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Medicaid and the Marketplace Exchange

Frequently Asked Questions

We want everyone to have access to high quality, low cost care by getting coverage through a government-assisted program that best fits his or her needs. 

What is Medicaid?

Medicaid is a government-assisted health insurance program that helps cover medical costs for people with limited incomes and resources. Eligibility is based on income, with a single adult making up to $17,608 per year, or a family of three making up to $29,973 per year eligible for coverage.

If you are not eligible for Medicaid, you may still be eligible for health insurance coverage through the Healthcare Exchange.

When can I sign up for Medicaid?

You can apply for Medicaid at any time.

How can I sign up for Medicaid?

There are several ways to sign up for Medicaid. You can apply by phone by calling the Cover Virginia Call Center at 1-855-242-8282 or the Virginia Department of Social Services Enterprise Call Center at 1-855-635-4370. You can apply in person by visiting your local Department of Social Services. You can also apply online by visiting commonhelp.virginia.gov.

You may also contact VCU Health Financial Counseling at (804) 828-0966 for assistance by telephone.

What if I’m still not eligible for Medicaid?

You still have options. You can sign up for insurance through the Healthcare Exchange, also called the Health Insurance Marketplace. You may be eligible for financial assistance to help you afford your Healthcare Exchange plan. You may also still be eligible for VCU’s Indigent Care Program.

When can I sign up for a Healthcare Exchange plan?

You can sign up for a Healthcare Exchange plan between November 1 and December 15. You cannot sign up for a Healthcare Exchange plan outside of these dates unless you have a life-changing event, like getting married or having a baby. You should visit www.healthcare.gov on November 1 so you can learn more information and review your Healthcare Exchange plan options.

How can I sign up for a Healthcare Exchange plan?

You can sign up for a Healthcare Exchange plan online by visiting www.healthcare.gov. You can also apply by phone by calling the Healthcare Exchange Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). You can also apply through an agent or broker in your community.

Will I be able to have a Medicaid or a Healthcare Exchange plan and participate in the Indigent Care Program?

Yes, if you have insurance through Medicaid or the Healthcare Exchange, you may still be eligible for the Indigent Care Program to cover out of pocket costs when you visit VCU Health providers.

Can I keep seeing my primary care provider after I sign up for Medicaid?

Most individuals on Medicaid are enrolled in a health insurance plan. When you qualify for insurance through Medicaid, you will receive information in the mail on selecting a health plan, including a side-by-side comparison of the six choices. If you do not select a health plan, you will be assigned one. You will have 90 days to change your health plan after you are enrolled. If you want to keep seeing your primary care provider, ask him or her which of the Medicaid health insurance plans he or she accepts. You will need to choose one of the health plans your primary care provider accepts if you want to keep seeing that provider. Make sure you also tell your health plan the name of your current primary care provider and that you would like to keep seeing him or her. All the health plans except Aetna will make that change effective the same day. Aetna will make the change effective the first day of the next month.

Can I keep coming to VCU Health to see specialists?

Your primary care provider will refer you to the appropriate specialist based on your needs. These specialists may include VCU Health providers.