Our mission is to improve the health and well-being of Virginians through access to high-quality health care coverage.
In 2019, Virginia Medicaid celebrated its 50th anniversary and successfully oversaw the largest expansion in its history. New eligibility rules expanded membership to more than 1.5 million Virginians. Most of our members are served through the two managed care programs, Medallion 4.0 and Commonwealth Coordinated Care Plus. Agency leaders responded to these historic changes by adopting data-driven, member-focused innovations including a Medicaid Member Advisory Committee to provide feedback and ideas for current and future initiatives.
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Commonly Asked Questions and Answers about Coverage
The Virginia Medicaid agency pays providers directly for services to fee-for-service members. Most Medicaid members are only in fee-for-service for a short time until they get a managed care health plan. In managed care, a health plan helps members find providers and get the services they need.
Your coverage includes inpatient, outpatient and emergency medical services. Medicaid also covers preventive care, behavioral health, addiction and recovery treatment, prescription medicines, dental, and more. Your member handbook explains all of the benefits and services that are covered or not covered. Medicaid managed care members also receive a member handbook from their managed care organization, which outlines additional benefits that you may receive.
A managed care organization (MCO) is a health plan with a group of doctors and other providers working together to give health services to its members. Your MCO will cover all Medicaid services you get now, including medical services, behavioral health services, nursing facility services and long-term services and supports for community-based long-term care.
If you are eligible for Medicaid managed care, you can pick your own MCO from any of the six health plans that work with Virginia Medicaid.
Medicaid will automatically enroll you into a managed care health plan. You will then have 90 days to choose a different plan if you want to switch. You will get an ID card from your health plan and some basic information about your health care.
You are able to select a primary care provider who participates with your health plan. You can call the Member Services phone number listed on the back of your member ID card to speak with someone who can help you select a provider.
Your Medicaid coverage will not change when we launch Cardinal Care. You will still receive the same benefits, visit your same doctors and have the same coverage.
You do not need to do anything to prepare for Cardinal Care. Your transition to Cardinal Care will be automatic, as long as you are a current, eligible Medicaid member.
Regular fee-for-service members can call the member helpline at 804-786-6145 for help with or questions about claims, complex billing and covered services.
You may continue to see your current providers as long as they accept Virginia Medicaid and participate with the health plan that you selected if you are in managed care.
Resources - About Us
Board of Medical Assistance Services
Learn more about the 11 Virginia residents appointed by the Governor to serve on the State Board of Medical Assistance Services
Freedom of Information Act
About The Virginia Freedom of Information Act (FOIA), located § 2.2-3700 et. seq. of the Code of Virginia
Language and Disability Access Plan
View the DMAS Language and Disability Access Plan in English and Spanish
Medicaid at a Glance
Improving the health and well-being of Virginians through access to high-quality health care coverage
Office of Quality and Population Health
Learn more about our Office of Quality and Population Health
Virginia's current Medicaid state plan that describes how Virginia administers its Medicaid program
Financial and non-financial incentives driving strong performance at multiple levels within the health system