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Important Changes Coming July 1, 2025 for Medicaid & FAMIS Members

 

 

 

1115 Demonstration Waiver

ARTS and Former Foster Care 1115 Demonstration Renewal

Provider Services Solution (PRSS)

We don't want to lose our valuable providers! If you are a provider who recently received notice that you are no longer in a managed care network, the issue most likely can be fixed quickly with your help. DMAS, the MCOs, and Gainwell are committed to working with providers to remedy the issue. Learn how to resolve common issues and enroll in PRSS.

Member Advisory Committee

Learn about Virginia Medicaid's Member Advisory Committee and apply to join today.

Cheryl J Roberts,  J.D.

Agency Director

Member Managed Care

In Virginia Medicaid's Managed Care program (including FAMIS), you are a member of a Managed Care Organization (MCO).  An MCO is a health plan with a group of doctors and other providers working together to give you health services.

Virginia Medicaid currently has five MCOs: Aetna Better Health, Anthem HealthKeepers Plus, Molina Healthcare, Sentara Community Plan, and UnitedHealthCare Community Plan.

As of July 1, 2025 Virginia Medicaid will have the following Managed Care Plans: Aetna Better Health, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Community Plan, and UnitedHealthCare Community Plan.

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