On July 1, 2021, a new FAMIS category, FAMIS Prenatal, opened eligibility to all income-eligible uninsured pregnant women, regardless of their immigration status. As of September 21, over 2,000 women had enrolled!

FAMIS Prenatal enrollees have access to full, comprehensive benefits, including: doctor visits, lab services, prescription drugs, hospitalization, dental care, behavioral health services, and more. Labor and delivery are covered, as well as all prenatal services. To learn more, check out the Virginia Department of Medical Assistance Services (DMAS) FAMIS Prenatal Fact Sheet.

Have questions about how to help someone apply for FAMIS Prenatal? Email signupnow@vhcf.org, or call 804-828-6062.

With the shift in Afghanistan’s political climate, many Afghan evacuees are now entering the U.S. Many, including hundreds of pregnant women and children, are arriving in Virginia, and may need help applying for Medicaid/FAMIS.

These immigrants will fall into one of 3 immigration status categories:

Children and pregnant women with SIV, SIP, or Humanitarian Parolee status may be eligible for full-benefit Medicaid/FAMIS now. They are not required to meet a 5-year residency requirement (sometimes called the “5-year bar”). Children and pregnant women who are over-income for regular Medicaid may be eligible for a special program known as Refugee Medical Assistance (RMA), for the first 8 months after they arrive in the U.S. The application process for RMA is the same as for regular Medicaid.

Adult immigrants with SIV or SIP status may be eligible for Medicaid without meeting the 5-year residency requirement. Adults with SIV or SIP status who are over-income for regular Medicaid may also be eligible for RMA, for 8 months after they arrive in the U.S.

Non-pregnant adult immigrants with Humanitarian Parolee status are required to meet the 5-year residency requirement to be eligible for full-benefit Medicaid. These adults may be eligible to receive Medicaid coverage of emergency services. There is currently Federal legislation pending that may expand eligibility for Humanitarian Parolees.

Special Note: If an Afghan evacuee has not yet applied for a Social Security Number (SSN), and/or does not yet have a formal immigration ID card, s/he should still apply for Medicaid/FAMIS. Virginia Medicaid will not delay or deny coverage if an Afghan evacuee has not yet applied for a SSN, if s/he has good cause for not having it yet.

Public Health Emergency (PHE) Updates and Reminders

The COVID-19 Federal Public Health Emergency (PHE) has been officially extended until mid-October 2021, and will likely continue through the end of 2021, at the earliest. This means that no Virginians should lose Medicaid/FAMIS coverage for failure to complete a renewal during the PHE.

Those who are helping families apply for Medicaid/FAMIS during the PHE can use the Acknowledgement of Receipt of Verbal Consent (ARVC) form, found at coverva.org/en/covid-19. The ARVC form enables an Application Assister to complete and sign an application on the applicant’s behalf, with his/her permission. To use the ARVC form (after receiving a client’s verbal consent):

When the PHE does end, many Virginians will need help renewing their Medicaid/FAMIS coverage. You can help now by making sure Medicaid/FAMIS members:

Oral health is an important component of overall health. DentaQuest strives to improve the oral health of our communities by providing access to comprehensive dental care for every Smiles For Children member. The Smiles For Children Medicaid dental plan has been administered by DentaQuest, for the Department of Medical Assistance Services (DMAS) since 2005. DentaQuest, in partnership with DMAS, is working diligently to bolster the Virginia Medicaid dental network to support the expansion of the new adult benefit.

Both DMAS and DentaQuest’s main objective is to provide a high-quality dental network capable of meeting the needs of Smiles For Children members. The DentaQuest and DMAS team understand the importance of ensuring there is a large and diverse network of dental providers to care for Smiles For Children members in all urban and rural counties statewide. Outreach continues to further develop a network that includes all dental specialties, ready to serve the Medicaid population, both adults and children, including members with special needs.

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.

Fall and Winter 2021 SignUpNow Training Dates Announced!

Need information on Virginia’s Medicaid/FAMIS programs, including NEW FAMIS Prenatal (coverage for undocumented pregnant women), the Adult Dental Benefit, and changes to Medicaid due to the Public Health Emergency? Register to attend a SignUpNow workshop at vhcf.org/workshops.

