may also include payment of Medicare’s deductible and coinsurance, up to Medicaid’s maximum payments.

To apply for Virginia Medicaid contact the Department of Social Services in the city or county where the applicant lives. A face-to-face interview is not required. A Medicaid application must be filed and it must be signed by the applicant unless it is completed and signed by the applicant’s legal guardian, committee, attorney-in-fact or authorized representative. Applicants for Medicaid are asked to:

  • Provide Social Security numbers
  • Confirm they are Virginia residents
  • Confirm U.S.citizenship or provide documentation of alien status
  • Verify income and resources
  • Submit bills for medical services received in the past three months

For more information on Medicaid you may link to Virginia information on applying for Medicaid. You may also see the Medical or Medicaid Assistance Services listings for your area in the For More Information section of this guide.