Frequently Asked Questions
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?
We want 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 Federal 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 Virginia Medicaid can buy health insurance through Enroll Virginia. Enroll Virginia has offices in communities across the state to helping Virginians get high quality, affordable health coverage. You can sign up for insurance on the Federal Marketplace on HealthCare.gov:
- Within 60 days after losing health coverage or
- Anytime during the annual open enrollment period from November 1 through January 15
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 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
- Get enrolled!
How can I get more information?
Where can I send questions or share my views?
Members can reach us at firstname.lastname@example.org.
This fact sheet outlines our policies to streamline application processing and maintain coverage for our members during the COVID-19 pandemic.
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