Virginia Health Care Foundation

Here’s what you need to know.

During the COVID-19 pandemic, Virginians enrolled in Medicaid/FAMIS were not required to renew their eligibility each year, the way they normally would. All states kept most people covered by Medicaid enrolled throughout the pandemic, even if their circumstances changed.

This approach ended in March 2023, when Virginia and the other states resumed conducting eligibility renewals again for those enrolled in Medicaid/FAMIS. Some Medicaid/FAMIS members’ renewal will be able to be completed automatically, but others will need to provide more up-to-date information to retain their coverage. No members’ coverage will be canceled without the state asking them for updated information first.

How will I know if I am automatically renewed or if I must complete a renewal form?

Members whose coverage is renewed automatically will get a notice from their local Department of Social Services (DSS) letting them know their coverage will continue for another year (see the blue box on the first page of the notice, under Effective Dates). Members who are under 65 years old, and whose income and household information is already known to the state, are more likely to have their coverage renewed automatically. 

How will I know when my Medicaid/FAMIS renewal is due?

Renewals will not happen all at once. Instead, the state will handle the renewals in a staggered fashion over 12 months. Some Medicaid members may have already receive a renewal packet in the mail from their local Department of Social Services (DSS). Others will receive a packet sometime between now and mid-2024.

But, they should take steps to ensure that they receive correspondence from the state when it is their turn to renew.

What can I do to prepare for my Medicaid/FAMIS renewals?

Medicaid/FAMIS members’ contact information must be up-to-date, so that they can receive mailed correspondence from the state about their Medicaid/FAMIS renewal at the appropriate time. Those who are in contact with those covered by Medicaid/FAMIS can help now by encouraging those who have moved since 2019 to update their contact information (especially mailing address and phone number). They can report this important change:

• To their Medicaid/FAMIS health plan, Managed Care Organization (MCO)
• Online at Commonhelp.virginia.gov,
• By calling Virginia’s One Benefits line at 1-833-5CALLVA, or
• By contacting their local DSS.

Medicaid/FAMIS members should be on the lookout for official notices from their local DSS, Cover Virginia, or their MCO. They should review these notices and respond, if instructed, to help ensure their Medicaid/FAMIS coverage can continue if they are still eligible.

Members should read all official mail, email or texts asking them for updated information, and respond within the timeframe specified to avoid losing their Medicaid/FAMIS coverage.

What should I do when I receive a renewal packet?

Members who receive a renewal packet in the mail from their local DSS should open it immediately, and complete their renewal by the due date in the blue bubble on the first page. The renewal form is 20+ pages long, and will include prepopulated information about the member and his/her household (e.g., names, addresses, and employment/income). The member should review and correct information as needed and before the due date. The packet will include a prepaid return envelope.

Members can submit their renewal:

• Online at commonhelp.virginia.gov by using the Case Number and Client ID found on the renewal form to “Associate My Case” to a CommonHelp account;
• Via the Cover Virginia Call Center at 1-855-242-8282 (TTY: 1-888-221-1590). (Note: it helps to have the requested information gathered and ready to give over the phone);
• By completing the paper form and sending it in the prepaid return envelope; or
• By completing the form and submitting it by fax or in person at the member’s local DSS. 

What should I do if my Medicaid/FAMIS coverage is terminated?

If someone is terminated from Medicaid/FAMIS, s/he will receive a Notice of Action via mail that indicates the date that coverage will end, and the reason for the termination. If the member’s coverage is being terminated because s/he failed to complete the renewal or turn in paperwork, s/he has a 90-day “grace period” to complete the renewal and/or submit required documents. If the member provides the requested information within the grace period, coverage will be reinstated back to the date of the termination.

If a member is terminated due to no longer being eligible for Medicaid/FAMIS (e.g., having an income above the limit), s/he may be eligible to obtain health insurance through the Health Insurance Marketplace. Financial help is available to most Virginians who buy their insurance through the Marketplace. ENROLL Virginia! Navigators can provide free, local, 1:1 help to evaluate options on the Marketplace.

Where can I find out whether I am still eligible for Medicaid/FAMIS? 

VHCF funds 21 local Project Connect application assisters who help individuals and families apply for, enroll in, and renew eligibility for Virginia’s Medicaid/FAMIS programs. Click here to find a Project Connect assister near you.

I want to help others in my community understand Medicaid/FAMIS and renew their eligibility. Where can I find training on eligibility and how to help others enroll and renew?

VHCF offers 2 SignUpNow workshops, to equip those who serve patients or clients who are potentially eligible for Medicaid/FAMIS with what they need to know to help with enrollment or renewal:

• SignUpNow – Medicaid/FAMIS workshops cover the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs for children and families, nonelderly adults, and pregnant people. Click here to register for a SignUpNow – Medicaid/FAMIS workshop
• SignUpNow – Aged, Blind, or Disabled (ABD) workshops provide information about Medicaid for those are 65+, or who have a disability. Click here to register for a SignUpNow – ABD workshop

Where can I find more information about what will happen when Medicaid/FAMIS renewals resume?

For up-to-date information on Virginia’s plans for resuming Medicaid/FAMIS renewals, and key resources for partners: Cover Virginia.

Last Updated on October 23, 2023