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Medicaid Expansion 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 expansion?

The rules have changed. There is new health care coverage for adults beginning January 1, 2019. If you applied for Medicaid in the past and were denied, you may be eligible. Eligibility is based on income, with a single adult making up to $17,237 per year, or a family of three making up to $29,436 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.

Additionally, Financial Counseling will staff a kiosk every Tuesday, Wednesday and Thursday from 9:00 a.m. to 3:00 p.m. through January 31, 2019. The kiosk is located inside the Main Hospital diagonal to the Subway entrance to the cafeteria. 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?

When you sign up for insurance through Medicaid, you will be randomly assigned to a health insurance plan and a primary care provider so you can use your coverage as quickly as possible. You will also receive information on how to change your health insurance plan and a side-by-side comparison of six choices. You will have 90 days to change your plan. If you want to keep seeing your primary care provider, ask him or her which of the six health insurance plans he or she accepts. You will need to choose one of the plans your primary care provider accepts if you want to keep seeing that provider. Make sure you also tell the plan you choose 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.