Virginia MedicaidCardinal Care Managed Care covers the full scope of Medicaid managed care covered services, including long-term services and supports within the established screening and coverage criteria. Cardinal Care Managed Care continues to provide comprehensive care management for members with significant health needs.
Cardinal Care Introduction
Virginia Medicaid members are part of Cardinal Care - a single system of care for all of our 2 million members. Cardinal Care connects members to the care that they need when they need it and reduces transitions between programs as their health care needs evolve. All managed care and fee-for-service Medicaid members are part of the Cardinal Care program. Cardinal Care continues to offer members the same programs and services and does not reduce or change any existing coverage.
The Medicaid fee-for-service program will continue to serve newly enrolled members for a short time as well as those with limited health coverage. Members can use their blue-and-white Medicaid ID cards, or green-and-white Plan First ID cards until they receive a Medicaid Fee-for-Service card with the Cardinal Care logo. Both the old and the new cards are accepted by Medicaid providers.
Cardinal Care Managed Care
In 2023, Virginia combined its two existing managed care programs – Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4.0 – into one unified managed care program known as Cardinal Care Managed Care (CCMC).
CCMC continues to partner with the same MCOs administering Medallion 4.0 and CCC Plus and will still cover the full scope of Medicaid managed care services. Over time, DMAS will discontinue use of the CCC Plus and Medallion 4.0 managed care program names.
Visit the Cardinal Care Managed Care page for more information.
The Department's Commonwealth Coordinated Care Plus Home and Community-Based Services (HCBS) Waiver program will continue to operate as the CCC Plus HCBS Waiver.
Learn More about Cardinal Care
Learn more about Cardinal Care and how it benefits Medicaid providers in this presentation. We encourage you to use these slides to present information about Cardinal Care to provider groups and organizations. You may also learn more about Cardinal Care in this Fact Sheet.
Foster Care
Children who are eligible for Medicaid and placed in foster care will be enrolled into Medicaid managed care. Visit the Foster Care home page.
New Cardinal Care ID Cards
The new Cardinal Care brand is visible on Medicaid, FAMIS and Plan First ID cards and MCO Medicaid and FAMIS ID cards. We've made available resources you can print to display in your office explaining the new Medicaid ID cards for members. Resources: Flyer or Poster
The blue-and-white Medicaid and FAMIS ID cards, and green-and-white Plan First ID cards are still valid. Both the old and new cards enable claims processing. New Cardinal Care Plan First ID cards clearly reflect the program’s limited benefits coverage.
Frequently Asked Questions
What services are covered through Cardinal Care?
How will Cardinal Care benefit Medicaid providers?
Cardinal Care will simplify provider contracting and credentialing processes. With the retirement of Medallion 4.0 and CCC Plus, providers will maintain and adhere to only one contract and credentialing process for each of the health plans in which they participate as network providers.
How will Cardinal Care benefit Medicaid members?
A single, unified managed care program will reduce confusion, simplify the member experience, reduce enrollment churn between managed care and fee-for-service, and improve continuity of care as the member’s needs evolve over time.
What aspects of Virginia Medicaid managed care will stay the same under Cardinal Care?
Cardinal Care Managed Care continues to partner with the same managed care organizations (MCOs) that administered the Medallion 4.0 and CCC Plus programs. Providers continue to use the DMAS web-based automated response system (ARS), the Medicall telephonic system, and 270/271 eligibility transactions to verify member eligibility and managed care enrollment.
The DMAS enrollment broker supports the consolidated Cardinal Care Managed Care program. Members can select or change their MCO during open enrollment through the Cardinal Care Managed Care enrollment website or phone number 800-643-2273. TTY: 800-817-6608
What action do I need to take now?
MCOs will issue separate guidance regarding any Cardinal Care Managed Care related changes to MCO contracting, claims, and service authorization processes.
Should I provide services only to Medicaid members with a Cardinal Care ID card?
Fee-for-service
No, the blue-and-white Medicaid ID cards are still valid. The old and new cards enable claims processing. The new cards include information about claims processing and contact information for members and providers. New Cardinal Care Plan First ID cards clearly reflect the program’s limited benefits coverage.
Managed care
MCOs have issued new ID cards to replace Medallion and CCC Plus program names with the Cardinal Care logo.
Who can I contact for more information?
If you have questions, please email the Cardinal Care Managed Care contract inbox at ccmccontract@dmas.virginia.gov.
Providers can also contact their managed care health plan for more information. Please find contact information for the plans below:
Cardinal Care Managed Care Plans Provider Services Contact Information
|
MCO |
Phone/Website |
|
Aetna Better Health of Virginia |
1-800-279-1878 https://www.aetnabetterhealth.com/virginia/providers/index.html |
|
Anthem HealthKeepers Plus |
1-800-901-0020 |
|
Molina Healthcare |
1-800-424-4518 https://www.molinahealthcare.com/providers/va/medicaid/home.aspx |
|
Optima Health |
Medical - 1-844-512-3172 Behavioral Health – 1-800-648-8420 |
|
UnitedHealthcare |
1-844-284-0146 |