Preventive Services Now Covered for Adult Medicaid Enrollees
As of July 1, preventive services are covered for adults enrolled in full-benefit Medicaid. While adults enrolled in the New Health Coverage for Adults have had access to these services since 2019, those enrolled in the Low-Income Families with Children (LIFC) program, the Medicaid program for Former Foster Care youth, and many enrolled in the full-benefit programs for those who are Aged, Blind, or Disabled (ABD), were not able to access them.

Covered preventive services align with the recommendations of the U.S. Preventive Services Task Force, a panel of experts that helps evaluate evidence-based practices for disease prevention. The following are now available at no cost to adults, and without the need for prior authorization:
  • Checkups;
  • Smoking cessation services;
  • Vaccinations (including Hepatitis A and B, flu, shingles, and many others); and
  • Screenings, including for cancer, cholesterol, high blood pressure, and mental health conditions.

Preventive services through Medicaid were already available to children and pregnant individuals. Those enrolled in Medicaid for Emergency Services only, and those enrolled in partial-benefit or partial coverage programs (e.g., PlanFirst), are not able to access these new preventive services.
SignUpNow Announces New Fall-Winter 2022-23 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:
  • New Adult Coverage (“Medicaid Expansion”)
  • Programs for children and pregnant women (FAMIS, FAMIS Plus, FAMIS Prenatal, FAMIS MOMS, and Medicaid for Pregnant Women)
  • Low Income Families with Children (LIFC)
  • Medicaid for Former Foster Care Youth
  • 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
  • Virginians who receive Supplemental Security Income (SSI) or an Auxiliary Grant
  • Medicare Savings Programs (Qualified Medicare Beneficiary, Special Low-Income Medicare Beneficiary, etc.)
  • Virginians needing Long-Term Services and Supports (LTSS), including those who are Institutionalized, in Hospice, or receiving Community Based Care.

Fall-Winter 2022 workshop dates and registration links are NOW LIVE at vhcf.org/workshops/.

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.
Are You Afraid of the Dentist?
Lots of people fear the dentist. Some people even skip going the dentist altogether because of fear. While being afraid is normal, good dental hygiene and treatment are important to overall health.

Here are 5 tips to help overcome dental fears:
  1. Find a dentist that you like and trust. Virginia Medicaid/FAMIS members can call 1-888-912-3456 for the names of participating dentists close to home.
  2. See the dentist “better late than never.” Even if you haven’t seen the dentist for a while, it’s important to go. You may be embarrassed about the shape your mouth is in. You may be afraid the dentist will be upset with you. The dentist wants to help you with your oral care.
  3. Try to see your dentist two times a year. The dentist cares about your mouth and wants to help you take care of it. The more you see the dentist, the better your mouth and overall health will be.
  4. Relax. If dental noises scare you, take music along. Breathe slowly in and out. Think of something you like, a favorite place, or a good memory.
  5. Keep in mind: Worried about pain? Dentists have many new ways to work on your mouth – there is very little pain now with anything the dentist does.

And, here are some do’s and don’ts for helping children have a good dentist visit:
  • DO brush and floss together. Put on your favorite song. Make it fun! This will help your child learn, and help set good habits.
  • DO tell your child that the dentist will count his/her teeth, and clean them, to make his/her smile bright and healthy.
  • DO tell your child that if a tooth needs a little extra work, the dentist will put the tooth to sleep, and it will wake up when you get home.
  • DON’T talk to your child about pain, or tell your child scary dentist stories. Don’t let brothers and sisters tell scary stories, either.
  • DON’T use words like “drill” or “shot.”
  • DO be cheerful, relaxed, and eager about visits to the dentist. Your child will look at how you are reacting and react like that, too.

Want to learn more about Smiles For Children, and Medicaid/FAMIS dental benefits? Attend a Smiles For Children 101 virtual information session! These sessions allow Medicaid members, nonprofit organizations, and local government entities to learn about the Smiles For Children program and its benefits for adults, children, and pregnant members. Sessions also include an overview of DentaQuest’s roles in Virginia; the importance of oral health; the physical and oral health connection; and member education, tools, and supports.

Sessions are offered every second Tuesday of the month. Advance registration is required at: https://us06web.zoom.us/meeting/register/tZEkf-mgqzItHNenWDvxWAEjRLvJlcyISG8e.

Questions? Contact Altise M. Street, Virginia’s Smiles For Children Outreach Coordinator, at 804-201-5439, or Altise.Street@greatdentalplans.com.
Free Materials Available to Bolster Medicaid/FAMIS Community Outreach
Did you know? You can now order FREE materials to help you promote Virginia’s Medicaid/FAMIS programs in your community, through the Cover Virginia website. Visit the Materials page, and complete the online form to note which materials you’d like to order. Many, including materials targeting students and parents during the Back-to-School period, are available in multiple languages, including:
  • Arabic
  • Amharic
  • Dari
  • Pashto
  • Spanish
  • Urdu
  • Vietnamese

Looking for posters, palmcards, and more, customized with your organization’s contact information and logo? The U.S. Centers for Medicare and Medicaid Services (CMS)’s Connecting Kids to Coverage initiative will create and send a free, customized digital design of the materials within its Outreach Tool Library. To learn more or request materials, go to insurekidsnow.gov.


