Beginning today, adults who are Lawful Permanent Residents (LPRs, sometimes called “green-card holders”) will no longer be 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, so that their eligibility can be re-determined. Keep in mind that some LPR Virginians who were ineligible for Medicaid because of the “40-Quarter Rule” may be enrolled in health insurance through the Health Insurance Marketplace, with financial help. Once these individuals become enrolled in Medicaid, it will be important for them to end their Marketplace plan, so they can avoid being billed for coverage they no longer need.

Check out this factsheet for details about this exciting change! Learn more at coverva.org.

Effective March 29, a new contractor, Maximus, has assumed key functions at Cover Virginia. Callers to the Cover Virginia Call Center (CVCC) should soon notice a new-and-improved interactive voice response (IVR) experience, decreased wait times, and an automated customer service satisfaction survey. This summer, the new CVCC will also include access to information about all benefits (including SNAP, TANF, and energy assistance), via the Department of Social Services (DSS) Enterprise Customer Service Center.

Additional improvements will include faster processing at the Cover Virginia Central Processing Unit (CVCPU), and new collaborations between the Cover Virginia Incarcerated Unit (CVIU) and state and local organizations that work with incarcerated Virginians. And, be sure to check out the new look to the Cover Virginia website (www.coverva.org)!

Beginning July 1, 2021, Smiles For Children will provide dental benefits to adults in Medicaid! Dental coverage for adults enrolled in Medicaid will focus on overall oral health, prevention, and restoration. Members can contact DentaQuest for program limitations and requirements. Services will include:

A new FAMIS prenatal benefit is on the way for income-eligible pregnant women living in Virginia, regardless of their immigration status. (Yes, you read that correctly!)

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.

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.

The 2021 Profile of Virginia’s Uninsured is available now on the Virginia Health Care Foundation’s (VHCF) website. The Profile provides a wealth of information about uninsured Virginians, including:

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 (dkonrad@vhcf.org).

On March 9, 2021, the Department of Justice announced that it would stop defending the Trump Administration’s regulations around what makes a person considered likely to become a “Public Charge.” These regulations had caused many families with immigrant members to forego applying for Medicaid/FAMIS, even though many were eligible for the programs, and/or would not be subject to a “Public Charge” test.

Federal courts have dismissed all existing cases pertaining to the rule. U.S. Citizenship and Immigration Services (USCIS) removed the new rule from the Federal Register. As a result, the Department of Homeland Security (DHS) will return to using the “Public Charge” policies outlined in 1999, which state that enrollment in health coverage programs like Medicaid/FAMIS do not count against a person undergoing a “Public Charge” test, unless that person is receiving long-term care services.

For up-to-the-minute information, go to www.protectingimmigrantfamilies.org.

Reminder: Health Insurance Marketplace Reopened until August 15, 2021!

Virginians who need health insurance, but are above the income limits for Medicaid/FAMIS, 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.

SignUpNow Training Available On-Demand!

Did you know that there is 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 20-30-minute modules.

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

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

As of March 1, 2021, there were: