State-Sponsored Health Insurance for Virginia’s Families (the FAMIS programs and Medicaid)

Virginia has several free or low-cost health insurance programs for children and pregnant women. Virginia also has free or low-cost health insurance for some eligible adults.

To learn more about each of the programs, click on the links below or scroll down:

Adults

On Thursday, June 7, 2018, Governor Northam signed a state budget that expanded Virginia’s Medicaid program. Starting January 1, 2019, Medicaid will be available to eligible adult Virginians ages 19 – 64 who live in households earning ≤138% of the Federal Poverty Level ($28,676 for a family of three in 2018). Nearly 400,000 Virginians will be income-eligible. Coverage will be comprehensive, and will include doctor, hospital and emergency services; prescription drugs; behavioral health and substance use services; and more. To find out more or to use an eligibility screening tool, please go to the Cover Virginia website.

Health insurance programs for eligible adults in Virginia are available through Medicaid and Plan First. Both programs have no enrollment costs and no monthly premiums.

You can check to see if you’re eligible for either Virginia’s Medicaid program or Plan First by going to Cover Virginia eligibility site.

There is a targeted Medicaid benefit package for adult Virginians with a serious mental illness (SMI), called GAP or the Governor’s Access Plan. GAP includes mental health and substance use disorder services, medical doctor visits, medicines, access to a 24-hour crisis line, recovery navigation services, and case management. To see if you might be eligible or to apply, click here.  To learn more about GAP benefits, click here.

If you would like more information about GAP, please email BridgetheGAP@dmas.virginia.gov.

Children 

Give your children a healthy start in life.  Check out the FAMIS programs today!

Your children may be eligible to get free or low cost insurance through Virginia’s FAMIS and FAMIS Plus programs. FAMIS stands for Family Access to Medical Insurance Security.

FAMIS and FAMIS Plus are comprehensive health insurance. They help children stay healthy and get care when they are sick. FAMIS coverage includes:

  • Doctor visits
  • Prescription medicines
  • Hospital care
  • Dental care
  • Mental Health services
  • Eyeglasses
  • Immunizations
  • Regular check-ups — and more

Eligibility is based on a family’s current monthly income. A family of four earning up to 200% of the Federal Poverty Level may qualify.  (click here to see the income guidelines).

Important! Families must renew their child’s coverage in FAMIS/FAMIS Plus each year.

For more information about the FAMIS programs, eligibility requirements, or help with enrollment:

  • Project Connect outreach workers provide free one-on-one help to parents and pregnant women with questions about the FAMIS programs. They can also help gather the information needed to apply for or help complete annual renewal applications. See if there’s a Project Connect location near you.
  • Go to the CoverVA website
  • Contact the Cover Virginia Call Center at: 1-855-242-8282
  • Call SignUpNow for help at: 1-804-828-6062
Pregnant Women

If you are pregnant, you may be able to get free health insurance that will cover you during your pregnancy and for 60 days after your baby is born. Pregnant women living in households earning up to 200% of the Federal Poverty Level are eligible (click here to see the income guidelines). Pregnant women must be US citizens and Virginia residents to be eligible.

Coverage includes:

  • Doctor or clinic visits
  • Hospitalizations
  • Prescription medicines
  • Eye care
  • Mental health services
  • Substance abuse services
  • Tobacco cessation services (help to quit smoking)
  • Non-emergency transportation
  • Dental care

For more information on free health insurance for pregnant women:

  • Contact Project Connect, which provides free one-on-one help to parents and pregnant women with questions about the FAMIS programs. See if there’s a Project Connect location near you.
  • Go to the Cover Virginia website
  • Call Cover Virginia at: 1-855-242-8282