Medicaid
What is Medicaid?
Medicaid is a federal and state-funded health insurance program that helps pay for health care. It is for low-income people who meet eligibility requirements. Pregnant women, children, people with disabilities, and people age 65 and older may also qualify. The rules may be different for children, adults, and people in nursing facilities, but they all may get the same services.
What programs and services are available under Medicaid?
The federal law allows the Virginia Medicaid program to cover a wide range of services. Services include:
- inpatient and outpatient hospital care
- doctor’s services
- lab and x-ray services
- transportation
- skilled nursing care
- home health care, and
- prescription medications
What does Medicaid cost?
Some Medicaid covered services have a co-payment that you must pay if you are an adult. There are some exceptions. For example, an adult in hospice care may not have to pay a co-pay. Co-payments range from $1 for a clinic visit to $100 for an inpatient hospital admission. You may also have to pay more toward your care (called a patient pay amount) if you use nursing home or other long-term care services.
How do I qualify for Medicaid services?
You may be eligible if you are:
- a child in a low income family
- a pregnant woman
- elderly
- have a disability, or
- are a parent who meets specific income levels
You must also meet certain financial requirements. You will be asked to verify any financial resources you have. This includes your checking and savings accounts, stocks, and property depending on what you are applying for.
You will also be asked for your Social Security number, proof of Virginia residency, U.S. Citizenship, and identity or alien status. If you cannot work due to a disability, you will be asked whether you have applied for disability benefits. If you have not, you may be asked more information about your medical condition. If you are pregnant, you will be asked to provide proof of pregnancy from a medical provider.
Where do I apply for Medicaid services?
If you are interested in applying for Medicaid, you can visit the Department of Social Services website by clicking the button below and printing the application. You must then send the application to your local Department of Social Services. You may also file an application at some larger hospitals. If you cannot sign the application, your parent , legal guardian, conservator, attorney-in-fact, or authorized representative can sign on your behalf. An interview is not needed.
Complete the Medicaid Application online by clicking the button,
or print the (PDF) Medicaid Application. Please Note: If you encounter a server error when attempting to open the online application, please contact your local network administrator.
Other Medicaid Programs
MEDICAID WORKS (also known as Medicaid Buy-In) is a work incentive program offered by Virginia Medicaid for people with disabilities who are employed or want to go to work. If you have Medicaid, this voluntary option allows you to work, earn more money, and still keep Medicaid. For information about Medicaid Works visit the Medicaid Works section of the Department of Medical Assistance Services website.
The Health Insurance Premium Payment (HIPP) Program is run by the Virginia Medicaid Program and offered to individuals enrolled in Medicaid. This program may pay some or all of a person’s share of their private health insurance when it is cheaper for Medicaid to do so. For information about the Health Insurance Premium Payment Program visit the Department of Medical Assistance Services website, Health Insurance Premium Payment Program.
Where can I find out more?
- The Virginia Department of Medical Assistance Services
- The Centers for Medicare and Medicaid Services
- To apply for Medicaid: The Virginia Department of Social Services
