As of March 15, 2022, over 2 million Virginians are enrolled in Medicaid/FAMIS. Read on to learn important information about what they’ll need to do to keep their Medicaid/FAMIS, or transition to other coverage if they are no longer eligible, when the Public Health Emergency (PHE) concludes.

NEW! SignUpNow Training About Medicaid for Aged, Blind, and Disabled (ABD) Coming Soon!

With support from DMAS, the SignUpNow team at the Virginia Health Care Foundation is hard at work developing a training about the Medicaid programs for Aged, Blind, and Disabled (ABD) Virginians! The new training will include key information about ABD covered groups, including Medicaid for those receiving Supplemental Security Income (SSI), those requiring Long-Term Care (LTC), and the Medicare Savings Programs (MSP).

These new trainings will begin in Summer 2022. To be the first to know when training dates are released and registration becomes available, click here.

When the U.S. Department of Health and Human Services declared a Public Health Emergency (PHE) due to the COVID-19 pandemic, it allowed DMAS to create helpful new policies, flexibilities, and waivers; leverage enhanced federal Medicaid dollars; and, continue members’ Medicaid coverage without renewing eligibility annually.

The PHE is expected to conclude in summer 2022. When this happens, Virginia’s Department of Medical Assistance Services (DMAS) will have 14 months to determine which of those currently covered by Medicaid are still eligible. This will be a big undertaking, and DMAS needs your help to ensure that all eligible Medicaid/FAMIS members retain their coverage!

One of the most important things you can do is remind members to keep their contact information up-to-date so that they receive DMAS’s communication about their renewal. DMAS has even developed Unwinding Tool Kits to help you get the word out!

If a member has moved or changed phone numbers in the last 3 years, s/he can report this important change:

For up-to-date information about the steps DMAS is taking to ensure eligible members remain covered after the PHE concludes, check out the Cover Virginia PHE Planning page.

DMAS is hard at work to reach every Medicaid member to help ensure that those still eligible stay enrolled when the PHE ends. However, there may be some individuals who lose their coverage for administrative reasons (not completing a renewal on time, or not reporting an address change). There are others who will no longer be eligible, due to a change in circumstance (e.g., an income increase that puts them above the limit, household size decrease). If your patient/client loses coverage, it’s important to know the reason his/her Medicaid ended so you can help with next steps.

Those who are no longer eligible for Medicaid/FAMIS at renewal should receive a notice from the local Department of Social Services letting them know: 1) when their coverage will end, and 2) the reason they are no longer eligible. It will be important to help these individuals see what other health insurance they may be eligible for when that notice arrives.

Many people whose income is over the limit for Medicaid at renewal may be able to get health insurance through the Health Insurance Marketplace, and may qualify for financial help to buy a Marketplace plan. Others may be able to enroll in a health insurance plan through an employer. For both the Marketplace and most employer plans, most people must enroll within 60 days of losing other coverage.

If you believe an individual or family might be eligible for coverage on the Marketplace, a Navigator or Certified Application Counselor (CAC) can help! Check out the Health Insurance Marketplace “Find Help” Page on Cover Virginia to find a Navigator or CAC near you.

Did your client miss the January 15 deadline to enroll in 2022 health insurance through the Marketplace? If his/her income is at or below 150% of the Federal Poverty Level (FPL; $20,385 for an individual or $27,465 for a couple), s/he may be able to get a Special Enrollment Period (SEP) to enroll in coverage through the Marketplace!

The Marketplace will begin conducting outreach to individuals it believes may qualify for the new SEP. Virginia adults whose income exceeds the limit for Medicaid can access this SEP, and because of the enhanced financial help the Marketplace now offers, they may be able to sign up for a silver plan for $0 per month!

If you believe an individual or family might be eligible for coverage on the Marketplace, a Navigator or Certified Application Counselor (CAC) can help! Check out the Health Insurance Marketplace “Find Help” Page on Cover Virginia to find a Navigator or CAC near you.

SignUpNow Workshops Available LIVE and On-Demand

The Virginia Health Care Foundation (VHCF) has added new live, virtual SignUpNow workshops in spring 2022! To see training dates and register, go to vhcf.org/workshops/.

SignUpNow teaches about the Public Health Emergency (PHE) unwinding, as well as the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs:

Can’t attend a virtual workshop? There is also an online, on-demand version of the SignUpNow training. On-demand workshops can be completed when it’s convenient for you, wherever you are – one module at a time. The on-demand workshops consist of the same content as the live trainings, broken down into 20-60-minute modules.

Have a question about SignUpNow? Email signupnow@vhcf.org, or call 804-828-6062.

Smiles For Children Provides Comprehensive Dental Benefits for Kids and Adults!

As of July 1, 2021, Virginia adults have access to the nation’s most comprehensive Medicaid adult dental benefit. More than 100,000 Virginia adults have received now received at least one dental service since the Medicaid adult dental benefit began! To see a list of covered services, please click here.

Smiles For Children is Virginia’s Medicaid and FAMIS dental program for children and adults, as of July 1, 2021.  For information about Smiles For Children or to find a dentist in your area, call toll-free: 1-888-912-3456.

Preview of Coming Attractions: Extension of Postpartum Coverage to 12 Months

Beginning July 1, 2022, lawfully-residing pregnant Medicaid/FAMIS members will receive continued coverage for one full year postpartum! (Right now, coverage in these programs is available only for the duration of pregnancy, and around 60 days postpartum.) While the Public Health Emergency (PHE) has kept many Medicaid members enrolled beyond their 60 days postpartum, permanently extending members’ coverage to 12 months will enable them to receive medical care so they and their newborns can stay healthy!

Postpartum members will continue to have access to the same comprehensive set of benefits offered by the programs during pregnancy, including dental services, doctor visits, prescription coverage, and much more!

As of March 15, 2022, there are: