In Virginia, Medicaid programs offer health coverage to those who qualify. Traditional Medicaid is available for low-income families and individuals, as well as people with disabilities. Medicaid Managed Care is a type of Medicaid that uses managed care organizations (MCOs) to provide services to members. MCOs are health plans that contract with the state to provide certain services to Medicaid recipients. There are a few different types of Medicaid Managed Care programs in Virginia, including: fee-for-service, capitated, and global capitation. Each type of program has its own set of rules and regulations, so it’s important to research the different options to find the one that best fits your needs. Finally, there is also Medicaid Expansion, which is available to low-income adults who meet certain criteria.
Basic Medicaid
Basic Medicaid is a state-run program that provides health coverage to eligible low-income individuals and families. In Virginia, Basic Medicaid is known as VHHA (Virginia Health Hotline Access).
To be eligible for Basic Medicaid in Virginia, you must meet the following requirements:
- Be a Virginia resident.
- Have a household income at or below 138% of the federal poverty level (FPL).
- Meet certain citizenship or immigration status requirements.
Basic Medicaid in Virginia covers a wide range of medically necessary services, including:
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health and substance abuse treatment
- Dental care
- Vision care
- Long-term care
Medicaid for the Elderly and Disabled
Medicaid for the Elderly and Disabled is a federal-state program that provides health coverage to people aged 65 and older, or who are disabled.
To be eligible for Medicaid for the Elderly and Disabled in Virginia, you must meet the following requirements:
- Be a Virginia resident.
- Be aged 65 or older, or be disabled.
- Have a household income at or below 135% of the FPL.
- Meet certain citizenship or immigration status requirements.
Medicaid for the Elderly and Disabled in Virginia covers a wide range of medically necessary services, including:
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health and substance abuse treatment
- Dental care
- Vision care
- Long-term care
Medicaid for Children and Pregnant Women
Medicaid for Children and Pregnant Women is a federal-state program that provides health coverage to children and pregnant women.
To be eligible for Medicaid for Children and Pregnant Women in Virginia, you must meet the following requirements:
- Be a Virginia resident.
- Be under the age of 19, or be pregnant.
- Have a household income at or below 138% of the FPL.
- Meet certain citizenship or immigration status requirements.
Medicaid for Children and Pregnant Women in Virginia covers a wide range of medically necessary services, including:
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health and substance abuse treatment
- Dental care
- Vision care
- Long-term care
Medicaid Managed Care
Medicaid Managed Care is a type of Medicaid in which health care services are provided through a managed care organization (MCO).
In Virginia, Medicaid Managed Care is available to all Medicaid recipients. You can choose to enroll in a Medicaid Managed Care plan, or you can continue to receive your Medicaid benefits through Fee-for-Service (FFS) Medicaid.
There are many benefits to enrolling in a Medicaid Managed Care plan, including:
- Access to a wide network of providers
- Coordinated care
- Reduced out-of-pocket costs
- Personalized care plans
If you are interested in enrolling in a Medicaid Managed Care plan, you can contact the Virginia Department of Medical Assistance Services (DMAS) at 1-800-430-1517.
Medicaid Long-Term Care
Medicaid Long-Term Care is a program that provides coverage for long-term care services for people aged 65 and older, or who are disabled.
To be eligible for Medicaid Long-Term Care in Virginia, you must meet the following requirements:
- Be a Virginia resident.
- Be aged 65 or older, or be disabled.
- Have a household income at or below 135% of the FPL.
- Meet certain citizenship or immigration status requirements.
- Require a nursing home level of care.
Medicaid Long-Term Care in Virginia covers a wide range of long-term care services, including:
- Nursing home care
- Assisted living care
- Home health care
- Personal care services
- Adult day health care
Medicaid for Families
Medicaid is a health insurance program that provides coverage to low-income individuals and families. In Virginia, there are different types of Medicaid programs available to families, depending on their income and family size. Some of the most common types of Medicaid programs for families in Virginia include:
- Medicaid for Pregnant Women: This program provides coverage to pregnant women who meet certain income and residency requirements. Coverage includes prenatal care, labor and delivery, and postpartum care.
- Medicaid for Children: This program provides coverage to children under the age of 19 who meet certain income and residency requirements. Coverage includes doctor visits, hospital care, prescription drugs, and mental health services.
- Medicaid for Parents and Caregivers: This program provides coverage to parents and caregivers of children who are eligible for Medicaid. Coverage includes doctor visits, hospital care, prescription drugs, and mental health services.
- Medicaid for Families with Dependent Children (AFDC): This program provides coverage to families with dependent children who meet certain income and residency requirements. Coverage includes doctor visits, hospital care, prescription drugs, and mental health services.
- Medicaid for Temporary Assistance for Needy Families (TANF): This program provides coverage to families who are receiving TANF benefits. Coverage includes doctor visits, hospital care, prescription drugs, and mental health services.
