COMING SOON: New Health Coverage for Adult Virginians!
January 1, 2019 will bring new health coverage to Virginia for adults, ages 19 - 64, with household incomes up to 138% of the Federal Poverty Level ($16,754 per year for an individual or $28,677 for a family of 3)! Applicants must also meet citizenship or immigration and residency requirements. The new coverage will provide low or no-cost health insurance to nearly 400,000 adults across the state.
The Department of Medical Assistance Services (DMAS), Virginia Department of Social Services (VDSS), and the Cover Virginia Call Center (CVCC) are working hard to get ready and are making every effort to ease the application and enrollment process for the new coverage.
As details become solidified and more information is available, updates are posted to Sign up to receive updates from Cover Virginia and check out the  Cover Virginia "Advocates" pagefor PowerPoint slides and other materials to stay up-to-date on the new coverage. Download or order Cover Virginia brochures and posters here .

Pathways to New Coverage
There are a number of ways for adult Virginians to enroll in the new coverage. To streamline enrollment for as many Virginians as possible, DMAS has developed several strategies that are being implemented in September and October.
Auto Enrollment
  • GAP enrollees (Governor's Access Plan)
  • Plan First enrollees (up to 138% FPL) 
Individuals already enrolled in Virginia's limited-benefit Medicaid programs, GAP and Plan First, will be automatically enrolled in the new coverage. They will receive a letter from DMAS indicating that they will be enrolled in the new full-benefit coverage, effective January 1, 2019.
Plan First enrollees with incomes at or above 139% FPL to at or below 205% FPL will continue to be enrolled in Plan First.
Express Application
  • SNAP (Supplemental Nutrition Assistance Program) enrollees
  • Parents of children currently enrolled in Medicaid
SNAP enrollees and parents of children enrolled in Medicaid will receive a letter and a 3-question Express Application in the mail. They can enroll in the new coverage by calling Cover Virginia (855-242-8282), going online to CommonHelp, or by returning the Express Application in the postage paid envelope included with the letter. These individuals will need to act by the deadline (tentatively January 4, 2019) to be enrolled through the Express Application.

All other adult Virginians who may be eligible for the new coverage can apply any time, starting in late fall 2018, via:
  • Cover Virginia Call Center (855-242-8282)
  • VDSS Enterprise Call Center
  • Paper application, which can be submitted via mail or hand delivered to the local Department of Social Services (LDSS)
  • In person at the LDSS (an appointment is likely necessary)
Want to know more about the new coverage? Come to a SignUpNow training!
SignUpNow teaches the "ins and outs" of the eligibility requirements, application procedures, and post-enrollment information for Virginia's state-sponsored health insurance programs:
  • New adult coverage
  • Programs for children and pregnant women
  • Plan First
  • Low Income Families with Children (LIFC) program
Been to SignUpNow before? This year's workshops will cover important information about the new health coverage, as well as updates to other state-sponsored health insurance programs (Medicaid/FAMIS). Please, join us!
SignUpNow workshops are FREE. Seating is limited, so register early! Workshop specifics and online registration are available on the SignUpNow website,

New Medicaid Tracking Enhancements Coming Soon to TPC
VHCF is in the midst of making helpful enhancements to TPC that will be available at the end of October. These include:
  • Adding the Virginia Medicaid application to TPC
  • Ability to auto-populate some patient information onto Medicaid application (same as with PAP forms)
  • Links to online Medicaid portals/applications 
  • Mechanism to track the status of Medicaid applications (submitted, pending, approved, denied)
  • New report features
TPC    will host two webinars in early November to review all of the new enhancements related to Medicai d. Click here to register for one of these webinars.  
You "Rx"ceptional Award Winner Honored at VHCF's Heroes in Health Care Event

Jeanne Kidwell of the   Fauquier Free Clinic was recognized as the recipient of the 2018  You "Rx"ceptional Award at VHCF's Heroes in Health Care event on September 24th  in Richmond. Learn about her commitment to her patients by watching the video   here . This event also recognized the extraordinary work of VHCF's Unsung Heroes and supporters whose dedication has increased access to primary healthcare for so many uninsured and underserved Virginians.

Highlights of Important PAP Updates & Resources
Allergan's PAP has a new brandname cardiovascular product now available, Byvalson
( nebivolol and valsartan ). It is used to lower high blood pressure and is now available in

GSK's Patient Assistance Program has a few changes in medication availability: Requip XL 2mg (Dystonias/Parkinson Disease) is no longer available to new patients effective 7/13/2018. Other dosages are still available on the program. Lamictal tablets (Bipolar Disorder/Seizure Disorders) will no longer be available to new patients after 01/01/2019. The last day for new patient enrollments to be accepted is 12/14/18. If no generic options are appropriate for certain patients, providers will be able to complete an Attestation of Necessity form for enrollment consideration. Lamictal XR will not be impacted.

 Novartis Patient Assistance Foundation has new technology! Hard copy financial documentation is no longer required during annual patient re-enrollment if the consent checkbox is marked on the application, Novartis can perform an automated income check. A new automated follow-up call service has been implemented to confirm medication refills by phone without the need to speak to a representative if you opt in for this service. Physicians can also ePrescribe directly to the pharmacy! For questions about these new services, contact Novartis customer service at 1-800-277-2254.

ANI Pharmaceuticals has acquired Arimidex (prescription hormonal treatment that helps fight breast cancer) from AstraZeneca and this product is no longer available on the AZ&Me Prescription Savings Program. Ani offers the Arimidex Patient Direct Program. Patients must have a valid prescription even if you are a Medicaid or Medicare Part D recipient. Through Arimidex Patient Direct, Arimidex tablets are available for $30 (30-day supply) or $90 (90-day supply) - only $1/day. Learn more about the program  here.

Check out other recent PAP Program Changes in the Research section of TPC for more information on recent changes and updates to the system!

Q:  How do I add eyeglasses or other supplies to a patient's formulary?

Q: Can health care providers and other staff use the mobile app to see what medications are available through the PAPs?

Check out the  answers. More FAQs and Training Videos are located under the TPC Help menu!
Upcoming TPC Trainings
Sign up for a TPC training session if you are new to your organization and need to learn the basics, if you currently use TPC and are looking to refresh your skills or want check out additional advanced features.

November 2, 2018 - Online
December 4, 2018 - Online

November 13, 2018 - Online
January 10, 2019 - Online
Please check out the rest of the schedule and register for a session  here ! New sessions for 2019 will be added soon!  If you are looking for training in your area and don't see a location near you, please let us know.