The Renewals are Coming! The Renewals are Coming!
Dear Colleagues,
As you are well aware, the COVID-19 pandemic brought considerable changes to Medicaid/FAMIS coverage in Virginia and throughout the country. Most significantly, the Medicaid continuous coverage requirement ensured that the majority of Virginians enrolled in Medicaid/FAMIS would not lose their coverage, even if their circumstances changed. As a result, Medicaid/FAMIS enrollment in Virginia is higher than ever.
Due to recent federal action, the continuous coverage requirement is ending, which means that Virginia’s Department of Medical Assistance Services (DMAS) will need to redetermine eligibility for all 2.1 million Virginians enrolled, beginning in Spring 2023.
DMAS is hard at work putting measures in place to keep eligible Virginians covered, but your help will be needed more than ever to ensure that Medicaid/FAMIS members receive communication about their renewal from DMAS at the appropriate time. Stay tuned for different strategies you can use to help raise awareness of Medicaid renewals resuming, beginning in Spring 2023…and, we’d love to see you at an upcoming VHCF SignUpNow training, if you need a refresher on the Medicaid renewal process.
Onward!
-SignUpNow Team at the Virginia Health Care Foundation
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Virginia Medicaid is now Cardinal Care!
Beginning in 2023, Virginia’s two managed care programs – Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) – will be combined into one program, Cardinal Care Managed Care! This change will help reduce transitions or gaps in care if a member’s needs change, and streamline credentialing for providers. Here are answers to some of the most frequently asked questions about Cardinal Care:
Will members get a new Medicaid ID card?
Beginning in January, new Virginia Medicaid/FAMIS members (those enrolling for the first time) will receive Cardinal Care cards. Existing members will receive the new Cardinal Care card at a later date, and should continue to use their old, blue-and-white Virginia Medicaid ID cards and Managed Care Organization (MCO, or Medicaid/FAMIS health plan) card until their new Cardinal Care card arrives.
Do existing members need to do anything to get their new Cardinal Care card?
No, members do not need to take any action, so long as their telephone number and mailing address are up-to-date with Virginia’s Department of Medical Assistance Services (DMAS). Their new Cardinal Care card, and new MCO Cardinal Care card, will come to them automatically later this year.
If a member needs to update his/her address, s/he can do this by:
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Visiting commonhelp.virginia.gov,
- Calling the Cover Virginia call center at 1-855-242-8282,
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Calling his/her local Department of Social Services (LDSS), or
- Contacting his/her Medicaid/FAMIS MCO.
What changes should members expect under Cardinal Care?
One key change under Cardinal Care will be the availability of care coordination for all Medicaid/FAMIS members, if needed. They will no longer have to transition between 2 delivery systems if their needs change. Cardinal Care will also streamline members’ MCO enrollment (including annual regional opportunities to change MCOs), to help reduce confusion for families.
Will benefits change under Cardinal Care?
The core benefits available to Medicaid members will remain the same under Cardinal Care. The same 6 MCOs (Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Molina Healthcare, Optima Community Care, UnitedHealthcare Community Plan, and Virginia Premier) will continue to offer services.
Where can I learn more about Cardinal Care?
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3 Ways to Find a Dentist in the Smiles For Children Network
Everyone deserves a bright oral health future, and DentaQuest is here to help! DentaQuest makes it easy to find a dentist close to home. There are three easy ways to find a dentist in the Smiles For Children network:
1. Using the SFC Member Services Call Center. Member Services can help make appointments, find transportation, begin complaints/appeals, and more. Members can reach Member Services at 1-888-912-3456, Monday through Friday, 8am – 6pm. The TTY/TDD number (for those with speech or hearing challenges) is 1-800-466-7566. Your phone must be TTY/TDD-equipped to use this line.
2. Using the Member E-mail Form. Members can visit www.dentaquest.com/virginia, click “Member Page,” and click “Member E-mail Form” on the left side of the screen. Fill out the form and click Submit.
3. Using the DentaQuest Website. Members should only visit dentists enrolled in the SFC program. A list of these dentists is available online at www.dentaquest.com/virginia.
- Click on “Find a Dentist.”
- Click on the “Find a Dentist” button for your plan.
- Click “Choose a location and plan.”
- Enter your address, city, or zip code (Note: for the most accurate distance, enter your address). Click “Yes, this is correct.”
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Select your VA Smiles For Children plan. Confirm Selection.
You can search for a dental provider in four ways:
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Find a Dentist by Name – enter the last name of the dental provider you are looking for and select the name in the drop-down menu.
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Find a Dentist by Specialty – use this to search for specific kinds of dental providers like General Dentists, Orthodontists, and Periodontists.
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Find Services by Location – use this if you know the provider’s name and want to know the address, phone number, office hours, and other information.
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Places by Type – use this to look for locations like health care clinics and Federally Qualified Health Centers.
Smiles For Children is Virginia’s Medicaid Dental Managed Care Organization for children and adults. It is administered by DentaQuest. To learn more, visit www.dentaquest.com/virginia.
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The Virginia Department of Social Services (VDSS) has been hard at work translating key Medicaid/FAMIS correspondence into 5 additional languages! Now, more Virginians enrolling in Medicaid/FAMIS can receive their notices and other important communications in their preferred written language.