The eligibility criteria and benefits for each Medicaid program vary. To learn more about the different types of Medicaid programs available in Virginia, visit the Virginia Department of Medical Assistance Services website or contact your local Medicaid office.
| Program | Eligibility | Benefits |
|---|---|---|
| Medicaid for Pregnant Women | Pregnant women who meet certain income and residency requirements | Prenatal care, labor and delivery, postpartum care |
| Medicaid for Children | Children under the age of 19 who meet certain income and residency requirements | Doctor visits, hospital care, prescription drugs, mental health services |
| Medicaid for Parents and Caregivers | Parents and caregivers of children who are eligible for Medicaid | Doctor visits, hospital care, prescription drugs, mental health services |
| Medicaid for Families with Dependent Children (AFDC) | Families with dependent children who meet certain income and residency requirements | Doctor visits, hospital care, prescription drugs, mental health services |
| Medicaid for Temporary Assistance for Needy Families (TANF) | Families who are receiving TANF benefits | Doctor visits, hospital care, prescription drugs, mental health services |
Medicaid for Pregnant Women and Children
Medicaid provides health insurance coverage to low-income pregnant women and children. In Virginia, Medicaid covers a wide range of services for pregnant women and children, including:
- Prenatal care
- Delivery
- Postpartum care
- Well-child visits
- Immunizations
- Dental care
- Vision care
- Hearing care
- Mental health services
- Substance abuse treatment
Eligibility for Medicaid for Pregnant Women and Children
To be eligible for Medicaid for pregnant women and children, you must meet the following requirements:
- Be a resident of Virginia
- Be a U.S. citizen or a qualified non-citizen
- Be pregnant or have a child under the age of 19
- Meet the income and asset limits
The income and asset limits for Medicaid for pregnant women and children are as follows:
| Family Size | Income Limit | Asset Limit |
|---|---|---|
| 1 | $28,608 | $2,500 |
| 2 | $36,468 | $3,750 |
| 3 | $44,328 | $5,000 |
| 4 | $52,188 | $6,250 |
| Each additional family member | $7,860 | $1,000 |
If you meet the eligibility requirements, you can apply for Medicaid for pregnant women and children online, by mail, or by phone. You can also apply through a local social services office.
Medicaid in Virginia
Medicaid is a government program that provides health insurance to people with low incomes and limited resources. In Virginia, Medicaid is administered by the Department of Medical Assistance Services (DMAS). There are different types of Medicaid in Virginia, each with its own eligibility requirements and benefits. Let’s take a closer look at the various types of Medicaid available in Virginia.
Medicaid for the Aged, Blind, and Disabled
Medicaid for the Aged, Blind, and Disabled (ABD) is a program that provides health insurance to individuals who are 65 years of age or older, blind, or disabled. To be eligible for ABD, individuals must meet certain income and asset limits. In Virginia, the income limit for ABD is $1,387 per month for individuals and $2,086 per month for couples. The asset limit is $2,000 for individuals and $3,000 for couples.
- Benefits: ABD provides a wide range of benefits, including doctor visits, hospital care, prescription drugs, and nursing home care.
- Eligibility: To be eligible for ABD, individuals must be 65 years of age or older, blind, or disabled and meet certain income and asset limits.
- How to Apply: Individuals can apply for ABD online, by mail, or in person at their local DMAS office.
Other Types of Medicaid in Virginia
In addition to ABD, there are several other types of Medicaid available in Virginia, including:
- Medicaid for Families with Dependent Children (AFDC): This program provides health insurance to families with children who meet certain income and asset limits.
- Medicaid for Pregnant Women: This program provides health insurance to pregnant women who meet certain income and asset limits.
- Medicaid for Children: This program provides health insurance to children under the age of 19 who meet certain income and asset limits.
- Medicaid for Adults with Disabilities: This program provides health insurance to adults with disabilities who meet certain income and asset limits.
- Medicaid for Long-Term Care: This program provides health insurance to individuals who need long-term care services, such as nursing home care or assisted living.
| Medicaid Program | Eligibility Requirements | Benefits |
|---|---|---|
| Medicaid for the Aged, Blind, and Disabled (ABD) | – Age 65 or older – Blind or disabled – Income limit: $1,387 per month for individuals, $2,086 per month for couples – Asset limit: $2,000 for individuals, $3,000 for couples |
– Doctor visits – Hospital care – Prescription drugs – Nursing home care |
| Medicaid for Families with Dependent Children (AFDC) | – Families with children – Income limit: Varies depending on family size – Asset limit: Varies depending on family size |
– Doctor visits – Hospital care – Prescription drugs – Dental care – Vision care |
| Medicaid for Pregnant Women | – Pregnant women – Income limit: Varies depending on family size – Asset limit: Varies depending on family size |
– Doctor visits – Hospital care – Prescription drugs – Dental care – Vision care |
| Medicaid for Children | – Children under the age of 19 – Income limit: Varies depending on family size – Asset limit: Varies depending on family size |
– Doctor visits – Hospital care – Prescription drugs – Dental care – Vision care |
| Medicaid for Adults with Disabilities | – Adults with disabilities – Income limit: Varies depending on disability – Asset limit: Varies depending on disability |
– Doctor visits – Hospital care – Prescription drugs – Dental care – Vision care |
| Medicaid for Long-Term Care | – Individuals who need long-term care services – Income limit: Varies depending on type of care – Asset limit: Varies depending on type of care |
– Nursing home care – Assisted living – Home health care |
Each type of Medicaid has its own eligibility requirements and benefits. For more information about the different types of Medicaid available in Virginia, please visit the DMAS website.
Hey folks, that’s all we have for you today on the different types of Medicaid in Virginia. I hope this article has been helpful in understanding your options. If you have any further questions, feel free to reach out to your local Medicaid office. And don’t forget to check back later for more informative articles like this one. Take care and stay healthy!