From Us to You
Dear Friends and Colleagues,
We hope you are hanging in there as you navigate the many changes and challenges COVID-19 has brought to your lives. We at the Virginia Health Care Foundation are grateful every day to be working with you, who are so dedicated to helping uninsured and medically underserved Virginians obtain needed health care.
The Medicaid application assistance you are providing to some of the tens of thousands left unemployed by COVID will result in comprehensive insurance coverage and the peace of mind that comes with it. Your creative approaches to serving them remotely or at an appropriate social distance are remarkable. Your commitment is inspiring.
As a result, we’ve devoted this quarter’s newsletter to making sure you’re informed about the many positive changes occurring because of COVID-19. Some maximize health coverage and expedite food assistance to those affected by COVID job loss. Others provide new resources for medical, behavioral health, and dental providers.
We dedicate this newsletter to you and thank you for all you are doing to help your patients/clients during these unprecedented times.
Debbie Oswalt & the VHCF Team
VHCF launches COVID-19 Resource Page
COVID-19 Resource Page
contains a wide array of resources for those seeking information or help during this time of COVID. It contains topics such as personal health, medication assistance, Medicaid/FAMIS coverage, unemployment, child care, food and other many other resources.
Please let us know if it is missing something that would be helpful to you.
Medicaid/FAMIS Eligibility for Those Newly Unemployed
Virginia Medicaid covers comprehensive health and mental health services, including testing and treatment for COVID-19.
Many Virginians who have lost their jobs or been furloughed as a result of COVID-19 are now eligible for Virginia’s Medicaid or FAMIS programs. Even those who have been denied in the past may now qualify.
Current monthly income and family size are the only criteria used to evaluate financial eligibility for this comprehensive insurance coverage, for those under age 65.
For example, the following would be income eligible:
- Single adult Virginians with a monthly income up to $1,469 (annual income up to $17,609)
- Adults in a household of three with a monthly income of $2,499 (annual income up to $29,974) may be eligible.
- Children in families earning up to $2,680 for a family of three (annual income up to $38,776).
Home, land and retirement savings
do not count as income. COVID-19 stimulus checks and Economic Income Payments from the IRS, and additional federal unemployment
do not count as income for Medicaid/FAMIS eligibility.
VHCF-funded Outreach Workers provide remote, free, one-on-one help to those who want to learn about, apply for, or renew Medicaid/FAMIS coverage. To reach an Outreach Worker in your area, visit the “Find Help in Your Area” page of the
website. If there is no Outreach Worker in your community, patients can apply
or via phone: 855-242-8282.
Changes to Virginia’s Medicaid/FAMIS Programs to Ensure Coverage and Care During COVID-19
The Virginia Department of Medical Assistance Services (
) has moved quickly to identify and remove potential policy and program barriers to maximize availability of Medicaid coverage. Highlights follow:
- No Medicaid/FAMIS cases will be closed during this health emergency, unless the client requests the case to be closed, the client dies or the client permanently moves out of state.
- If a member’s coverage was cancelled on or after March 31, 2020, Virginia Medicaid is taking steps to reinstate coverage retroactively back to the cancellation date. Coverage will continue through the remainder of the COVID-19 emergency. If coverage was reduced from full coverage to limited coverage, like Plan First, after March 1, 2020, it will be restored to full coverage for the rest of the COVID-19 emergency. Members will receive a letter in the mail documenting that coverage was reinstated.
- Medicaid for Pregnant Women and FAMIS MOMS members will remain covered after the 60-day postpartum period ends.
- The appeal process has been modified to increase flexibility (keep coverage while appeal is pending, phone hearings, can reschedule hearings)
- Out-of-network authorization requirements have been relaxed.
- Use of telehealth (phone and video visits) is billable and encouraged. Telehealth and technical requirements are relaxed.
- Co-pays have been eliminated for Medicaid/FAMIS-covered services.
- Members can fill a 90-day supply of many routine prescriptions.
- No pre-approvals are needed and approval extensions are automatic for many critical medical services.
- If a Virginia Medicaid member is temporarily living in another state during this health emergency, the member stays enrolled in Virginia Medicaid during this time.
- Outreach will occur to higher risk populations and older members to review critical needs.
DMAS is posting information on COVID-19 on both
and on the
website. The information on Cover Virginia’s page is more focused on Medicaid/FAMIS benefits and client-focused information. Go to
and look for the red COVID-19 button at the top of the page
DMAS is Here for Virginians
Kudos to DMAS for its heartfelt video for Medicaid members and prospective members! Take a
minute to watch this thoughtful message
from Karen Kimsey and the DMAS Team, warmly reminding Virginians that the Department and Medicaid are here to serve the Commonwealth during the pandemic.
Health Insurance from the Federal Marketplace
Many Virginians may now be eligible to obtain health insurance from the Federal Health Insurance Marketplace due to COVID-related job loss or a reduction in hours. Individuals in households with household income up to 400% FPL may also qualify for financial assistance from the Marketplace. While the 2019 Open Enrollment period for the Marketplace has ended, these Virginians may be eligible for a Special Enrollment Period, which would allow them to apply for coverage outside of Open Enrollment.
For more information about who may qualify for a Special Enrollment Period, including for Loss of Health Insurance, go to the
page on the Cover Virginia website or visit
Food Assistance via the Supplemental Nutrition Assistance Program (SNAP)
Many more Virginians are applying for SNAP food assistance during this time. Click
for the SNAP income eligibility limits.