Medicaid/FAMIS enrollees can now receive the following notices in Amharic, Arabic, Spanish, Vietnamese, and Urdu:
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Notices of Action on Benefits (including approval or denial notices)
- Verification Check Lists
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Ex Parte Renewal Notices
- Spenddown Supplements
- Notices of Referral to the Health Insurance Marketplace
To ensure a Medicaid/FAMIS enrollee receives his/her correspondence in his/her preferred language, please ensure that the correct language is noted on Question #17 on the Application for Health Coverage and Help Paying Costs, or via the CommonHelp online application or Cover Virginia telephonic application.
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SignUpNow Announces New Winter/Spring 2023 Workshop Dates
SignUpNow now offers 2 training workshops: SignUpNow – Medicaid/FAMIS addresses Virginia’s Medicaid/FAMIS programs for children, pregnant people, and Medicaid Expansion Adults, and SignUpNow – ABD addresses Medicaid for Virginians who are Aged, Blind, or Disabled.
SignUpNow – Medicaid/FAMIS workshops cover the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs for children and families, including:
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New Adult Coverage (“Medicaid Expansion”)
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Programs for children and pregnant women (FAMIS, FAMIS Plus, FAMIS Prenatal, FAMIS MOMS, and Medicaid for Pregnant Women)
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Low Income Families with Children (LIFC)
- Medicaid for Former Foster Care Youth
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Plan First (family planning)
SignUpNow – ABD workshops cover eligibility requirements, application procedures, and post-enrollment information for Virginia’s Aged, Blind, or Disabled (ABD) Medicaid covered groups, including:
- ABD with Income ≤80% FPL
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Virginians who receive Supplemental Security Income (SSI) or an Auxiliary Grant
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Medicare Savings Programs (Qualified Medicare Beneficiary, Special Low-Income Medicare Beneficiary, etc.)
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Virginians needing Long-Term Services and Supports (LTSS), including those who are Institutionalized, in Hospice, or receiving Community Based Care.
Unable to wait for a live workshop? Check out the SignUpNow on-demand modules here! To receive a notice when new workshop dates become available, and to receive updates about Medicaid/FAMIS policy and procedures, please click here.
New Public Charge* Rule Final and In Effect!
In September 2022, the Biden Administration released a final rule regarding Public Charge, that codified important existing guidance. This new rule will help ensure that immigrant families nationwide do not need to be concerned about enrolling in Medicaid/FAMIS. Key provisions of the rule include:
- That eligible children, parents, and others can enroll in Medicaid/FAMIS and other key benefits for which they qualify, without needing to worry about their future immigration status being impacted.
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That Medicaid/FAMIS will not count against a person for the purposes of the Public Charge totality of circumstances test, unless the person is receiving institutional long-term care (not including home- and community-based services),
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That a child’s or family member’s receipt of benefits cannot be used against his/her family member who is attempting to gain admission to the U.S., and
- Elements that make it challenging for future rulemaking to reverse these rules.
The new Public Charge rule went into effect on December 23, 2022. The Biden Administration hopes it will help reverse the “chilling effect” of the now-defunct 2019 Public Charge rule, that caused some Medicaid/FAMIS-eligible children, parents, and pregnant people to forego enrolling, despite being eligible.
*The “Public Charge” test seeks to determine whether a person who wants to establish or adjust his/her immigration status is likely to become reliant on the government for his/her support. It is based on an individual’s totality of circumstances. Most individuals who are eligible for Virginia’s Medicaid/FAMIS programs are already not subject to a Public Charge test.
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Affordable Connectivity Program Available to Virginia Families
Have you heard about the Affordable Connectivity Program (ACP)? This new federal program can help families pay for broadband service and internet-connected devices. Eligible families can receive:
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Up to $30/month discount for broadband service;
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Up to $75/month discount for households on qualifying Tribal lands; and
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A one-time discount of up to $100 for a laptop, desktop computer, or tablet purchased through a participating provider, so long as the household contributes between $11 – $49 toward the purchase price.
The ACP is limited to one monthly service discount, and one device discount per household. A household is eligible for the ACP if its income is at or below 200% of the Federal Poverty Level (FPL), or if a member of the household meets at least one of the criteria outlined at fcc.gov/acp.
To benefit from the ACP, eligible households must both:
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Apply for the program at affordableconnectivity.gov/. The application can be completed either online or by downloading, printing, and mailing a paper version, AND
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Contact their preferred participating provider to select a plan, and have the discount applied to their bill. Participating providers include VerizonFios, Comcast, and many others. See a full list at whitehouse.gov/getinternet/.
For more information and full details, visit fcc.gov/acp, or call 877-384-2575.
Medicaid/FAMIS Enrollment
As of January 1, 2023, there were 2.14 million Virginians enrolled in Medicaid/FAMIS. This includes:
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863,850 adult Virginians (includes 716,760 in Medicaid Expansion)
- 860,552 children enrolled in FAMIS or FAMIS Plus
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33,834 pregnant individuals enrolled in Medicaid for Pregnant Women (MPW), FAMIS MOMS, or FAMIS Prenatal
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239,872 Virginians enrolled due to being Aged, Blind, or Disabled (ABD)
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