NEW! Rules Change Makes More Individuals Eligible for Medicaid
Beginning April 1, adults who are Lawful Permanent Residents (LPRs, sometimes called “green-card holders”) are no longer required to have 40 qualifying quarters of work in order to be eligible for Medicaid!
The “40-Quarter Rule” has prevented many otherwise-eligible LPR adults from being able to enroll in Medicaid, even if they meet all other eligibility requirements (including having been lawfully present in the U.S. for 5 years or longer).
Individuals who may become eligible due to this change should be encouraged to apply or re-apply as soon as possible, so that their eligibility can be re-determined.
Check out this factsheet for details about this exciting change! Learn more here. |
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New Benefits Coming Soon to Virginia Medicaid
Core Dental Benefit for Adults
Beginning July 1, 2021, Virginia’s Medicaid program will provide dental benefits to adults through what is now called the Smiles For Children program! Dental coverage for adults enrolled in Medicaid will focus on overall oral health, prevention, and restoration. Services will include:
- X-rays and examinations
- Cleanings
- Fillings
- Root canals
- Gum-related treatment
- Dentures
- Tooth extractions and other oral surgeries
- Other appropriate general services, such as anesthesia
To find a dentist, call Smiles For Children at 1-888-912-3456. A representative can even help members make an appointment. The call center is available 8am – 6pm, Monday through Friday. Contact DentaQuest for program limitations and requirements, or to enroll.
Benefit on the Way for Pregnant Women!
A new FAMIS prenatal benefit is on the way for income-eligible pregnant women living in Virginia, regardless of their immigration status.
Virginia’s General Assembly voted to make this new coverage available to women in households with incomes at or below 205% of the Federal Poverty Level (FPL), even if they do not meet the current lawfully residing immigration status requirement for pregnant women. Once the Governor officially approves the state budget, Virginia will apply to the Federal government to make this change. Federal approval is expected this year, with implementation as soon as July 1.
Extension of Postpartum Coverage for New Moms
Soon, women enrolled in FAMIS MOMS or Medicaid for Pregnant Women (MPW) will remain covered for one full year postpartum! Currently, women in these programs are covered only for the duration of their pregnancy, and 60 days postpartum. For women who currently do not qualify to transfer to another Medicaid coverage group, extending postpartum coverage to the 12-month mark will enable them to receive essential services aimed at helping mothers and their newborns stay healthy.
Virginia is applying to the federal government to make this change. The extension is expected to be implemented sometime in 2022.
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New Data on Virginia’s Uninsured!
Looking for data to help you better reach uninsured Virginians? The 2021 Profile of Virginia’s Uninsured, created for VHCF by The Urban Institute, is available now on the VHCF website. The Profile provides a wealth of information about uninsured Virginians, including:
- Estimates of their number, percentage, and demographics
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Separate analyses of uninsured children and adults
- Estimates of access to care
- Tables highlighting key information about the uninsured who are income-eligible for Medicaid/FAMIS and the Marketplace, including demographics and regional estimates
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Maps profiling key subpopulations
This is our first glimpse at the impact of Medicaid expansion (effective January 1, 2019) on reducing the number of uninsured in Virginia.
Note: The report shows an incremental increase in Virginians enrolled in health insurance over the course of the year, rather than the total number enrolled at the end of 2019, due to the methods used to collect data.
Questions? Please contact Denise Daly Konrad, VHCF’s Director of Strategic Initiatives ( [email protected]). |
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Reminder: Health Insurance Marketplace Reopened until August 15, 2021
Virginians who need health insurance, but are above the income limits for Medicaid/FAMIS coverage, have a “second chance” to buy 2021 coverage through the Health Insurance Marketplace until August 15, 2021. And, as a result of certain provisions in the American Rescue Plan Act ( ARPA), more Virginians than ever can receive financial help to purchase a plan!
Virginians can apply for health insurance through the Marketplace on their own at www.healthcare.gov. Those who need help applying for Marketplace coverage can obtain it by contacting a local Navigator or Certified Application Counselor ( CAC), who is specially-trained to help Virginians weigh their options on the Marketplace. Visit coverva.org/assistance to find the one closest to you.
Don’t forget: Virginians can apply for Medicaid/FAMIS year-round.
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Virtual Tooth Talk Roundtable: Back to the Future
Save the Date!! VHCF’s next Tooth Talk will be held on May 13 th from 9:30am - 11:30am. During the roundtable, oral health professionals and administrators from across the state will discuss what’s on the horizon for the dental safety net world, including the new dental coverage for adults in Virginia’s Medicaid program, policy opportunities, innovative techniques to navigate current realities, and funding opportunities ( just to name a few). Register today - you won't want to miss it!
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Tools and Learning Opportunities from our Partners
- Every non-profit should be ready to define and demonstrate the value it delivers. To help achieve this, Community Health Solutions has developed a checklist tool (one of many available via its website) that offers a stepwise strategy for demonstrating the community value of your organization. Consider sharing the checklist with your team and board members to engage them in strategic thinking about community value. Visit the CHS website for more tools and resources.
- The Collaborative Family Healthcare Association (CFHA) supports healthcare professionals in integrating physical and behavioral health. In addition to offering a one-stop site for the latest developments in integrated care, CFHA provides access to numerous webinars, both live and archived, to continue your learning.
- The Transforming Oral Health for Families (TOHF) learning collaborative, part of the national Networks for Oral Health Integration program, is an 18-month learning collaborative, consisting of FQHCs in VA, NY, MD, and DC, all aiming to improve the oral health of young children through interprofessional training and effective care coordination models. Participating health centers receive a stipend of $25,000 to offset project-related costs. Virginia Health Catalyst is recruiting eligible FQHCs with dental programs to apply for the next cohort, beginning September 2021. If you’re interested in applying for this collaborative, complete an application here by April 30. Contact Brita Allen, Virginia Health Catalyst’s Program Manager, with any questions.
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Upcoming VHCF Trainings/Meetings
Trainings on how to use The Pharmacy Connection
Beginner Trainings
Advanced Trainings
For additional training dates or more information click here or contact Lisa Hueston, TPC Program Manager, at (804) 828-5803.
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Take Advantage of VHCF’s Professional Development Funds!
Are you (or a staff member) considering taking advantage of learning opportunities? VHCF has a variety of informational resources to help you and your staff meet your goals. Check out some of our resources for providers here! Don't see what you are looking for? Let us know!
VHCF also offers funding for capacity building, including:
- Up to $3,500 to underwrite the development of a new strategic plan
- Up to $650 per organization per year to pay for professional development opportunities that enhance the skills or knowledge of health safety net staff or board members
Contact a Program Officer at (804) 828-5804 to learn more.
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Does your clinic have any innovative programs or creative solutions to share?
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