Several policy and procedure changes have been made to facilitate access to food during this time:
- Certification periods for SNAP expiring in March, April and May 2020 will be extended for 6 months until September, October and November 2020.
- Virginia SNAP recipients will receive emergency SNAP benefits during this time. This will increase allotments for all households to the maximum allowable for that household size. Emergency benefits for March were made available on March 25. April Emergency benefits were issued on April 16, the day regular SNAP benefits are issued.
- Effective April 1, 2020, the SNAP work requirement was waived for the duration of this health emergency.
For individuals experiencing difficulty with SNAP, assistance is available from the Virginia SNAP Hotline: 800-552-3431
Contacting Your Local Department of Social Services (DSS)
Local DSS agencies are not open to the public during the pandemic. However, DSS staff are working to process applications and manage cases. Click
to get information about Office Closures, Delays and Outages for your local agency. Click on the “Details” button to the right of the local agency name for more information.
Public Charge Rule and Medicaid/FAMIS
The new Public Charge Rule became effective on February 24, 2020. Many immigrants worry about receiving public benefits, including Medicaid, due to the Rule. These individuals are afraid they will be labeled a “Public Charge”, which may prevent the person from becoming a Legal Permanent Resident or prevent other family members from immigrating to the United States.
Enrollment in Medicaid/FAMIS by children or pregnant women in the family does not count in the public charge test (
neither does use of Emergency Services Medicaid
). The public charge test does not apply to some immigration statuses (
e.g., asylees, TPS, and U or T Visas
). For more helpful information on Public Charge and the Virginia Medicaid/FAMIS programs, go to
: Pending lawsuits may change the Rule in the future.
Public Charge and COVID-19
Good news! Testing, treatment, or preventive care related to COVID-19 will not be considered as part of the Public Charge Inadmissibility Determination, even if treatment is provided or paid for by one or more public benefits, as defined in the
e.g., federally funded Medicaid
). See the “Alert” in the box at the top of the page.
If someone is diagnosed as having a communicable disease, like COVID-19, that fact may cause them to be inadmissible until the condition is treated or the person is no longer communicable. This is different from the Public Charge Ground of Inadmissibility.
If the person wants to apply for a green card, s/he will need to seek treatment. Thankfully, treatment will not be considered in the public charge determination.
These patients should keep very good records and, where possible, have clinics/doctors specify that the treatment they are receiving is related to COVID-19.
Update: Medicaid/FAMIS Member Correspondence
The DMAS and the Virginia Department of Social Services (
) have worked hard to make correspondence received by Medicaid/FAMIS applicants and members easier to read.
The Phase I rollout of new correspondence occurred as expected in early March 2020 (
including the new Notice of Action and Verification Check List
). The Phase II rollout is now planned for June 2020 (
including the revised Renewal Notice
Smiles For Children
The priority remains to ensure continued coverage and access to dental coverage during this period. During the COVID 19 health emergency, there will be the following flexibilities applicable to
Smiles For Children
- Pregnant Women Eligibility Extension - There will be no termination of dental benefits for pregnant women during this emergency period. Pregnant women will remain in the pregnancy aid category past their 60-day postpartum period. Providers should continue to verify eligibility for members on the DentaQuest provider portal or by calling Customer Service at 888-912-3456.
- Teledentistry codes may be used in accordance with the ADA and Smiles For Children program guidelines.
the DentaQuest Partnership for Oral Health Advancement is offering special webinars designed to help oral and other health professionals implement practice improvement and prevention-focused care within this unique environment. Past and present webinars are located
Virginia’s Health is In Your Hands
prepared by the Virginia Department of Health and narrated by Lilian Peake, MD, Virginia’s epidemiologist, about Virginia and COVID-19 and what Virginians need to know.
VDH provides up-to-date information on Virginia’s response to COVID-19. Click
to view the VDH COVID-19 webpage and
for more COVID-19 resources from the health department. Please also see
Steps to Slow the Spread of COVID-19
For more than 10 years, RxOutreach, a nonprofit pharmacy, has provided medicines at 70% – 90% below retail pharmacy cost to low-income individuals and families, mailed directly to their homes. RxOutreach is temporarily extending its deep discounts to individuals and families facing financial hardship because of COVID-19. To see the guidelines and to enroll, visit their
, then, click on COVID-19.
Behavioral Health Resources
Behavior Health Hub
serves as a venue for the behavioral health community to share new resources, tips, and thoughts related to the delivery of behavioral health services and self-care during the COVID-19 public health emergency. To join the Behavioral Health Hub listserve, email
April 2020 Enrollment in Medicaid/FAMIS
As of April 1, 2020, there were…
- 410,980 adults enrolled in Virginia’s new Medicaid health insurance (as of April 15, 2020)
- 601,634 children enrolled in Medicaid (including the CHIP Medicaid Expansion)
- 76,074 children enrolled in FAMIS
- 13,741 pregnant women enrolled in Medicaid for Pregnant Women
- 1,642 women enrolled in FAMIS MOMS
- 1,588 young adults enrolled in Medicaid for Former Foster Care youth
- 109,412 adults enrolled in Medicaid for Low-Income Families with Children (LIFC)
- 46,521 adults enrolled in Plan First