We scoured the internet to bring you everything you need to know about Virginia’s Medicaid Benefits.
Medicaid is a joint federal-state program that provides health insurance to low-income people who satisfy specific criteria, such as children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, by phone, or online.
This article will tell you all you need to know about Medicaid in Virginia.
Table of Contents
What is the Virginia Medical Program?
Virginia Medicaid is a service for adults and families that meet specific income and resource requirements. Within the confines of stated laws, resources broadly apply to the elderly, blind, or crippled population.
Who is eligible for the Virginia Medical Program?
Through the Medicare Savings Plan, Virginia Medicaid provides some financial assistance to select limited Medicare beneficiaries who are not eligible for the entire Medicaid benefit package.
- Expectant mothers
- People who are blind or disabled or who have a spouse who is blind or disabled;
- People whom someone adopts;
- People whom someone adopted;
- People who are blind or disabled or have a spouse who is disabled.
The Annual Household Income Limits (before taxes)
|Household Size*||The Maximum Income Level (Per Year)|
*For households with more than eight people, add $6,277 per additional person.
How do I contact Medicaid in Virginia?
600 East Broad Street, Richmond, Virginia.
PO Box# 23219
What are the Medicaid plans in Virginia?
MEDALLION primary care case management (PCCM)
More than half of Medicaid recipients were enrolled in a managed care program. The MEDALLION primary care case management (PCCM), Virginia’s first managed care program, began in four trial locations in 1993 and was made available statewide in 1995.
Its beneficiaries included the elderly, blind, disabled, low-income adults, and kids.
Additionally, Virginia started the Options program, which allowed beneficiaries in a few areas to participate in a managed care organization until 1999.
The MEDALLION II program, developed by Virginia based on the MEDALLION and Options programs, included capitated-risk-based managed care first in a few locations and later expanded to more regions.
Acute, primary, specialist services, outpatient behavioral health, and other services are all covered by MEDALLION II.
In most counties, enrollment is required for most children, low-income adults, and non-dual aged and disabled participants. For more details regarding Medicaid plans in Virginia, visit here.
How do I apply for Virginia Medicaid?
Call 1-877-486-2048 to enroll.
Apply in person at East Broad Street, Richmond, Virginia
Online: Download and print the application.
Mail: To 600 East Broad Street, Richmond, Virginia, PO Box# 23219
What is covered by Virginia Medicaid?
Virginia Medicaid covers the following services:
|Ambulatory surgery||Hospital stays|
|Audiology services||Laboratory tests|
|Behavioral health services||Vision care|
|Women’s health care||Non-emergency transportation|
|Dialysis||Orthotic and prosthetic devices|
|Doctor visits||Occupational therapy|
|Smoking cessation services||Pharmacy (medications)|
|Emergency care||Physical rehabilitation|
|Family planning services||Preventive care|
|Hearing aids||Hospital outpatient care|
|Home health care||X-rays and other radiology services|
Can I have both Virginia Medicaid and Medicare?
Those who are dual-eligible meet the requirements for both Medicaid and Medicare. Most of your medical expenses are covered if you have Medicare and complete Medicaid coverage.
The local Department of Social Services in the city or county where you reside runs the Medicaid program.
- VA Building Independence Waiver
- VA Children’s Mental Health Waiver PRTF
- VA Commonwealth Coordinated Care Plus
- VA Family and Individual Support Waiver
- VA HIV/AIDS
They do not have to pay a copayment. When a member is
- under 21 years old;
- Held by the state
- Placed under government supervision
- Native American participants who qualify for Contract Health funding
- Services or Tribal Union of Indian Health Services
- The hospital (inpatient)
- A facility for skilled nursing
- A nursing home
What is not covered by Virginia Medicaid?
In Virginia, Medicaid is not required to provide in-home care or private nursing coverage. Bandages, adult diapers, and other disposable products, as well as cosmetic surgery and other elective operations, are routinely excluded from insurance coverage.
What is the highest income limit for Virginia Medicaid?
The highest income limit for Virginia Medicaid is $18,075 for an individual and $24,353 for a family of two per year.
What if a person’s income is too high to qualify for regular Medicaid benefits?
Even if your income is too high, thanks to the asset spend down option; you may still be qualified for Virginia Medicaid.
What documents do I need to apply for Medicaid?
The following documents are required with the application:
- The Social Security Number;
- Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
- Evidence of all income sources, both legal and illegal
- Proof of origin
- Proof of residency
- Including the Medicare card, any insurance cards
- When non-parents apply for Medicaid on their behalf, they must provide evidence of their financial position.
What is the best Medicaid in Virginia?
The highest level of accreditation an MCO can earn is VA Premier, followed by Commendable and Accredited.
Where do I find the letter showing the reason(s) for denial or discontinuance from Virginia Medicaid?
By signing into your account at Portal, you can see the progress of your Virginia Medicaid application.