Virginia's Medicaid Managed Care program is here to help you choose the best health plans and providers for you and your family. Apply for and manage GI Bill and other education benefits to help pay for college and training programs. These services arentincluded in the VA medical benefits package under current regulations: Exception: You can get VA health care for medicines and medical devices that arent approved by the FDA if youre in an approved clinical trial. Important Changes to Benefit Programs In accordance with Congress passing the Consolidated Appropriations Act 2023, starting in March 2023, Virginia will begin reviewing Medicaid members' health coverage to make sure they still qualify. Get information about your VA facility, like how quickly you can be seen and what other Veterans say about their experiences. Medicare For people 65+ or those under 65 who qualify due to a disability or special situation Medicaid For people with lower incomes Dual Special Needs Plans (D-SNP) For people who qualify for both Medicaid and Medicare Individuals and familiesSkip to Health insurance Supplemental insurance Dental Vision Short term health insurance Find out when to expect a decision on your application, and what to do next. Select Patient Information and then Customer Service.Find your medical centers website, We cover routine eye exams and preventive tests. You can find information on how to update your member information online on the Cover Virginia website. UnitedHealthcare recently announced a $50,000 donation to the Mountaineer Food Bank of West Virginia. Search for providers like these by name, region, specialty, or plan: Behavioral health providers. We can also help you connect with resources in your community, like homeless shelters or faith-based organizations. To check your status, you can log in to your account at commonhelp.virginia.gov by clicking the Check My Benefits button or call 1-855-242-8282 (TDD: 1-888-221-1590). Here's how you know Talk to the Veterans Crisis Line now Search About Facility Performance Provider Information Access & Quality More data Find a VA Healthcare Provider Search Location (zip, city/state, full address) Radius Search Show States and Territories List + Do you need help with COVID-19? UnitedHealthcare Catalyst is a large-scale framework that uses data and collaboration to help improve health care solutions. Virginia offers several health coverage programs for qualifying pregnant and postpartum women: Medicaid for Pregnant Women, FAMIS MOMS, and FAMIS Prenatal Coverage. IMPORTANT NOTE: All hospitals that participate in Medicare, and hospital-based health care professionals who are employed by, or contracted to, such hospitals are required by law to accept the VHA OCC allowable amount for inpatient hospital services. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. ET. Search for providers using Name, Provider Type, Language or Location, and access tools for searching for Dental Providers. Go to the CoverVA website; Contact the Cover Virginia Call Center at: 1-855-242-8282; Virginia's Medicaid/FAMIS programs cover: Doctor visits If you are in crisis or having thoughts of suicide, MITA was designed to facilitate the nationwide upgradeto States Medicaid systems to a flexible, modularform. and each program has different eligibility requirements. FAMIS and Medicaid for Children are Virginias two health coverage programs for children who qualify. It takes less than a minute to check if you or your family may qualify for Virginia Medicaid. . In Virginia's Medicaid Managed Care program, you are a member of a Managed Care Organization (MCO). Childrens Health Insurance Program Advisory Committee (CHIPAC) advises onpolicies, operations, and outreach efforts for the Family Access to Medical Insurance Security (FAMIS) and childrens Medicaid programs. visit VeteransCrisisLine.net for more resources. Yours will include care and services to help: All Veterans receive coverage for most care and services, but only some will qualify for added benefits like dental care. The site is secure. You may still qualify after giving birth. What does Medicaid Cover? For provider enrollment inquiries, contact the Virginia Medicaid Provider Enrollment Helpdesk by phone at 804-270-5105 or 888-829-5373. Optima Health 2023, PO Box 66189, Virginia Beach, Virginia 23466. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. Learn how to file a claim for disability compensation and manage your disability benefits. Information for Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4.0 Managed Care Programs. Attention A T users. View our current copay rates for different types of care, tests, and medications. Assisted living and home health care (depending on your needs and income as well as space in the programs). The Virginia Medicaid Provider Manual describes the role of the provider in the Virginia Medical Assistance Program (Medicaid). If you have fewer than 25 employees making less than an average of $50,000 per year, you . Providers in the following occupations are listed on this website: physicians, dentists, nurse practitioners, clinical nurse specialists, physician assistants, chiropractors, certified registered nurse anesthetists, optometrists, podiatrists, and psychologists. Learn about the types of plans below. Health Insurance Marketplace is a registered trademark of the Department of Health & Human