Important Member Information

Our partners play a crucial role in helping Medicaid members, including by answering questions about coverage, eligibility, services, and more! This month’s Partner Points includes a member FAQ to help you answer those questions and provide members with key resources. The DMAS website is a great source of information for anyone looking to learn more about Medicaid.

Frequently Asked Questions

• Question (Q): How do I file an appeal or determine my appeal status?
  • Answer (A): First, visit our website (https://www.dmas.virginia.gov) and under the “Appeals” section on the home page, click “Applicant/Member Appeals Resources.” There will be various PDFs and forms to look over and complete when looking to file an appeal or determine an appeal status.
• Q: How do I know if I am in FFS or Managed Care?
  • A: For Fee-for-Service (FFS), eligibility requires limited income and resources and must be in a covered group. The local DSS office process the applications, determine eligibility and enroll members.
    For Managed Care, the Enrollment Broker MCO helpline conducts all enrollment and education activities for Medicaid managed care eligible members. The Managed Care eligible Medicaid members are assigned to a MCO by the Enrollment Broker.  For newly eligible Medicaid members, this occurs within 30 days after Medicaid eligibility is entered into VaMMIS. Prior to managed care plan assignment, the member is in FFS. 

• Q: How do I schedule Transportation?
  • A: Fee-for-Service Medicaid members who arrange their transportation will have to call Modivcare at 866-386-8331 between hours of 6:00 am and 8:00 pm to schedule their transportation for routine appointments covered by VA Medicaid, five business days before the day of the appointment. In certain cases, transportation can be provided with less than a 5-day notice.  If member is enrolled in a MCO plan and eligible for transportation, they will contact their MCO plan for transportation arrangements.

                     Reservation Line:               

                     Aetna: 1-800-734-0430               

                     Anthem: 1-855 325-7581               

                     Molina: 1-833- 273-7416               

                     Sentara: 1-877-892-3986               

                     United Health: 1-844-604-2078 

• Q: How do I update my member information?
  • A: To update member information, visit the CoverVa website (https://coverva.dmas.virginia.gov) and under the “Members” section on the home page, click the “Update your Information” tab. There, it will provide information/resources on how to report a change in contact information, how to create an account at Common Help, and how to apply for coverage for a family member.
• Q: How do I cancel my coverage?
  • A: To cancel your Medicaid or Family Access to Medical Insurance Security (FAMIS) coverage, submit a request in writing to your local Department of Social Services (DSS). To find your local DSS office, please visit https://www.dss.virginia.gov/localagency/index.cgi
• Q: How do I change my healthcare plan?
  • A: Members may stay with their same health plan and will continue to have the option to change their health plan once a year during open enrollment. To change your health care plan, please visit the enrollment website for help changing your health plan at https://www.dmas.virginia.gov. Under “Members” on the home page, click the “Cardinal Care” tab. To the right under “For Members,” click “Managed Care Programs” and then “Change Your Health Plan.” It will then direct you to the enrollment website.
    
    You can also use the Cardinal Care App (Virginia Cardinal Care on the App Store) to change a health care plan.

• Q: How do I find a provider?
  • A: Visit our website (https://www.dmas.virginia.gov) and under “Members” on the home page, click the “Find a Provider” tab. From there, it will have a provider search for either Fee-for-Service members or Managed Care Organization members.
• Q: How do I report fraud?
  • A: You can report suspected fraud cases in two ways: Call the Fraud and Abuse Referral Hotline at 1-866-486-1971 or email recipientfraud@dmas.virginia.gov. For more information on Medicaid fraud and abuse, please visit our website (https://www.dmas.virginia.gov) and under “About Us” on the home page, click on the “Contact Us” tab. From there, click on the “Fraud and Abuse” tab.

Upcoming Events

4th Annual Back to School Giveaway

The 4th annual Back to School Giveaway is coming soon on Saturday, July 27, 2024! Please note that one backpack per student will be given, the student must be present to pick up. Bring school materials to Club 17, INC. from 1:00 p.m. - 4:00 p.m. to support Petersburg City Public School students!

Back 2 School Community Day  

On Saturday, August 3, 2024 the Back 2 School Community Day will be held at Petersburg High School from 10:00 a.m.-2:00 p.m.! Two events in one are being held to get Petersburg City Public Schools students and families ready for the 2024-2025 school year. Make sure to come by to enjoy a DJ, live entertainment, food trucks, vendors, face-painting, haircuts, braids, and more. There will be an on-site job fair. Required back-to-school vaccinations will be provided by Crimson Clinic! Be sure to bring your insurance card.

3rd Annual Back to School Health Rally

The 3rd annual Back to School Health Rally is back on Saturday, August 3, 2024 from 12:00 p.m. - 4:00 p.m.! Please come out for free school supplies, fun and games, a bounce house, face painting, food trucks, and health screenings at 110 N. Dunlop St., Petersburg. There are free island sno sno cones for the first 100 people! 

Upcoming DMAS Meetings

DMAS hosts many public meetings every month that you are welcome to attend. These meetings are listed on the DMAS website, under Boards and Public Meetings. Some of the upcoming August meetings include:

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