A new federal law made major changes to Medicaid eligibility. All states, including Virginia, must adopt these new rules starting in October 2026.
Changes to Eligibility for Non-U.S. Citizen Adults
Begin Date: October 1, 2026
Limits Medicaid eligibility for adult noncitizens (who are not pregnant or within the 12 months postpartum) to Legal Permanent Residents, Cuban-Haitian Entrants, and Compact of Free Association (COFA) Migrants. Members who lose eligibility for full-benefit Medicaid due to this change may still be eligible for Emergency Services Medicaid. These changes apply only to adults. The eligibility rules for children and pregnant/postpartum members are not changing.
New Limits on Retroactive Coverage
Begin Date: January 1, 2027
Reduces retroactive Medicaid (coverage provided before the month in which a person applies) to one month for Medicaid Expansion members and 2 months for all other Medicaid members. Currently, all Medicaid members can get up to three months of retroactive coverage.
More Frequent Eligibility Checks
Begin Date: January 1, 2027
Requires states to review the eligibility of Medicaid Expansion members, except certain American Indians and Alaskan Natives, every 6 months. All other members will continue to have their eligibility reviewed once per year. Pregnant members still receive coverage through 12 months postpartum.
Work & Community Engagement Requirements
Begin Date: January 1, 2027
Requires Medicaid Expansion members (most non-pregnant adults ages 19-64) to work, volunteer, or participate in a work training or education program to keep their Medicaid coverage. Some adults may be exempt from this requirement.
Please advise your patients to:
- Check their mail, email, and text messages regularly.
- Report all changes to their address and contact information.
- Read all information sent by Cardinal Care as soon as they receive it and respond quickly to all requests.
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