We're here to help you understand your health care choices!
These Frequently Asked Questions (FAQs) answer some questions you may have.
If you have other questions, call the Managed Care HelpLine at 1-800-643-2273 (TTY: 1-800-817-6608).
How do I enroll in a health plan I choose?
- Download the free Virginia Managed Care App on your Android or iPhone. You can compare health plans, find a provider and change your health plan and more.
- Go to the Verify/Login page. After you log in, click "Choose a Plan."
- Call the Managed Care Helpline at 1-800-643-2273 (TTY: 1-800-817-6608). Open Monday through Friday, 8:30 a.m. to 6:00 p.m. Interpreter services are free.
Who does Medicaid cover?
Medicaid coverage is usually available to Virginians who are:
- Children in low-income families
- Pregnant women
- The elderly
- People with disabilities
- People who make less than a certain income
All states must follow federal guidelines about who is covered by Medicaid. States set their own income and asset eligibility rules.
What is a Managed Care Organization (MCO)?
An MCO is a health plan. It is made up doctors, hospitals and other providers working together to give you the health care and services you need.
Who can enroll in an MCO?
Most people in Medicaid must enroll in an MCO. People with other insurance or in a nursing home may not have to enroll.
What if I don’t choose an MCO?
When you qualify for Medicaid, Virginia’s Medicaid Managed Care program will send you a letter. The letter will ask you to call to choose an MCO. If you don’t call when the letter tells you to, the program will choose an MCO for you.
When is open enrollment?
Your open enrollment period depends on the program that you are enrolled in and where you live. Different regions may have different open enrollment periods. To learn when open enrollment happens where you live, go to Open enrollment. You will receive a letter informing you of your open enrollment period before open enrollment begins.
What happens after I enroll?
Can I change my MCO?
Yes. If you are newly enrolled, you can change your health plan during your first 90 days of enrollment. The first 90 days of enrollment is called your grace period. Health plans can also be changed during the annual open enrollment period.
What is a Primary Care Provider (PCP)?
Your PCP is the doctor, clinic or other health provider you choose to manage your health care. Your PCP will get to know you and your health care needs. Your PCP will see you when you are sick or need a checkup and refer you to specialists when you need them.
Can I change my PCP?
Will I have transportation services?
Yes, health plans provide Medicaid members with transportation to Medicaid covered services. Your health plan ID card has a phone number to call for transportation. FAMIS members are not eligible for transportation services.
If you are on a Developmental Disabilities waiver, ModivCare covers transportation to waiver services. Call 1-866-246-9979 for a ride.