MEDICAID - Family and Children's Services

Who May Be Eligible for Full Medicaid Benefits?

The following people may be eligible for full Medicaid benefits: 

1. Pregnant women (single or married) whose income is at or below 133% of the Federal Poverty Guidelines. Once eligible for Medicaid, pregnant women remain eligible throughout the pregnancy and up to 60 days after the pregnancy ends (additional 10 months).
2. Infants born to Medicaid-eligible women. The infants stay eligible until their first birthday if their mothers stay eligible for Medicaid (or would still be eligible if their mothers were pregnant).
3. Children under age 19 (parents do not have to be absent, disabled or unemployed) and medically indigent pregnant women whose family income is at or below 133% of poverty level.
4. Children under age 21 who are in foster care or subsidized adoptions.

Medicaid Effective Date

Medicaid eligibility usually starts on the first day of the month of application. (Medicaid can begin as early as three months immediately before the month in which you applied if there are unpaid medical bills that need to be covered and eligibility existed at the time.) Medicaid may be available for the 3 months prior to your application if you are found eligible and have unpaid medical bills.

What Income Is Counted?

All earnings (with certain deductions) and unearned income, such as Social Security, Veterans’ benefits, retirement pensions, interest on savings, support payments, alimony and certain other types of income are added together and compared to set limits.

Income Limits (Effective 1/23/2009)

Medically Indigent Children Under 19 and Pregnant Women (below 133% of poverty level income)

You will need the following verifications for PREGNANCY MEDICAID:

We will need to see proof of:

• A Photo I.D.
• All incomes: Social Security, SSI, Veterans, Child Support, Self Employment Incomes, and all wages for the month prior to the application month.
• Health Insurance Card
• Pregnancy Statement – signed by a doctor
• Birth Certificate – Agency must view Original

A face to face interview IS NOT required for Medicaid. This application can be mailed, faxed, e-mailed or dropped off at our office. However, your application CANNOT be processed unless it has been COMPLETED, SIGNED, and DATED. You will then be contacted by mail as to the specific proofs needed, such as those listed above.

Other Insurance and Medicaid 

You may have medical insurance in addition to Virginia Medicaid. In some instances, Medicaid will pay the cost of private insurance premiums if it is cost-effective to do so. This is known as the Health Insurance Premium Payment Program (HIPP).

The Medicaid Program pays after other insurance pays. 

Family Access to Medical Insurance Security Plan

Low-cost medical insurance for children of working families. 1-866-87FAMIS

For more information: www.dss.virginia.gov/benefit/me_famis