What is FAMIS?
FAMIS, or Family Access to Medical Insurance Security Plan, is Virginia's health insurance program for children. It makes health care affordable for children of families who qualify. FAMIS covers all the medical care that growing children need to stay healthy. It also covers medical care if they get sick or hurt.
What services does FAMIS cover?
FAMIS covers these services:
- Dental care
- Doctor visits
- Emergency care
- Hospital visits
- Mental health care
- Prescription medicine
- Tests and X-rays
- Vision care
- Well-baby check-ups
- Well-child check-ups
How much do you pay?
There are no monthly premiums, co-payments, deductibles or other costs for covered services to children enrolled in the FAMIS program.
Who qualifies for FAMIS?
Children may qualify if they:
- Live in Virginia
- Are uninsured
- Are under age 19
- Are U.S. citizens or lawfully residing immigrants
- Live in families that meet income rules
FAMIS is now a choice for children of state employees.
What are the income limits?
Qualifying for FAMIS also depends on household income and family size:
- For family size, count the number of people included on your federal taxes.
- If you don’t file taxes, count how many children and stepchildren under age 19 live in your home.
- Add yourself if you are the children’s parent or stepparent. Then add your spouse or partner.
For example, if you have 4 children and stepchildren under age 19 living in your home, plus yourself and your spouse, your family size is 6. We use monthly income to find out if you qualify. The current monthly income limit for a family of 6 is $6,882.
*Includes 5% FPL Disregard
2023 Income Guidelines as of January 20, 2023
How do you apply?
To find out if your children may qualify for FAMIS, answer the questions on the Eligibility Screening Tool at Am I eligible?
If you think your children qualify, go to Apply.
Eligibility for health coverage is based on income plus other factors. The Eligibility Screening Tool screens for income only You may qualify for coverage based on other things like age or disability. To get a full review, you need to apply.
Learn more about how to appeal a decision at Appeals.
Where to learn more
FAMIS Member Handbook