Virginia Medicaid, FAMIS and FAMIS Plus Managed Care Programs. How you can enroll
How you can enroll in Medicaid:
(adapted from the Virginia Medicaid Handbook)
To apply for Medicaid, contact the Department of Social Services (DSS) in the city or county where you live. The phone number for your local DSS can be found in the blue pages of your phone book. Applications can also be filed at some larger hospitals. An application must be signed by the person who needs assistance unless it is completed and signed by the applicant’s legal guardian, conservator, attorney-in-fact, or authorized representative. A parent, guardian, authorized adult representative, or caretaker relative with whom the child lives must sign applications for children under the age of 18. Children under the age of 18 cannot apply for themselves, unless they are emancipated. However, if a child under the age of 18 has a child of their own, they may file an application for the child. A face-to-face interview is not required.
You may use the screening tool on the DSS website (http://dssiad.dss.state.va.us/EligibilityScreening
) to help determine whether you are eligible for Medicaid or children's health insurance, but the final decision must be made by an eligibility worker at your local DSS.
Most Virginia Medicaid enrollees are required to receive their medical care through managed care programs. Virginia has two managed care programs established to provide quality health care services to enrollees – MEDALLION and MCO (Managed Care Organization) programs. If you meet the criteria to be assigned to a managed care program, within 15-45 days after your Medicaid approval you will receive a letter from DMAS requiring you to choose either a MEDALLION Primary Care Provider (PCP) or an MCO for your health care. You will receive helpful information about the programs such as a list of MEDALLION PCPs and a Help Sheet, or an MCO Comparison Chart and a brochure. If you do not make a choice, you will be assigned to a PCP or MCO.
How you can enroll in FAMIS, FAMIS Plus, and FAMIS MOMS
(adapted from the FAMIS handbook)
Applying for FAMIS, FAMIS Plus and FAMIS MOMS is quick and easy. Just call toll-free 1-866-87FAMIS (1-866-873-2647). Interpreters are available. Our representatives will connect you with someone who speaks your preferred language. Or, log onto http://www.famis.org
to Apply Online! You may also apply at your local Department of Social Services. All completed applications must include one month’s proof of income (for the most recent month) and proof of the children’s immigration status if the children are not U.S. citizens. If your child qualifies for FAMIS Plus and is a U.S. citizen, you will also be asked to provide proof of U.S. citizenship and identity.
You must contact FAMIS if you want to apply for coverage for a new baby, or for a child who has moved into your household. Please note: A signed application for a new baby must be received in the birth month or within three months following the month the baby is born to ensure that birth-related expenses will be covered if the baby is found eligible. You may fax your child’s application to FAMIS at 1-888-221-9402 or start the application process on line at www.famis.org. If you have questions, call FAMIS at 1-866-873-2647.
You must contact FAMIS if you want to apply for coverage for a pregnant woman in your household who is currently not covered by FAMIS. You may fax the application to FAMIS at 1-888-221-9402 or start the application process on line a http://www.famis.org/
. If you have questions, call FAMIS at 1-866-873-2647.