Medicaid expansion open enrollment

Published 2:22 pm Wednesday, October 24, 2018

Beginning Nov. 1, participants around the Heart of Virginia eligible for health care coverage under Medicaid expansion can apply.

“When both sides of the aisle came together earlier this year to pass Medicaid expansion, the Commonwealth set a realistic, aggressive timeline for implementation and I’m proud to report the remarkable progress we’re making on these goals in close coordination with our federal partners,” said Governor Ralph Northam in a news release. “Virginia will begin accepting applications for expanded health coverage on November 1. I encourage all Virginians to get acquainted with the new eligibility rules and learn how they and their family members qualify for access to quality health coverage.”

Eligible adults will begin receiving services starting Jan. 1, 2019, the release cited. The new coverage is available to men and women ages 19 through 64 who are not eligible for Medicare and who meet income requirements, which vary by family size. For example, a single adult with an annual income at or below $16,754 may be eligible for coverage. An adult in a three-person family with a total household annual income at or below $28,677 may be eligible.

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More information about the new health coverage and eligibility rules are available at The website includes an eligibility screening tool to help individuals assess whether they may qualify for coverage, the release cited. Visitors to the website can sign up to receive regular information through email and text about the new coverage and enrollment process. Information is also available by calling (855) 242-8282. Individuals who are deaf or hearing impaired can call (888) 221-1590.

April Ross, Care Coordinator/ Virginia Insurance Counseling and Assistance Program (VICAP) Coordinator with Piedmont Senior Resources (PSR), said PSR serves people who have Medicare, which differs from Medicaid in that Medicare provides health coverage for those 65 years old, or are eligible due to early retirement or being disabled. Open enrollment for Medicare began Oct. 15 and ends Dec. 7.

Ross said for those who would like additional information about open enrollment, they can contact their local Social Services in the county they reside or call (855) 242-8282.

Sam Gerstemeier, manager of government relations with Centra Health, said that statewide, the Virginia Department of Medical Assistance Services estimates that 400,000 individuals may be eligible for coverage under Medicaid expansion.

“A significant portion of those individuals will certainly be from Central and Southside Virginia,” Gerstemeier said.

Gerstemeier said there aren’t expected to be any differences at Centra’s healthcare facilities in 2019 due to the expansion.

“Centra already accepts Medicaid patients in addition to offering financial assistance charity care to low income patients,” Gerstemeier said. “While Centra expects to see the number of self-pay patients decrease as more individuals have access to Medicaid, we anticipate that there will still be individuals without healthcare coverage. Centra’s financial assistance policy will still be available to provide charity care to those in need.”

Gerstmeier said in addition to looking out for Medicare and Medicaid expansion, he encouraged participants to see if they are beneficiaries of the Governor’s Access Plan (GAP), for adults with serious mental illnesses, or Plan First family planning services, for those planning to have children, as they will be automatically transitioned to full Medicaid Jan. 1.

“If residents are participants in the Supplemental Nutrition Assistance Program (SNAP) or are parents of children enrolled in Medicaid, they will be mailed a letter with an express Medicaid application option this fall,” Gerstmeier said.

For those who currently have coverage through the marketplace and are eligible for Medicaid, their information will be transferred to Virginia Medicaid when they log in to their account, Gerstmeier said.

Any newly eligible adult not captured in these categories  can apply over the phone, online, or in person at (855) 242-8282 (TDD (888) 221-1590), at or at their county Department of Social Services Office. The Prince Edward Department of Social Services Office can be reached at (434) 392-3113, the Cumberland Department of Social Services Office can be reached at (804) 492-4915 and the Buckingham Department of Social Services Office can be reached at (434) 969-4246.