Getting health coverage in Virginia can feel confusing.
You might wonder if you qualify for Medicaid and how to sign up.
The good news is that applying for Medicaid in Virginia is easier than you might think. You can apply for Medicaid online, by phone, or through Virginia’s Insurance Marketplace.
Virginia expanded its Medicaid program a few years ago.
This means more people can now get free or low-cost health insurance.
You don’t need to guess if you qualify.
The state looks at your income and family size to decide.
If you’re not sure, it’s worth checking.
Don’t worry about complicated paperwork.
Virginia tries to make signing up simple.
You can apply from home on your computer or phone.
If you prefer talking to someone, you can call for help.
There are people ready to answer your questions and guide you through the process.
Key Takeaways
- You can apply for Virginia Medicaid online, by phone, or through the state marketplace
- Virginia’s Medicaid expansion means more people now qualify for coverage
- Help is available if you need assistance with your Medicaid application
Eligibility Requirements
To get Medicaid in Virginia, you need to meet certain rules.
These rules look at your money, where you live, and your situation.
Assessing Income and Household Size
Your income and how many people live with you are key factors.
Virginia uses the Federal Poverty Level (FPL) to decide if you can get Medicaid.
For adults 19-64, you can make up to 138% of the FPL.
A family of four can earn up to $3,013 per month.
The Cover Virginia website has a tool to check if you might qualify.
It’s quick and easy to use.
Kids and pregnant women can get FAMIS if their family makes a bit more money.
FAMIS is Virginia’s program for children’s health insurance.
If you make too much for regular Medicaid, you might still get help.
The Medically Needy program can help if you have high medical bills.
Understanding Residency and Immigration Criteria
You must live in Virginia to get Virginia Medicaid.
You also need to be a U.S. citizen or have a qualifying immigration status.
Legal permanent residents usually need to wait 5 years before they can get full Medicaid.
But there are exceptions for refugees and asylees.
Pregnant women and kids can often get coverage right away, even if they’re not citizens.
You’ll need to show proof of your status when you apply.
This could be a birth certificate, passport, or immigration papers.
Special Circumstances
Some people can get Medicaid even if they don’t meet the usual rules.
This includes folks with disabilities, those who need nursing home care, and people with certain medical conditions.
If you’re disabled, you might qualify for Medicaid even if your income is higher.
The same goes for people who need long-term care.
Virginia has a program called Plan First for family planning services.
It has different rules that let more people qualify.
Pregnant women and kids with special needs might also have an easier time getting Medicaid.
They often have higher income limits and fewer restrictions.
If you’re not sure if you qualify, it’s best to apply anyway.
The Department of Social Services can look at your exact situation and let you know what help you can get.
How to Apply
Applying for Medicaid in Virginia is straightforward.
You have options to apply online, by phone, or in person.
It’s important to gather the right documents and understand what happens after you submit your application.
Application Process Online and In-person
You can apply for Medicaid online through the CommonHelp website.
This is often the quickest way.
Just create an account and fill out the application.
If you prefer, you can call the Cover Virginia Call Center at 833-5CALLVA.
They’re open Monday to Friday, 8 AM to 7 PM, and Saturday 9 AM to 12 PM.
Want to apply in person? Visit your local Department of Social Services office.
They can help you with the paperwork.
Some people find this helpful if they have questions.
You can also apply through Virginia’s Insurance Marketplace.
This might be a good choice if you’re looking at other health insurance options too.
Gathering Necessary Documentation
Before you start, get your papers ready.
You’ll need proof of:
- Identity (driver’s license or passport)
- Virginia residency
- Income (pay stubs or tax returns)
- Citizenship or immigration status
If you’re self-employed, gather your business records.
For those applying for long-term care, you might need the ABD-LTC application.
Don’t worry if you’re missing something.
You can still apply and send documents later.
The important thing is to start the process.
After Submission: What to Expect
Once you submit your application, you’ll get a confirmation.
The Department of Social Services will review your info.
This can take up to 45 days, or 90 days if you’re applying based on a disability.
They might ask for more details.
If so, respond quickly to avoid delays.
You’ll get a decision letter in the mail.
If approved, it will explain your coverage and when it starts.
If denied, you can appeal.
The letter will tell you how.
Remember, if your situation changes, you can always reapply.
Frequently Asked Questions
Signing up for Medicaid in Virginia can be confusing.
Here are answers to some common questions about the process, eligibility, and plan options.
Understanding how to sign up for Medicaid is important to ensure you receive the healthcare coverage you need.
Eligibility is based on factors like income, household size, and disability status.
You can apply online, by phone, by mail, or in person through the Virginia Department of Medical Assistance Services.
What’s the step-by-step process to get Medicaid in Virginia for a grown-up?
To get Medicaid as an adult in Virginia, you’ll need to:
- Check if you qualify based on income and other factors.
- Gather documents like proof of income and residency.
- Apply online, by phone, or in person.
- Wait for a decision, which usually takes 45 days or less.
- Choose a health plan if approved.
Where do I find the form to apply for Medicaid in Virginia?
You can find the Medicaid application form online at CommonHelp.
This website lets you apply for multiple assistance programs with one form.
You can also get a paper application at your local Department of Social Services office.
Who do I call if I need to talk to someone about applying for Medicaid in Virginia?
If you need help applying, you can call the Cover Virginia Call Center at 833-5CALLVA (833-522-5582).
They’re open Monday to Friday, 8 am to 7 pm, and Saturday 9 am to 12 pm.
You can also visit your local Department of Social Services office for in-person help.
What are the income rules to qualify for Medicaid here in Virginia?
Income limits for Medicaid in Virginia depend on your household size and the specific program you’re applying for.
For adults, the income limit is generally 138% of the federal poverty level.
For a single person, that’s about $18,754 per year in 2024.
For a family of four, it’s around $38,295.
How quickly can I expect to hear back after I apply for Medicaid in VA?
Virginia Medicaid usually makes a decision within 45 days of getting your application.
If you’re pregnant or have a disability, they may decide faster.
You’ll get a letter in the mail telling you if you’re approved or not.
If approved, you’ll also get info about choosing a health plan.
What are the different Medicaid plan options available in Virginia?
Virginia offers several Medicaid managed care plans.
These include:
- Aetna Better Health of Virginia
- Anthem HealthKeepers Plus
- Molina Complete Care
- Optima Health Community Care
- United Healthcare Community Plan
- Virginia Premier Health Plan
Each plan covers the same basic services, but may offer extra benefits.
You can compare plans and choose one that fits your needs best.