Services. Cover Virginia also operates a statewide customer service call center for Medicaid and the FAMIS Programs at 1-855-242-8282. all possible programs based on your age, income, financial resources, and other information. We offer many programs and services that may helpincluding free health care and, in some cases, free limited dental care. You can report suspected fraud cases in two ways: Renew your health coverage or update your information. Applying for Medicaid Information on how to apply for Medicaid in Virginia. Set up your personal health record and download reports to share with your VA and non-VA doctors. Virginia Medicaid will soon return to normal enrollment processes. For Providers Many Veterans see health care providers from VA as well as providers in the community outside of VA who need their health information to make more informed treatment decisions. Learn about transitioning from TRICARE to VA health care. Applying for FAMIS Programs. This letter will let you know if you are eligible for Medicaid health coverage. Camp Lejeune Family Member Program (C L F M P). Learn more about your health care benefits. It may take up to 45 days to get a decision on your application. Your current cards are still valid until you get a new one. Start your Veterans health care application now. up to Looking for the Provider Portal? If you dont have veterans or other health coverage, you can use the Marketplace to enroll in a plan. Click here to learn more about the Learn more about VA copaysFind out more about financial assessments, At VA, we take a team approach to health carewith you at the center. An MCO is a health plan with a group of doctors and other providers working together to give health services to its members. MES (Pronounced 'Mez) was created to transform our Medicaid technology from an antiquated all-in-one-box solution, to a modular, expandable and cost-effective solution which benefits our Members, Providers and stakeholders. To enter and activate the submenu links, hit the down arrow. Call: 988 (Press 1), U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. As of December 20, 2020, HUD has allocated more than 105,000 vouchers . Sign in for an easier way to see your plan information. Find out what you need to know about the Affordable Care Act and what it means for Veterans. Eligibility requirements can change from state to state. While DMAS adheres to the Federal 21st Century Cures Act, encouraging all providers to enroll through MES and the PRSS portal. Were here Monday through Friday, 8:00 a.m. to 8:00 p.m. Click the blue login button at the top to login to MES. Where can I update my member information? Excluded individual medical providers and medical institutions cannot, by law, receive payments for health care services or supplies from any federal health care program. You cannot be denied for pre-existing conditions. In the pages navigation, click on Patients & Visitors. A submenu will appear. How to apply for Medicaid Apply in one of these ways: Call the Cover Virginia Call Center Monday through Friday, 8 a.m. to 7 p.m. and Saturday 9 a.m. to 12 p.m. at TDD: 1-888-221-1590 Apply online at the Health Insurance Marketplace at Medical providers on this list have been convicted in state or federal court of certain felonies, criminal offenses, or have had other offenses toward federal agencies related to the delivery of health care. Attention A T users. The renewal process is back. Virginia Department of Medical Assistance Services (DMAS), The new MES Status page provides information on planned maintenance and the current status of the system, New Providers can enroll or check their enrollment status here, Try our Provider FAQ for answers to common questions asked by Providers and other users, Department of Medical Assistance Services, You can login and connect to MES modules you have been approved for. Find out if youre eligible for Veterans health care benefits and how priority groups work. Well fill prescriptions by a non-VA community provider only if you meet all these requirements. You can apply at any time of year. Or contact your states Veterans agency. Learn about the updates for Green Card holders. Please call usat 877-222-8387. Enrollment Website. You can order a new Medicaid ID card and receive it within 10 days. You cannot be denied for pre-existing conditions. You have a choice To help you stay enrolled, please keep these open enrollment dates in mind. Health care coverage options for military veterans If you're enrolled in TRICARE or the Veterans health care program, you're considered covered under the health care law. In accordance with Congress passing the Consolidated Appropriations Act 2023, Please switch auto forms mode to off. Find out if you can get increased pension pay as a Veteran or surviving spouse who has disabilities. This service is private, free, and available 24/7.Chat online with a trained VA staff member. Whether you are seeking coverage for yourself or helping someone else, we are here to answer your questions about our added benefits and services. The Department of Medical Assistance Services (DMAS) is hosting a series of public webinars to discuss topics related to language and disability access. Visit the new MCO Provider Network Resources page for resources and tools to check your status. Visit the Virginia Managed Care website for more information or call 