Return to Normal Enrollment
Unwinding: Return to Normal Enrollment
Virginia Medicaid proudly provided protected coverage to our members during the COVID-19 public health emergency. Now that those federal protections have ended and normal program rules apply, all members must complete the annual redetermination process. If you or your family no longer need assistance from the Medicaid program, please call Cover Virginia at 833-5CALLVA (TDD: 1-888-221-1590) or your local Department of Social Services to request that your case be closed.
Starting in March 2023, Virginia began reviewing members’ health coverage to make sure they still qualify, however closures will not occur prior to April 30, 2023. We’re working with community partners, advocates and members to make sure eligible Virginians keep getting high quality health care coverage.
We need your help to meet this goal.
You can help our members take steps to get ready now. To make sure our members receive important paperwork, we need their up-to-date mailing addresses and phone numbers. Members can make updates:
- Online at commonhelp.virginia.gov, or
- By calling Cover Virginia at 1-855-242-8282,
- By calling their local Department of Social Services.
- By contacting your Medicaid Managed Care Organization (MCO, or "health plan")
If you do not qualify for full benefits through Medicaid or FAMIS, or you cannot afford Marketplace coverage, please know that people who are uninsured can get health care services at Virginia's Free and Charitable Health Clinics and Virginia's Community Health Centers.
Frequently Asked Questions (FAQ)
What is the federal public health emergency and how does it affect Medicaid members?
The federal government declared a public health emergency when the COVID-19 pandemic began. Since then, state agencies have continued health care coverage for all medical assistance programs, even for people who are no longer eligible, called the continuous coverage requirement.
The Consolidated Appropriations Act was signed into effect on December 23rd, 2022. This omnibus bill decoupled the continuous coverage requirement from the public health emergency effective March 31, 2023. This means on April 1, 2023, all states may return to normal enrollment processes, including redeterminations and processing reductions/closures of coverage. While Virginia is initiating its first month of redeterminations in March of 2023, reductions/closures of coverage will not begin until April 30, 2023.
When will normal Medicaid processes begin again?
- The Centers for Medicaid and Medicare Services (CMS) has given states the option to take up to 12 months to initiate all redeterminations, with an additional two months for clean-up work to meet all federal rules. We will not cancel or reduce coverage for our members without asking them for updated information. Starting in March 2023, we will begin reviewing members’ coverage. We may be able to renew your case without asking you for anything, and if so you will receive a letter in the mail letting you know your health care coverage will continue. If we do not have all information necessary to renew your benefits, we will send you a form or a checklist to complete and return.
NOTE: The Centers for Medicaid and Medicare Services (CMS) has given states the option to take up to 12 months to initiate all redeterminations, with an additional two months for clean-up work to meet all federal rules, so you may not hear from us for a while after normal processes begin.
What if members lose their coverage?
It is important for all eligible Virginians to get and stay covered. If a member no longer qualifies for health coverage from Virginia Medicaid, they will get:
- Notice of when the Medicaid coverage will end,
- Information on how to file an appeal if the member thinks our decision was incorrect, and
- A referral to the Health Insurance Marketplace and information about buying other health care coverage.
NOTE: Unless a member has died, moved from the state permanently, or requested closure of their case, we cannot close your case unless we ask for updated information prior to making a decision that you are not eligible. It is important to keep your eye out for any mail regarding your health care coverage so that you can return your information on time. If you think you might not stay covered, please return your information anyway so we can look at your situation and send your full information to the Marketplace for a review. If you do not return the information we need to review your case, we cannot automatically send your information to the Marketplace so that they can determine your eligible for that type of coverage or the Advanced Premium Tax Credits.
What can members do now?
- Update their contact information by calling Cover Virginia at 1-855-242-8282 or online at commonhelp.virginia.gov. We must have current contact information on file, such as a mailing address and phone number(s), so members receive important notices and so we can reach out if we need more information.
- Watch for and respond quickly to notices about their coverage.
- Sign up for email and text updates, follow us on social media and visit us at coverva.org and facebook.com/coverva/
What are the other health care coverage choices?
Virginians who do not qualify for health coverage from Medicaid may be able to get financial help to lower the cost of private health insurance through insurance through HealthCare.gov. The amount of financial help is based on the cost of insurance where the applicants live, how many people are in their household, and their estimated yearly income.
Learn more at enrollva.org or 888-392-5132:
Get help from trained assisters, called navigators, to sign up for health coverage online or in person.
Compare plans and cost with an easy, anonymous online tool
Find out how much financial help you may qualify to receive
How can I get more information?
Where can I send questions or share my views?
Members can reach us at email@example.com.
Cover Virginia has an email inbox for verification (proof) returns. This lets customers send proof by email in addition to fax or mail. We will tell customers about this return method during calls for applications, status, and renewal submissions. It is also on the Verification Checklist (VCL) we send customers asking for information.
The new inbox lets Virginians send proof by email. They can still use fax or U.S. mail. Applicants and members who call will be given the email address. The new option is also on the Verification Checklist (VCL) that we send to Virginians who ask for information. They can still use the email inbox after the emergency ends
Community Partner Information and Updates
- Virginia Department of Health
- Virginia Poverty Law Center has response resources for housing and immigration
- VCU Partnership for People with Disabilities short video explaining COVID-19 to people with intellectual disabilities
- Federal Public Health Emergencies
- COVID-19 Emergency Waiver Guidance - 01/24/2023
- COVID-19 Federal Public Health Emergency website
- COVID Flexibilities Update – 06/30/2021
- COVID-19 Emergency Waiver Guidance - 5/04/2020 & 05/06/2020
These forms authorize (allow) individuals or groups, including application assisters, Navigators and Certified Application Counselors (CACs), to help Medicaid applicants after getting verbal consent. The verbal consent authorization will expire at the end of the COVID-19 public health emergency.
[PDF] Acknowledgment of Receipt of Verbal Consent (English)
[PDF] Acknowledgment of Receipt of Verbal Consent (Spanish)
[PDF] Consumer-Directed (CD) Services Personal Care COVID-19 Flexibilities Fact Sheet - 2020
[PDF] Consumer-Directed (CD) Services COVID-19 Fact Sheet on Personal Protection - 2020
Keep track of changes to federal and state benefit programs with VDSS’ “Explanation of Changes to Benefit Programs” flyer. Available in multiple languages.