How to get Medicaid or low-cost care in Virginia

What Medicaid looks like in Virginia

Virginia Medicaid is run by the Department of Medical Assistance Services, which people call DMAS. The state's public name for the program and its help line is Cover Virginia. Local Departments of Social Services take applications and handle your case, and every city and county has one.

Virginia began covering more adults on January 1, 2019. Today an adult under 65 can qualify with income up to 138 percent of the federal poverty level. That level is a yearly dollar amount the government uses to measure poverty, and the cutoff grows with the size of your household.

Children and pregnant people can qualify under their own rules, and so can people with disabilities. The Cover Virginia website has a separate page for each group. Our guide on Medicaid eligibility explains the groups in more detail.

Ways to apply in Virginia

You can start online through Cover Virginia or through CommonHelp, which is the state's website for several benefits. You can also call the Cover Virginia Call Center at 1-855-242-8282. People who use a text phone can call 1-888-221-1590, and you can go in person to a local Department of Social Services office.

Cover Virginia also has a live chat on its website. If you are unsure whether Medicaid or a Marketplace plan fits you, you can begin at the state Marketplace instead. To get ready, look at our guide on how to apply for Medicaid, which lists the papers to have on hand.

Right now, Virginia Medicaid asks you to renew your coverage every year. Watch your mail and your CommonHelp account so that a renewal notice does not slip by. Acting on a letter the day it arrives is a safe habit.

What changes in 2027

Virginia says a new federal work rule begins on January 1, 2027, and the state says it will not start earlier. Letters in 2026 are only meant to explain the rule and who it affects.

The rule applies to adults in Medicaid expansion who are 19 to 64. You can meet it by earning at least $580 a month or by doing 80 hours a month of approved activity. Paid work, training, an unpaid internship, school at least half time and volunteering all count, and you can mix them.

The state checks the rule when you apply and again at renewal. Renewals will happen every six months instead of every year. At a renewal, you must have met the rule in one of the six months before it. A new applicant must have met it for one month before applying. If you lose coverage, you can reapply at any time.

The state also lists many kinds of people who are exempt. People who are pregnant or within 12 months after a pregnancy are exempt. So are members of federally recognized tribes and veterans with a 100 percent disability rating. Parents and caregivers of a child 13 or younger are exempt, and so are caregivers of a person with a disability. People with a disabling health or behavioral health condition are exempt as well.

Virginia Medicaid says it will use information it already has when it can. Keep your phone number and address up to date through CommonHelp or by calling Cover Virginia. After that, read every notice that you receive.

If you earn too much for Medicaid

Virginia left HealthCare.gov at the start of 2024 and now runs its own Marketplace, called Virginia's Insurance Marketplace. A Marketplace is a website where you compare private health plans. The state says it is the only place to get financial help with the cost. Certified assisters listed on the site give free help.

If your coverage ended with a job change, our guide on health insurance without a job explains the sign-up window.

Care you can use today

Federally funded community health centers serve everyone and adjust their fees by income and family size. A free federal tool called Find a Health Center shows the nearest ones, and you only need to type in your zip code. Call the center first and ask how to become a new patient. Our guide to community health centers explains what to ask on the phone.

Ask about the price of a visit when you call, since some clinics post it and others do not.

Doctor license lookups in Virginia

The Virginia Board of Medicine lists a License Lookup under its public resources, and the board is part of the Department of Health Professions. The lookup is free to use, and the board also has a separate tool called Doctors' Profiles. Those profiles cover medical doctors, osteopathic doctors and foot doctors.

Flat monthly fees and emergencies in Virginia

Some doctors in Virginia offer what is called direct primary care. In this kind of care, you pay a doctor a flat monthly fee. It does not replace insurance, and it does not cover a hospital stay. You can search our directory to find cash-pay doctors in your area. Ask whether the fee covers lab work, and get the price in writing.

For a sudden, serious problem, call 911 or go to the nearest emergency room. Virginia emergency rooms must screen you and treat you until you are stable, no matter what you can pay. If a bill follows, our guide to hospital financial assistance can help.