Fall 2025 Health Insurance Updates | | |
Stay Covered: What You Need to Know for Marketplace Open Enrollment
Open Enrollment on Virginia’ s Insurance Marketplace is right around the corner: this year, Open Enrollment begins November 1, 2025, and will end on January 31, 2026. Some recent federal changes may impact eligibility for financial help and costs of coverage on the Marketplace for certain individuals and families. To ensure the best value, individuals and families with Marketplace coverage should be sure to shop during Open Enrollment to review available options for their health needs and budget.
Have questions? Enroll Virginia navigators and assisters are trained and certified to provide free, unbiased assistance with health insurance options available through Virginia’s Insurance Marketplace. You can also call the Marketplace Call Center at 888-687-1501.
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Health Care Changes Impacting Immigrant Communities
The Virginia Poverty Law Center has published resources for immigrant families who may have questions about applying for Medicaid/FAMIS coverage, their data privacy, and potential impacts. See this overview page and this FAQ (both also available in Spanish) for more information. Additionally, DMAS remains committed to reviewing all federal guidance and providing communications to affected members.
New federal changes will impact who can access financial help and coverage through Virginia’s Insurance Marketplace based on their immigration status. The federal changes coming up soon include the following:
1) DACA recipients are no longer eligible for Marketplace coverage. As a result, Virginia Insurance Marketplace coverage for DACA recipients ended on September 30, 2025.
2) Legally present immigrants who are not eligible for Medicaid due to their immigration status (e.g., green card holders who have not met the 5-year bar) whose household incomes are below 100% of the federal poverty level will no longer qualify for financial help through the Marketplace. This change is effective January 1, 2026, but these enrollees will see these changes reflected in their Marketplace eligibility results during Open Enrollment.
- For example, this change would apply to a legally present individual who is not eligible for Medicaid due to their immigration status who earns up to $15,650 in a year or a household of three earning up to $26,650 annually.
- Legally present immigrants with higher incomes (above 100% of the federal poverty level) may still be eligible for financial help at the Marketplace.
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Cardinal Care Managed Care Is Live!
The new Cardinal Care Managed Care program is live! As a reminder, Medicaid/FAMIS members who previously had Molina as their managed care health plan are now enrolled with Humana Healthy Horizons, unless they selected a different managed care plan. Additionally, members who are in foster care, receive adoption assistance, or aged out of foster care but are under age 26 are now enrolled in the new Foster Care Specialty Plan with Anthem HealthKeepers Plus, unless they selected a different plan.
Going forward, Medicaid/FAMIS members have the opportunity to change their managed care health plan during their region’s managed care enrollment period, as follows:
- Western/Charlottesville: September 1, 2025 through October 31, 2025
- Roanoke/Alleghany and Southwest: December 19, 2025 through February 28, 2026
- Tidewater: February 19, 2026 through April 30, 2026
- Central: April 19, 2026 through June 30, 2026
- Northern/Winchester: June 19, 2026 through August 31, 2026
To learn more, compare health plans, and/or change health plans:
Have questions about the new Humana Healthy Horizons managed care plan? Check out this FAQ or call Humana Member Services at 844-881-4484.
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New DentaQuest Mobile App for Cardinal Care Smiles Dental Benefits
Virginians enrolled in Medicaid/FAMIS receive their dental services via the Cardinal Care Smiles program, administered by DentaQuest. Medicaid/FAMIS members can now make the most of their dental benefits with the DentaQuest free mobile app for Cardinal Care Smiles. With the mobile app, you can:
- View your plan’s benefits.
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Change your Dental Home. No need to call member services.
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Find a dentist near you. Filter by office hours, language and other needs.
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Download your ID card. Store it in your phone’s wallet and send it from your phone.
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New Cardinal Care Correspondence Center: Centralized Mailroom
The state has set up a new mailroom to handle all inbound Medicaid/FAMIS applicant/member-related mail. This mail was previously handled by the 120 local Departments of Social Services (DSS) throughout the state of Virginia. The new mailroom, known as the Cardinal Care Correspondence Center, now handles all inbound mail, such as completed applications/renewals and copies of verification documents, resulting in timely processing of documents and removing the burden of mail handling from local DSS staff.
Later this fall, the Cardinal Care Correspondence Center will also handle all returned mail and work to obtain updated address information for individuals and families whose mail is returned as undeliverable to ensure accurate mailing addresses on file. The Correspondence Center will utilize reliable data sources, such as forwarding addresses from the US Postal Service, along with direct email/phone/text outreach, to obtain new, accurate addresses for Medicaid/FAMIS members.
It is important for all members to report a new address so they don’t miss updates and notices. Learn how changes can be reported at Update Your Information | CoverVA
| Virginia Health Care Foundation Trainings & Resources | |
Launch of New Maternal Mental Health Initiative, It Takes a Village
Nearly one-third of Virginia’s counties are maternal health deserts, and one in eight mothers in the Commonwealth experiences a mental health condition—from persistent sadness to anxiety and hopelessness—often with serious consequences if left untreated.
Backed by the bipartisan 2025 Momnibus package, VHCF’s new statewide special initiative It Takes a Village bridges critical gaps in maternal mental health care with accessible, inclusive counseling statewide. Services are available at low or no cost and without a referral—powered by strong community partnerships and state support. For more information and a full list of participating locations click here.
Additionally, as part of It Takes a Village, VHCF and Postpartum Support Virginia are offering virtual trainings on maternal mental health at no cost to participants. Please click here to join our wait list for our November 13 and December 4 dates and potential future opportunities.
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Sign Up Now for SignUpNow!
VHCF's SignUpNow training workshops cover the ins and outs of the Medicaid and FAMIS programs, with a focus on eligibility and enrollment processes. We are regularly updating these workshops to reflect upcoming federal changes. Register for a live, virtual workshop and/or access on-demand training content here.
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SignUpNow – Medicaid/FAMIS workshops cover the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs for adults, children, and pregnant women (Medicaid, Medicaid Expansion, and the FAMIS programs). We also provide a high-level overview of Virginia’s Insurance Marketplace.
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SignUpNow – Aged Blind Disabled (ABD) workshops cover information for Virginia’s Medicaid programs for people who are 65 years or older, or who are disabled or blind, including ABD Medicaid; programs for Virginians who receive Supplemental Security Income (SSI), an Auxiliary Grant, or Long-Term Services and Supports (LTSS); and the Medicare Savings Programs.
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Project Connect Outreach Workers Are Here to Help
VHCF’s Project Connect application assisters/outreach workers help individuals and families apply for, enroll in, and renew eligibility for Virginia’s Medicaid/FAMIS programs. Project Connect assisters can help with completing Medicaid/FAMIS applications and renewals, navigating eligibility and enrollment processes, troubleshooting issues, and answering questions about Medicaid and FAMIS. A full list of Project Connect application assisters/outreach workers, their contact information, and the areas they serve is available here.
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