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Social Services Medicaid

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1. What Medical Assistance programs are available?

Virginia offers two Medical Assistance programs: the Medicaid Program and the Family Access to Medical Insurance Security Plan (FAMIS). Medicaid covers children under age 19 years, parents and caretakers of dependent children, pregnant women, blind or disabled individuals, and adults age 65 years and over. FAMIS covers children under age 19 and pregnant women, through the FAMIS MOMS program.

Medicaid and FAMIS have different financial and non-financial eligibility requirements. To be eligible for Medicaid or FAMIS, you must meet the financial and non-financial eligibility conditions for that program. Your application is a request for Medical Assistance. Your eligibility will be determined for all appropriate Medical Assistance programs, based on your age, income, financial resources, and other information.

2. How do I apply for Medicaid Assistance?

To apply, complete an application form that you may request from the local office serving the city or county in which you live or you may complete and submit the Medicaid application online.

3. To complete my application, what information will I be asked to provide?

You will need to provide certain information when you apply. You will only be asked for information needed to determine your eligibility. If you cannot send in some or all of the information with your application, you do not need to wait to apply. A checklist will be sent to you that tells you what information is needed.
• You will need to provide proof of your income.
• You may need to provide proof of your resources, such as bank accounts, stocks, certificates of deposit (CD’s), real property that you do not live on, and motor vehicles. Parents, children, and pregnant women do not have to provide resource information, in most cases.
• By Federal law, documentation of U.S. citizenship and identity must be obtained for Medicaid applicants and recipients who declare they are United State citizens. Certain groups of people do not have to prove the U.S. citizenship or identity. The groups are: People currently receiving Supplemental Security Income (SSI), People who receive Social Security benefits on the basis of a disability, People entitled or receiving Medicare, Children in foster care or who are classified as Title IV-E Adoption Assistance, and Children born in the U. S .to mothers who were covered by Medicaid at the time of the birth. You will be enrolled in Medicaid if you meet all other Medicaid eligibility requirements. You may be required to show your local Department of Social Services worker a document that proves you are a U.S. citizen and a photo identification card or document that identifies you at the time of your annual renewal (your case must be reviewed by the 12th month after your Medicaid coverage starts).
• If you are not a U. S. citizen, you must show proof of your immigration status. This proof is usually the document you received from the U.S. Citizenship and Immigration Services when you entered the United States or your immigration status changed. If you were not lawfully admitted to the U.S. you may apply for Medical Assistance. However, if you meet all other Medicaid eligibility requirements, you will only be eligible for Medicaid coverage of emergency services or for services related to giving birth (labor and delivery).
• You must provide your Social Security number. You do not need to provide your card if you are sure of your number.
• If you have Medicare or other health insurance, you will need to provide information about your coverage, such as your policy or member number.

4. How long does it take for my application to be processed?

For most people, your application should be processed within 45 calendar days from the date you apply. If you are pregnant, your application should be processed within 10 work days, if the eligibility worker has all of your required information. If you are referred to the Disability Determination Services for a disability determination, your application will be processed with 90 calendar days, or as soon as possible after your disability determination is complete if the disability determination takes more than 90 days. In most cases, medical services received during three months prior to the month you applied can be covered (if you are eligible). You will receive a written notice telling you whether or not you are eligible. If you are eligible, the notice will include the date your coverage will begin.

5. Is there a website that will give me more information about the Medicaid program?

Yes, you may go to the following site for more information regarding the Medicaid application process and to learn what is covered by the Medicaid Program.

6. What is DMAS?

The Department of Medical Assistance Services.