Materials

There are two ways to get materials from Cover Virginia.

1. Print from web: Need one copy? You can print materials right from this website. Select the language link next to the picture of the document you want below. This opens the document in PDF. If you don’t have Adobe Acrobat Reader, you can download it at Acrobat.

2. Order online: Need multiple copies? You can order many materials in bulk online. Your order will be shipped to you free of charge within two weeks. Fill out and send the form at Order materials.

Applications

Application for Health Coverage & Help Paying Costs
[PDF] English | Spanish | Order online

Additional Person Single Page Supplement can be used with an application to apply for more people in your household. The Additional Person Single Page Supplement is not a stand-alone application. You must also complete the Application for Health Coverage & Help Paying Costs and submit the Additional Person Single Page Supplement with the application.
[PDF] English | Spanish | Order online

ABD-LTC Application – Appendix D is for adults over age 19 with a disability and other adults aged 65 or over, including those who need long term care.
[PDF] English | Spanish | Order online

Medically Needy – Spenddown - Appendix E is for children and pregnant individuals who have income greater than the Medicaid limit and would like to be evaluated for a spenddown based on income, resources and medical expenses.
[PDF] English | Spanish | Order online

Nursing or Community Based Care – Appendix F is for those who need help with everyday things to live safely in their home or who have a physical disability or long-term disease, mental or emotional illness, or addiction problem.
[PDF] English | Spanish | Order online

Back to School

Renewal Processes

Renewal Process Flowchart

Renewal Process Flowchart is a helpful resource that community partners and members can use to understand the Medicaid renewal process and see what is the responsibility of Virginia Medicaid and members.
[PDF] English | Spanish | Double-sided

Renewal Process Flow Sheet Step-By-Step

Renewal Process Flow Sheet: Step-By-Step is a helpful resource to help community partners and members understand the Medicaid renewal process.
[PDF] English | Spanish

Coverage for Adults

Adult Healthcare Coverage Flyer

Adult Health Coverage Flyer Option 2

Adult Health Coverage Flyer Option 2 (digital download only) is a helpful resource with information on health coverage for Virginia adults. The flyer is available in 6 languages to print and to order as a double-sided flyer, with English on one side and Spanish on the other side.

The Medicaid Member Handbook is sent to all Medicaid members. It has information on member benefits, renewal requirements, who to call about lost ID cards and more.
This handbook is only available for order by department of social services (DSS) offices.
[PDF] English | Spanish

Cardinal Care Smiles Image

*Available for PDF print only*

The Cardinal Care Smiles Flyer is a helpful resource with information on dental coverage for Virginia children and adults. The flyer is available in 2 languages to print.
[PDF] English | Spanish

FAMIS and FAMIS MOMS (children and pregnant women)

*Available for PDF print only*

The FAMIS poster is a helpful resource that community partners can display. It has information on Virginia’s health insurance program for uninsured children. The 11" x 17" poster is available for print in English, Spanish and as a double-sided poster with English on one side and Spanish on the other side.
[PDF] Double-sided | Order online

The FAMIS Member Handbook is sent to all FAMIS members. It has information on member benefits, renewal requirements, who to call about lost ID cards and more.
This handbook is only available for order by department of social services (DSS) offices.
[PDF] English | Spanish

The FAMIS MOMS Member Handbook is sent to all FAMIS MOMS members. It contains information on covered services, other services, prenatal care and more.
This handbook is only available for order by department of social services (DSS) offices.
[PDF] English | Spanish

FAMIS Select Brochure provides information about the FAMIS Select program. FAMIS Select helps families with children enrolled in FAMIS pay for private or employer-sponsored health insurance.
[PDF] English | Spanish | Order online

FAMIS Select Brochure (Updated)

*Available for PDF print only*

The FAMIS Select Application is the form FAMIS-enrolled families use to apply for the premium assistance program.
[PDF] English | Spanish