1 -800-643-2273 to update your contact information today so you can receive official mail, email and texts. Try our Provider Search Tool. Individual & Family ACA Marketplace plans, Dual Eligible Special Needs Plans (D-SNP), Learn more about Dual Special Needs Plans (D-SNP), Childrens Health Insurance Program (CHIP). Provider Overview Community providers are a vital part of VA's high-performing health care network, ensuring eligible Veterans and their beneficiaries get the timely, high-quality health care they need. For people 65+ or those under 65 who qualify due to a disability or special situation, For people who qualify for both Medicaid and Medicare, Individual & family plans short term, dental & more, Individual & family plans - Marketplace (ACA). If you received a notice that your health coverage has changed and you have questions, please contact the Member Services phone number on your ID card. Medicaid is different in each state. Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. Find out if you can get disability compensation (monthly payments) from VA. Order hearing aid batteries and accessories, How to get your COVID-19 vaccine records online, Vacunas de refuerzo y dosis adicionales de COVID-19, Cmo obtener su historial de vacunas COVID-19 en lnea, Booster na iniksyon ng COVID-19 at karagdagang dosis, Paano makuha sa online ang talaan ng bakuna para sa COVID-19, Get a Veteran Health Identification Card (VHIC), Download our notice of privacy practices (PDF), Review more VA medical and surgical specialty care services, Get advice on choosing between urgent and emergency care, Learn more about non-VA emergency medical care, Learn more about assisted living and home health care, Beneficiary travel benefits (help paying for travel related to treatment), Caregiver support (help for the person who cares for you), Veterans transportation service (help getting to and from appointments), Find out if you can get dental care through VA, Find out how to access these long-term care services, Learn more about gender-affirming surgery regulations on our patient care website, Find out more about financial assessments, Find out who will care for you when you become part of the VA health care program, Learn more about how VA works with other health insurance, Send a secure message to your health care team. You can select a MES module, including the Provider portal after logging on. This helps us determine if you qualify for free VA health care. If youre signed up for the VA health care program, you can manage your VA health and benefits online: Refill your prescriptionsSend a secure message to your health care team, You can also check the status of a disability or pension claim online.Check your claim status. Use our provider directory to find a primary care provider (PCP), hospital, pharmacy, or specialist in your plan. View education benefits available by school. The family member programs administered by the Veterans Health Administration Office of Community Care (CHAMPVA, Spina Bifida Health Care Benefits Program, and the Children of Women Vietnam Veterans Health Care Benefits Program) do not have networks of medical providers. You can contact Cover Virginia at 1-833-5CALLVA. It provides assistance in submitting state-sponsored health . View, download, and print your labs and test results. This means you don't need to get additional coverage. The .gov means its official. We can help you learn about and apply for VA health care benefits. Form 1095-A. Health home providers. Highlights Dental providers who are currently participating and need to recredential or those who wish to enroll with the program for the first time, should do so through DentaQuest at CredEnrollment@DentaQuest.com or by calling 800-233-1468. You can choose from several methods to apply: Phone: Call Cover Virginia at 1-855-242-8282 (TDD: 1-888-221-1590). you are notified of any changes to your benefits. Information to help members understand their rights and responsibilities as participants in the Medicaid program. When you locate a medical provider, confirm that they will participate in the VA family member health care program you belong to. If you are in crisis or having thoughts of suicide, Benefits and Services available to Medicaid Members. It is Medicaid Medallion open enrollment in: Optima Health is dedicated to taking care of health and so much more. Call the Fraud and Abuse Referral Hotline at 1-866-486-1971. Learn more about prescriptions from community providers. Click the blue login button at the top to login to MES. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMP VA). For managed care assistance, call 800-643-2273 or email ManagedCareHelp@dmas.virginia.gov. Contact us Skip to Main Content Home Learn Our Programs Am I eligible? The MES Portal - What Can I Do Here? How do I contact my health care provider? Urgent care for injuries and illnesses that need attention right away, but arent life threatening, aturgent care locations that are part of our contracted network. Toll-free: 1-888-512-3171 (TTY: 711) Monday through Friday, 8 a.m. to 8 p.m. Choose Optima Health as your plan within your first 90 days, or during open enrollment. Central region: April 19 - June 30. An official website of the United States government. 2023, Virginia will begin reviewing Medicaid members' health coverage to make sure they still qualify. If you have any