SHARE:  
Join Our Email List
Virginia Extends Postpartum Coverage to 12 Months!
Beginning July 1, postpartum coverage will be available for one full year for Medicaid and FAMIS MOMS members! Virginia was the third state in the country to receive federal approval to extend coverage for 12 months postpartum and is on the leading edge of implementing this exciting change.

While the Public Health Emergency (PHE) has kept many Medicaid members enrolled beyond the previous cutoff of 60 days postpartum, extending postpartum coverage to one year is a permanent change that will continue after the PHE and will enable pregnant people to receive medical care, so they and their newborns can stay healthy. In addition, changes will go into effect July 1 to ensure that FAMIS MOMS and pregnant/postpartum lawfully residing immigrants will have access to the extended coverage.

Here are answers to 5 Frequently Asked Questions about the 12-Month Postpartum coverage:
  • Who is eligible for the extended coverage? The 12-month extension of postpartum coverage is available to Medicaid and FAMIS MOMS members in almost all full coverage groups. This includes Medicaid for Pregnant Women (MPW), FAMIS MOMS, Medicaid Expansion (“New Health Coverage for Adults”), and the Low-Income Families with Children (LIFC) programs. Lawfully residing immigrant pregnant individuals enrolled in any coverage group will have access to the extended postpartum coverage. FAMIS Prenatal Coverage will remain limited to 60 days postpartum. If your client is a Medicaid/FAMIS member who becomes pregnant, you can help the client report the pregnancy by calling Cover Virginia at 1-855-242-8282, or the local Department of Social Services (LDSS), to ensure coverage is protected for one year postpartum. To find LDSS contact information, go to www.commonhelp.virginia.gov, and click “Find Local Office.”

  • What benefits will be available during the year-long postpartum period? Postpartum Medicaid/FAMIS MOMS members will continue to have access to the same comprehensive set of benefits offered by the programs now, including dental services, doctor visits, prescription coverage, and much more!

  • Will the 12-Month Extension apply to those enrolled in FAMIS Prenatal Coverage? No. Pregnant individuals enrolled in FAMIS Prenatal Coverage (coverage for pregnant people without regard to immigration status) will only maintain their coverage for the duration of pregnancy and 60 days postpartum, like they do today.

  • Can someone who has already delivered, and is between 60 days and 12 months postpartum, be eligible to re-enroll for additional coverage? If your client is within 1 year postpartum, encourage that client to call Cover Virginia at 1-855-242-8282, or contact the client’s LDSS, to determine if they can be reinstated or will need to reapply.

  • Will someone who delivers after July 1 automatically receive 12 months of postpartum coverage? Yes, these individuals will not have their Medicaid/FAMIS MOMS coverage re-evaluated until one full year after delivery. They will receive a letter after their pregnancy to alert them of their new renewal date that aligns with the 12 month postpartum period.
NEW Doula Benefit Available to Virginia Medicaid/FAMIS Members!
Pregnant individuals enrolled in Virginia Medicaid/FAMIS now have access to a new benefit: community doula services! This includes: 4 prenatal visits, support during labor and delivery, and 4 postpartum visits.

Virginia is the 4th state in the nation to implement this exciting benefit. DMAS is working hard to recruit state-certified doulas to enroll with Medicaid, to help give every birthing Virginian access to doula services. If you know anyone who is interested in becoming a state-certified community doula with Virginia Medicaid, s/he can email babystepsva@dmas.virginia.gov to find out more.

SignUpNow Training on Medicaid for Virginians who are Aged, Blind, or Disabled (ABD) Now Available!
Do you work with clients who are:
  • 65+ years old, or
  • Enrolled in or eligible for Medicare?
Would you like to learn how to help them sign up for and renew Medicaid? Thanks to generous support from the Virginia Department of Medical Assistance Services (DMAS), SignUpNow now offers a NEW training on how to help these individuals apply for and renew their eligibility for Medicaid!