Previews of Coming Attractions
Health Insurance Marketplace Open Enrollment Period Begins November 1
It’s [almost] that time of year again! Open Enrollment for the Health Insurance Marketplace will run from November 1, 2022 – January 15, 2023. Most Virginians will need to sign up during the Open Enrollment Period to have coverage in 2023. Only in limited circumstances can someone sign up outside the Open Enrollment Period.

And, because of the Inflation Reduction Act, the enhanced financial help available through the Marketplace will continue in 2023! Those who received extra subsidies during 2021 and 2022 can continue to get them, to help make their Marketplace plan more affordable. Virginians interested in purchasing health insurance through the Marketplace can:
  • Find a local Navigator or Certified Application Counselor (CAC), who is specially-trained to help with application and plan selection at coverva.org/en/find-help-in-your-area. Navigator and CAC services are free to consumers.
  • Go to healthcare.gov, or call 1-800-318-2596 (TTY: 1-855-889-4325) to apply on their own.

And, don’t forget: Virginians can enroll in Medicaid/FAMIS year-round. There is no requirement to enroll within a special timeframe.


Virginia’s Medicaid Programs will soon be known as Cardinal Care
Beginning in January 2023, Virginia’s two Medicaid managed care delivery programs (Medallion 4.0 and CCC+) will be combined, and will get a new name: Cardinal Care.

Cardinal Care is a single system of care for all 2 million Virginia Medicaid/FAMIS members. It will continue to offer members the same programs and services, and will not change any existing coverage. While members will eventually be issued new Medicaid ID and MCO ID cards sporting the Cardinal Care logo, they do not need to take any action to enroll in Cardinal Care. They can continue to use their blue-and-white Medicaid ID cards, and existing Managed Care Organization (MCO) cards. Both the old and new cards will be accepted by Medicaid providers.

Cardinal Care will offer the following benefits for Medicaid/FAMIS members:
  • Single system of care that reduces transitions between programs, or gaps in care if a member’s needs change;
  • Care coordination, available to all members, as needed; and
  • Streamlined enrollment and renewal processes (including annual regional opportunities to change MCOs), to help reduce confusion for families.

Members and those who serve them can learn more at dmas.virginia.gov/for-members/cardinal-care/.
Cardinal Care will help reduce administrative burden for providers, since it will streamline contracting, credentialing, and billing. Providers will no longer have to credential twice (once as a Medallion 4.0 provider and again as a CCC+ provider). Providers can learn more at dmas.virginia.gov/for-providers/cardinal-care-transition/.


COVID-19 Public Health Emergency and Medicaid Continuous Enrollment Still in Effect
When the U.S. Department of Health and Human Services declared a Public Health Emergency (PHE) due to the COVID-19 pandemic, it allowed DMAS to continue most Medicaid/FAMIS members’ coverage without their having to renew eligibility annually. When the PHE ends, DMAS will have 12 months to initiate renewals for all 2 million Virginians enrolled in Medicaid/FAMIS (with an additional two months for cleanup work).

For renewal to be successful, members must keep their contact information up-to-date. Members who have moved in the last 3 years can report an address change by:
  • Logging on to Commonhelp.virginia.gov,
  • Calling their Medicaid/FAMIS Managed Care Organization (MCO),
  • Calling their local Department of Social Services, or
  • Calling Virginia’s ONEBenefits line at 1-833-5CALLVA.

And, don’t forget! To help spread the word about renewals resuming, DMAS has developed PHE "Unwinding” Tool Kits that include flyers, social media graphics, and newsletter blurbs you can use to help encourage your clients/patients to report a change in their address.


Medicaid/FAMIS Enrollment
As of September 1, 2022, there were 2.07 million Virginians enrolled in Medicaid/FAMIS. This includes:
  • 685,404 Virginians enrolled in the New Health Coverage for Adults
  • 841,307 children enrolled in FAMIS or FAMIS Plus
  • 27,495 pregnant individuals enrolled in Medicaid for Pregnant Women (MPW), FAMIS MOMS, or FAMIS Prenatal
  • 162,762 parents or caretaker relatives enrolled in LIFC
  • 65,234 Virginians receiving Limited Benefits as Aged, Blind, or Disabled (ABD, includes the Medicare Savings Programs)
  • 161,403 Virginians receiving Full Benefits as ABD
  • 79,106 Virginians enrolled in ABD due to receiving Long-Term Services and Supports (LTSS)

Did you know? Virginia’s Department of Medical Assistance Services (DMAS) regularly publishes data on Medicaid/FAMIS enrollment, and utilization trends. You can find this data on DMAS’s website:
  • Medicaid Expansion (New Health Coverage for Adults) enrollment data, and utilization data.
  • Medicaid/FAMIS enrollment. Be sure to check out the scrollbar at the top of the page for month-over-month enrollment by health plan and Medicaid/FAMIS category.
  • NEW! Behavioral Health Dashboard provides helpful information on service utilization and high-level demographic information about individuals using Medicaid/FAMIS behavioral health services.