If you or a family member receives health coverage through Virginia Medicaid, important changes are coming that could affect your eligibility and coverage.  

Virginia Medicaid is preparing for new federal requirements that will take effect in October 2026 and January 2027, including more frequent eligibility reviews and new work requirements for some members.  

The changes primarily apply to adults enrolled through Virginia's Medicaid Expansion program. Children, pregnant and postpartum individuals, adults age 65 and older, and many people with disabilities will continue receiving Medicaid under their current eligibility rules.  

What Virginia Medicaid changes start in October 2026? 

Beginning October 1, 2026, Medicaid eligibility rules for some non-U.S. citizen adults will change. Adult non-U.S. citizens who are not pregnant and not within 12 months postpartum will generally need to be one of the following to qualify for full Medicaid benefits: 

• Lawful permanent resident  
• Cuban-Haitian entrant 
• Compact of Free Association (COFA) migrant  

Individuals who no longer qualify for full-benefit Medicaid because of this change may still be eligible for Emergency Services Medicaid, which covers emergency medical services for eligible individuals. 

What Virginia Medicaid changes start in January 2027?  

Beginning January 1, 2027, Virginia Medicaid Expansion members will be subject to: 

• Eligibility reviews every six months instead of less frequent renewals 
• New work requirements that some members must meet to maintain Medicaid Expansion coverage 

These changes are required under federal law and will be implemented in Virginia and other states.  

Who will be impacted by these new eligibility and work requirements? 

The new requirements apply only to individuals enrolled through Medicaid Expansion, which generally covers adults ages 19 to 64 with incomes below 138% of the federal poverty level who are not eligible for Medicare.  

The changes do not apply to: 

• Children 
• Pregnant and postpartum individuals 
• Adults with disabilities 
• Adults age 65 and older  

What are the work requirements for Virginia Medicaid? 

Some Medicaid Expansion members will need to meet a work requirement or qualify for an exclusion or exception. 

Examples of individuals who may be excluded from the work requirement include: 

• Parents or caregivers of a child under age 14 
• Individuals caring for a person with a disability 
• Pregnant individuals and those who recently gave birth 
• Individuals participating in substance use disorder treatment 
• People with serious medical, mental health or disability-related conditions 
• Individuals already meeting SNAP or TANF work requirements  

The Virginia Department of Medical Assistance Services (DMAS) will provide additional information regarding the criteria for the work requirement.  

What should Virginia Medicaid members do now? 

While no immediate action is required for most people, Virginia Medicaid encourages members to: 

• Make sure their mailing address, phone number, and email address are current 
• Open and read all mail, emails, and text messages from Virginia Medicaid or their health plan 
• Respond promptly to requests for information or renewal forms 
• Report changes in income, household size, address or other information that could affect eligibility 

Keeping your contact information up to date is one of the best ways to avoid interruptions in coverage. Similar to previous Medicaid renewal efforts, members who miss notices or fail to complete requested renewals could risk losing coverage, even if they remain eligible.  

What if I no longer qualify? 

If you no longer qualify for Medicaid Expansion, Virginia Medicaid will first determine whether you are eligible for another coverage program. Members will receive written notice explaining any changes and will have the right to appeal eligibility decisions.  

Where do I get more information about these changes? 

Learn more about the new federal requirements from the Virginia Department of Medical Assistance Services (DMAS). Questions about upcoming Medicaid changes can be directed to: 

Cover Virginia 
Phone: 1-855-242-8282 
TTY: 1-888-221-1590 

Members can also visit the Virginia DMAS website at dmas.virginia.gov or contact their local Department of Social Services office for assistance.  

VCU Health resources 

VCU Health offers financial assistance services to support patients who may not be able to pay for their care.

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