Cover Virginia: New Look, Same Great Features
Have you seen the new Cover Virginia website? This spring, Cover Virginia got a new look, and became more mobile phone-friendly. The Cover Virginia website offers information on the Medicaid/FAMIS programs, including:
  • Where to get one-on-one help with an application
  • How to order materials (including materials promoting the New Adult Coverage)
  • Information about Medicaid Managed Care Organizations (MCOs)
  • And MORE!

Check it out here:

And, don’t forget to stay current on the number of adults enrolled in Virginia’s New Health Coverage for Adults on the Virginia Department of Medical Assistance Services’ ( DMAS) dashboard at

DMAS updates the dashboard every two weeks, so you can follow Virginia’s progress in enrolling newly-eligible adults. As of June 30 over 295,000 adults were enrolled!

Looking for Dental Care for a Newly-Eligible Adult?
For adults over 21 enrolled in the New Adult Health Coverage, the only “core” dental benefit is medically necessary oral surgery. Many MCOs offer additional, value-added dental benefits.

For more details about the additional dental benefits MCOs are providing members, please click here for Medallion 4.0 and here for CCC Plus ( Virginia’s program for Medicaid-enrolled adults who are medically complex).

To find a dental provider in an MCO’s network, click here. Scroll down until you reach a box that invites you to Select a State and Health Plan Group. Then, choose the applicable MCO from the dropdown menu ( “Plan”).

Remember: 19- and 20-year-old enrollees in the New Adult Coverage can get full dental services through the Smiles For Children program, including semi-annual screenings, x-rays, and fillings.

Pediatricians Can Help Prevent Cavities with Fluoride Varnish
When parents think about their children’s teeth, many think the only place they can get care and guidance is from their family dentist. Although the dentist is the most knowledgeable about caring for and keeping children’s teeth healthy, pediatricians also play an important role on the oral care team. In fact, the American Academy of Pediatrics recommends pediatricians address their patients’ oral health, too. 

Since 2014, the United States Preventive Task Force has recommended that pediatricians and other primary care providers apply fluoride varnish to the teeth of all children under the age of 6. Fluoride varnish helps prevent cavities, which is important, since dental caries are the number one health issue in children.

In addition, all Medicaid programs now pay pediatricians to apply fluoride varnish. Applying varnish and counseling parents can be done by pediatricians, physician assistants and nurse practitioners. 

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.

Reminder: Annual Renewal Coming Soon!
Medicaid/FAMIS enrollees must renew their coverage annually. When possible, the local Department of Social Services ( LDSS) will attempt to renew an enrollee without contacting the enrollee. This is called an ex parte renewal.

For some newly-enrolled adults, renewal may be right around the corner, even if their New Adult Coverage just began on January 1:
  • Adults who were automatically transitioned to the New Adult Coverage (from GAP or Plan First) will maintain the annual renewal date from their prior program. 
  • Adults who completed an Express Application (either as SNAP enrollees or as parents of a child enrolled in FAMIS Plus) will need to renew by their SNAP recertification date, or their child’s renewal date.
  • Adults who completed the full application should expect to get a renewal packet around 10 months after their coverage began. Many newly-eligible adults may find that their local DSS is able to complete their annual renewal ex parte, so they do not need to complete any paperwork at renewal time.

When LDSS renews an enrollee ex parte, s/he will get a Notice of Action that shows that his/her Medicaid/FAMIS coverage will continue for another year. If the LDSS cannot complete an enrollee’s renewal ex parte, s/he will get a prepopulated renewal form in the mail. S/he can then complete the renewal by:
  • Calling Cover Virginia at 1-855-242-8282
  • Going online to and “Associating” his/her case with his/her CommonHelp account (Note: The enrollee will need a Case Number and a Client ID number to do this). From there, s/he can select “Renew My Coverage” and complete the renewal online.
  • Correcting any information on the prepopulated renewal form, signing it, and mailing it to the LDSS.

Managed Care Reminders
Children enrolled in FAMIS Plus, and adults enrolled in the Low-Income Families with Children or Former Foster Care programs, can change their Managed Care Organization ( MCO) during their region’s Open Enrollment Period each year. For residents of Northern Virginia ( Alexandria, Arlington, Clarke, Culpeper, Fairfax City, Fairfax County, Falls Church, Fauquier, Frederick, Loudon, Manassas Park, Manassas City, Page, Prince William, Rappahannock, Shenandoah, Warren, and Winchester), Open Enrollment runs from June 17 – August 31, 2019.

For residents of the Charlottesville/Central/Halifax region ( Albemarle, Amherst, Appomattox, Augusta, Buckingham, Campbell, Charlotte, Charlottesville, Danville, Fluvanna, Greene, Halifax, Harrisonburg, Louisa, Lynchburg, Madison, Nelson, Orange, Pittsylvania, Rockingham, Staunton, and Waynesboro), Open Enrollment runs from August 19 – October 31, 2019.

Those enrolled in other programs can change their MCO at other times throughout the year ( see table below).
Some populations are excluded from managed care. They do not have an MCO, so their services are covered through Fee-For-Service ( direct payments from Virginia Medicaid). Click here for a list.

Tips for Talking with Virginians About Medicaid/FAMIS
Many Virginians eligible for the New Health Coverage for Adults may not realize they qualify. Click here for tips to keep in mind when talking to newly-eligible Virginians – including what to say if someone isn’t sure they want to apply.

New Income Guidelines for Low-Income Families with Children ( LIFC ) Program in Effect
Effective July 1, the LIFC income guidelines were updated. Please see the income chart here for the new guidelines. 

Enrollment Update
As of June 1, 2019, there were:
  • 284,466 adults enrolled in the New Adult Coverage
  • 105,663 adults enrolled in Medicaid for Low-Income Families with Children (LIFC)
  • 1,269 young adults enrolled in Medicaid for Former Foster Care Youth (FFC) 
  • 41,289 adults enrolled in Plan First
  • 579,981 children enrolled in FAMIS Plus
  • 71,936 children enrolled in FAMIS
  • 14,474 pregnant women enrolled in Medicaid for Pregnant Women (MPW)
  • 1,368 pregnant women enrolled in FAMIS MOMS