Medicaid for Children and FAMIS

Virginia's Medicaid and Family Access to Medical Insurance Security (FAMIS) programs provide no-cost health coverage to eligible children. Medicaid and FAMIS cover all the preventive care that growing children need to stay healthy, and the medical, dental, and behavioral health care they need if they get sick or hurt.

Covered Services

Dental care [PDF] English | Spanish
Doctor visits
Emergency care and transportation
Hospital visits
Behavioral health care
Prescription medicine
Tests and X-rays
Vaccinations
Vision care
Well-baby check-ups
Well-child check-ups
And more!

Children enrolled in Medicaid also qualify for the additional below benefits:

Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit for children (comprehensive preventive and treatment services)
Transportation to health services, if no other transportation is available

Cost

There are no monthly premiums, co-payments, deductibles or other costs for covered services for children enrolled in Medicaid or FAMIS.

Eligibility

Children may qualify if they:

Live in Virginia
Are under age 19
Are U.S. citizens or lawfully residing immigrants
Live in families that meet income rules

Income Guidelines

Most often, family size is the same as the number of people on the family's federal tax return. For families that do not file taxes, the family size includes the parents and children under 19 (including stepparents and stepchildren) living in the same home. (Example: if 4 children live with their mother and father, their family size is 6).

**Children's Income Guidelines**
	Medicaid for Children Guidelines		FAMIS Guidelines
Family Size	Yearly Income	Monthly Income	Yearly Income	Monthly Income
1	$23,162	$1,931	$32,083	$2,674
2	$31,302	$2,609	$43,358	$3,614
3	$39,442	$3,287	$54,633	$4,553
4	$47,582	$3,966	$65,908	$5,493
5	$55,722	$4,644	$77,183	$6,432
6	$63,862	$5,322	$88,458	$7,372
7	$72,002	$6,001	$99,733	$8,312
8	$80142	$6,679	$111,008	$9,251
Each Additional	$8,140	$679	$11,275	$940

2025 Income Guidelines as of January 15, 2025

Apply

Medicaid and FAMIS eligibility is based on many factors. Even if a child's family does not meet the income limits above, the child may qualify for coverage based on other things like disability or as a waiver recipient. To get a full review, you need to apply.

Ready to apply? Learn more and complete an application: Apply

Once Enrolled

Children in Medicaid and FAMIS get 12 months of protected, or continuous, coverage from the date of their enrollment, unless:

They turn 19 (eligibility will be re-evaluated as an adult).
They permanently move out of Virginia or pass away.
Their parent, guardian or authorized representative requests to end their coverage.
They were enrolled in coverage due to error or fraud.

Annual Renewal

The state will review the child’s eligibility annually. If the child is still eligible for Medicaid or FAMIS, they will be given a new 12-month period of continuous coverage. If they are no longer eligible, their coverage will end. They may be referred to Virginia’s Insurance Marketplace (VIM) where their family can evaluate other health plan coverage options. 

Reporting Changes

Even though children receive 12 months of continuous coverage, it is important for members to continue to report changes.

Changes may impact the eligibility of adults in the household.
Having the most up-to-date information streamlines the renewal process.
Reporting address and contact information changes is important so you continue to receive communication about your Medicaid or FAMIS coverage.
Coverage must be ended for the child if certain exceptions to continuous coverage are experienced, such as a permanent move from Virginia or the death of the child.

Learn More

For questions, additional help, or language assistance services or large-print, Medicaid and FAMIS members are encouraged to call Cover Virginia at 1-855-242-8282 (TTY: 1-888-221-1590).

Visit the Materials page to view, download and order program flyers and posters, and the Member Handbooks page for more info regarding how to use coverage.

Coverage for Children Flyer

Coverage for Children Poster