SignUpNow teaches the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs:

Can’t make it to a live virtual workshop? SignUpNow workshops are also available on-demand! The on-demand workshops include the same content as the live trainings, broken down into 20-30-minute modules.

Virginia’s Department of Medical Assistance Services (DMAS) regularly publishes data on Medicaid/FAMIS enrollment, and on Medicaid/FAMIS utilization trends.

You can find this data on DMAS’s new-and-improved website:

Did you or someone you know miss the August 15, 2021 Special Enrollment deadline? Those who were eligible for unemployment benefits at any time during 2021 are now eligible for a Special Enrollment Period (SEP), to buy health insurance through the Marketplace. This means they do not have to wait for the Open Enrollment Period to shop for a Marketplace plan.

This SEP is only available to Virginians through a special process. If you think your client may be eligible for this SEP, contact a Navigator or Certified Application Counselor (CAC) to apply. Find a local Navigator or CAC at coverva.org/en/find-help-in-your-area.

Open Enrollment for the Health Insurance Marketplace is November 1, 2021 – January 15, 2022. Most Virginians will need to sign up during the Open Enrollment Period to have coverage in 2022. Those who do not sign up during Open Enrollment may not be able to sign up for 2022 coverage, unless they lose other health insurance coverage (including Medicaid/FAMIS); move outside their current insurer’s covered area; or have a qualifying life event, like getting married or having/adopting a child.

Virginians interested in purchasing health insurance through the Marketplace can find a local Navigator or CAC at coverva.org/en/find-help-in-your-area, or go to healthcare.gov, or call 1-800-318-2596 (TTY: 1-855-889-4325) to apply on their own.

On July 1, new income guidelines for the Supplemental Nutrition Assistance Program (SNAP) went into effect. Many individuals and families with incomes up to 200% of the Federal Poverty Level (FPL) may now be eligible, if they meet other financial and non-financial eligibility criteria.

Interested in helping a client see if s/he might qualify for SNAP? Check out the SNAP Benefits Calculator from the Virginia Poverty Law Center.

As Virginia emerges from the COVID-19 pandemic, vaccinating adults and eligible children against COVID-19 is top-of-mind. But, other immunizations are just as important to protect children…and some of them are now legally required by the state before kids can return to school. Take a look at this one-page guide from the American Academy of Pediatrics – Virginia Chapter on what vaccines are now required for students in Virginia.

And, if you or a loved one has not yet gotten a COVID-19 vaccine, learn how to get your COVID-19 vaccine at vaccinate.virginia.gov, or call 1-877-VAX-INVA (1-877-829-4682) (TTY: 711), from 8 a.m. to 8 p.m. Language services are available.

Want to Change Your Medicaid Managed Care Organization (MCO)? Now is the Time!

From October 1 – December 18, those enrolled in Commonwealth Coordinated Care Plus (CCC+) can change their Medicaid MCO by:

From November 1 – December 31, adults enrolled in Medallion 4.0 can change their Medicaid MCO by:

Both call centers are open Monday – Friday, from 8:30am – 6pm.

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 working with the federal government to make this change. The extension is expected to be implemented sometime in mid-2022.

Women enrolled in Medicaid for Pregnant Women (MPW) or FAMIS MOMS will soon have access to doula services! Covered services will include: up to 8 visits with a doula before the birth, a doula’s attendance at the birth, and up to 2 linkage-to-care payments. The doula benefit is expected to begin in mid-2022.

Virginia’s Department of Medical Assistance Services (DMAS) is working hard to unify the 2 existing Medicaid/FAMIS managed care programs (Medallion 4.0 and CCC+) into a single managed care contract, called Project Cardinal. Project Cardinal will help streamline processes for Medicaid members, and help avoid confusion for families with members enrolled in both programs.

Project Cardinal will help reduce administrative burden for providers, too, since it will streamline contracting, credentialing, and billing. Providers will no longer have to credential twice (once as a Medallion 4.0 provider, and again as a CCC+ provider).

Most importantly, Project Cardinal will allow for innovation and efficiency, so DMAS can serve Medicaid/FAMIS members as effectively as possible. Stay tuned for more details!

As of September 1, 2021, there were: