Virginia: What to Do After Losing Medicaid Coverage

Key takeaways:

Medicaid renewal in Virginia is changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is called the unwinding of Medicaid, and some people will lose coverage during this process.
During the COVID PHE, Medicaid renewals were automatic and enrollees had continuous coverage. As part of the unwinding, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP) stopped nationwide on March 31, 2023.
Virginia has started to determine who is currently eligible for Medicaid. Make sure the Virginia Department of Medical Assistance Services has your current contact information. If you can’t be reached or no longer qualify for Medicaid, you could be dropped from coverage as early as May 1, 2023.

The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020, which was renewed a dozen times through February 2023.

Under the COVID PHE, Medicaid renewal changed. States were required to provide continuous coverage, so Medicaid enrollees kept their health insurance without eligibility reviews.

The PHE ends on May 11, 2023, and automatic renewals for Medicaid enrollees stopped on March 31, 2023. During this unwinding, more than 300,000 people in Virginia are projected to lose coverage from Medicaid — which is known as Cardinal Care — as well as the Children’s Health Insurance Program (CHIP), which is known in Virginia as Family Access to Medicaid Insurance Security Plan or FAMIS.

States, including Virginia, are resuming reviews of Medicaid and CHIP enrollees to determine who is eligible to continue receiving coverage. This process is called redetermination. If you or your family members no longer qualify for Medicaid or CHIP, you could lose coverage as early as May 1, 2023.

Here’s how to prepare for Medicaid changes in Virginia and what to do if you lose your coverage.

Why is Medicaid changing nationwide?

After the PHE ends, COVID-19 will remain a public health priority — but not an emergency. As part of this process, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid, and millions of people nationwide risk losing Medicaid coverage.

The unwinding will affect Medicaid in every state, Washington, D.C., and five U.S. territories.

What’s happening with Medicaid renewal in Virginia?

The Virginia Department of Medical Assistance Services (DMAS) is the office responsible for overseeing Virginia Medicaid, which provides healthcare access for 2.2 million people. DMAS has released details about its unwinding plans.

The department started reviewing eligibility for current Medicaid enrollees on April 1, 2023 and will continue to do so for a year. It sent the first renewal packets to eligible enrollees in March 2023.

What should I do if I lose my Medicaid coverage in Virginia?

You can receive Medicaid in Virginia if you meet all of the following criteria:

You are a Virginia resident.
You are a U.S. citizen, permanent resident, or legal resident.
You need healthcare or insurance assistance.
Your annual household income before taxes meets the limits for your household size.

And you are one of the following:

Pregnant
In charge of caring for a child 18 years old or younger
Blind
65 years old or older (under certain conditions)
Person with a disability, or a family member in your household has a disability

If you no longer meet the eligibility guidelines, your Medicaid in Virginia won’t be renewed. This means you will no longer have Medicaid coverage.

If you lose coverage, you should receive:

A notice of when your coverage ends
Information about how to appeal
A referral to the Affordable Care Act marketplace to purchase a plan there

If you lose your coverage, you may be able to get healthcare services at Virginia’s free and charitable health clinics and the state's community health centers.

If you lose coverage but believe you still qualify, you should reapply for Medicaid in Virginia. You may be uninsured for a while if you reapply for Medicaid and wait to be approved again. In that case, you can consider free and low-cost healthcare options. You can also use free GoodRx coupons to save on your prescription medications.

You should see if you qualify for coverage elsewhere if you don’t plan to reapply for Medicaid and aren’t eligible for another government healthcare program. Depending on your circumstances, you may be able to find health insurance with one of these options:

Affordable Care Act (ACA) marketplace: You may be able to find coverage for $10 or less per month on the ACA marketplace if you qualify for a premium subsidy. If you lose your Medicaid coverage, you’ll be able to purchase an ACA plan during an unwinding special enrollment period from March 31, 2023 to July 31, 2024.
Employer plan: You may now have a job that offers health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If your spouse or domestic partner has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.

Virginia Medicaid resources

Here are some resources to help you learn more about Medicaid in Virginia and upcoming changes related to the end of the COVID PHE:

Virginia Medicaid office: The Virginia Department of Medical Assistance Services oversees Virginia Medicaid and the Family Access to Medicaid Insurance Security Plan program for children.
Virginia Medicaid self-service portal: Use the CommonHelp portal to confirm or update your information. You can also make changes by calling 855-242-8282.
Virginia Medicaid unwinding Q&A: Get answers to frequently asked questions about the end of continuous Medicaid coverage.

The bottom line

Automatic Medicaid renewals ended on March 31, 2023 ahead of the COVID-19 public health emergency’s conclusion on May 11, 2023.

Virginia’s Department of Medical Assistance Services (DMAS) — which oversees Virginia Medicaid — will spend a year reviewing eligibility for enrollees. It expects to have enough information to automatically renew about one-third of enrollees who still qualify. It’s important for DMAS to have your current contact information so you can be reached when it’s your turn to renew.

If you lose your Medicaid coverage, you may still qualify for health insurance elsewhere. Your options may include ACA marketplace plans, Medicare, or job-based insurance.

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Written by:

Veneta Lusk

Veneta Lusk is a personal finance and healthcare writer with 15 years of experience. She holds a bachelor of arts in journalism from the University of North Carolina at Chapel Hill.

Edited by:

Cindy George, MPH

Cindy George, MPH, is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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