To view and register for available training dates, go to vhcf.org/workshops/ and select a training date for SignUpNow 2: Medicaid for Aged, Blind, or Disabled (ABD) Virginians. Additional trainings will be offered throughout fall/winter 2022, so check back often!

SignUpNow also has new training dates available to learn about the Medicaid/FAMIS programs for children and families, including the New Health Coverage for Adults (Medicaid Expansion). To view available dates and register, go to vhcf.org/workshops/, and select a training date for SignUpNow 1: Medicaid/FAMIS for Children and Families (including Medicaid Expansion).
Reminder: Virginians Should Act Now to Update their Contact Information with Virginia Medicaid.
When the U.S. Department of Health and Human Services declared a Public Health Emergency (PHE) due to the COVID-19 pandemic, it allowed Virginia’s Department of Medical Assistance Services (DMAS) to continue most Medicaid/FAMIS members’ coverage without having to renew their eligibility annually. As a result, more than 2 million Virginians are now enrolled in Medicaid/FAMIS.

When the PHE ends, DMAS will have 14 months to renew coverage for all Virginians enrolled in Medicaid/FAMIS. Since some Medicaid/FAMIS enrollees may have not seen a renewal form in almost 3 years, if at all, households may be unaware of what they need to do. To make matters worse, many families had to move during the pandemic, as housing costs skyrocketed. If they did not update their mailing address, they may not receive their renewal form.

Some Medicaid/FAMIS members can have their renewals completed automatically (ex parte), without having to send in renewal forms. But, for an ex parte renewal to be successful, members must still keep their contact information up-to-date.

To help spread the word about renewals resuming, DMAS has developed Public Health Emergency "Unwinding Tool Kits". The Tool Kits include flyers, social media graphics, and newsletter “blurbs” you can use to help encourage Virginians enrolled in Medicaid/FAMIS to report a change in their address, if applicable. Members who have moved or changed phone numbers in the last 3 years can report this important change:
  • To their Medicaid health plan (Managed Care Organization),
  • Online at commonhelp.virginia.gov,
  • By calling the local Department of Social Services, or
  • By calling Virginia’s ONEBenefits line at 1-833-5CALLVA.
Virginia Paves the Way to Grow Medicaid/FAMIS Dental Provider Network
For the first time in many years, Virginia Medicaid will increase the reimbursement rates it pays for dental services, thanks to the budget passed by General Assembly and signed by Governor Youngkin. This will pave the way for more dentists to join Medicaid’s network and make it easier for all Medicaid enrollees to access the dental care they need close to home.

Virginia’s adult Medicaid dental benefit includes checkups and cleanings, as well as periodontics, endodontics, prosthodontics, and restorations (some limitations may apply). Children and pregnant individuals enrolled in Medicaid/FAMIS also have access to comprehensive dental benefits, including braces for those under age 21.

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


Process Changes for Emergency Medicaid Eligibility Coming July 1
Local Departments of Social Services (LDSS) eligibility workers will soon have an easier process for determining eligibility for Emergency Services (ES) Medicaid, for Virginians who meet all eligibility criteria except immigration criteria. Beginning July 1, applications for ES will no longer require medical records to be submitted up front to determine eligibility. Instead, the individual would be enrolled in coverage limited to emergency services and the provider will submit the claim as normal.

This change will enable a smoother determination process for eligibility workers and applicants alike. It will not impact what services are able to be covered by ES. ES will still cover only medical emergencies.


Medicaid/FAMIS Enrollment
As of June 1, 2022, there were:
  • 665,154 Virginians enrolled in the New Health Coverage for Adults
  • 828,827 children enrolled in FAMIS and FAMIS Plus
  • 28,820 pregnant individuals enrolled in Medicaid for Pregnant Women (MPW), FAMIS MOMS, or FAMIS Prenatal
  • 157,986 parents or caretaker relatives enrolled in LIFC
  • 2,111 young adults enrolled in Medicaid for Former Foster Care youth
  • 48,927 adults enrolled in PlanFirst