CHIP in Virginia

LOOKING FOR ADDITIONAL INFORMATION?

Each year, the Virginia Children’s Health Insurance Program (CHIP) helps provide affordable health care coverage to tens of thousands of children across the state. This CHIP health care coverage provides access to vital medical services like routine check-ups, doctor visits and dental care for families who cannot afford to purchase private health insurance. In coordination with the federal government, Virginia’s state government offers its CHIP program both through an expansion of Medicaid and through other programs. For this reason, VA CHIP and Medicaid enrollment for children are closely related. However, although many often ask, “Is CHIP considered Medicaid?” there are different income eligibility requirements for each program. As in other states that have implemented CHIP partly through an expansion of Medicaid, children whose households qualify for one of these programs may not qualify for the other. This article provides a helpful overview of the Children’s Health Insurance Program in Virginia, explaining the relationship between CHIP and Medicaid in the state, as well as reviewing the eligibility requirements and application process.

Virginia CHIP Overview

The VA Children’s Health Insurance Program (CHIP) is administered by the Department of Medical Assistance Services (DMAS), the same agency that administers Medicaid. To achieve Medicaid eligibility children must meet a specific maximum income requirement. Generally, applicants will qualify to enroll in Medicaid for children if their household’s income is above a certain limit. However, many of these candidates can instead apply for affordable health care through VA CHIP. In Virginia, CHIP is called Family Access to Medical Insurance Security (FAMIS). Virginia Medicaid for kids is called FAMIS Plus.

For those asking, “What is covered by CHIP Medicaid in Virginia?” both FAMIS and FAMIS Plus cover doctor visits, check-ups, tests, mental health, prescriptions, shots and various other health services. CHIP and Medicaid coverage in VA also includes dental services provided through Smiles for Children, a program that utilizes a network of providers that families must choose from when seeking dental care for their children if they want that care to be covered. Those interested in securing affordable health insurance for their children may enroll in CHIP or Medicaid at any time, as FAMIS and FAMIS Plus are not subject to a special enrollment period (unlike with private health insurance). To learn more about CHIP and Medicaid services and eligibility guidelines, you can download our comprehensive Medicaid guide.

What is CHIP Medicaid in Virginia?

Although the CHIP program is different from children’s Medicaid in Virginia, the two health care programs share some similarities. First, both FAMIS and FAMIS Plus offer children the same comprehensive benefits, including vision and dental care, provided through managed care organizations like Aetna Better Health of Virginia and Anthem Healthkeepers Plus. Additionally, VA Medicaid for children and CHIP share many of the same eligibility requirements, although there are some important exceptions. CHIP and Medicaid covered services are the same for both programs, and families enrolled in either program will not experience monthly or yearly premium costs. Those enrolled in Virginia’s FAMIS, however, will need to make small co-payments for certain health care services. Finally, since the two programs are administered through one agency, the children of those who apply will automatically be considered for both programs without needing to fill out multiple applications.

Who is eligible for the Virginia CHIP program?

Those interested in CHIP or Medicaid enrollment in Virginia must meet certain eligibility requirements in order to successfully enroll in FAMIS or FAMIS Plus, Virginia’s respective versions of CHIP and kids’ Medicaid. First, FAMIS and FAMIS Plus candidates must:

  • Live in Virginia.
  • Have U.S. citizenship or be a qualified non-citizen.
  • Be younger than 19 years of age.
  • Have a gross monthly household income that is under roughly 200 percent of the federal poverty level.

It is important to keep in mind that the government adjusts the Medicaid and CHIP income limits annually, and actual income criteria may vary. Children who do not have health insurance and whose families meet the income requirements for the program may enroll in FAMIS. However, to meet VA Medicaid eligibility kids are not required to be without health insurance, as FAMIS Plus is available to children in certain income brackets whether or not they are already covered by health insurance. Finally, those enrolled in FAMIS or FAMIS Plus will not be labeled a public charge, and enrolling in either program will not, in any way, affect a family’s ability to obtain citizenship in the U.S.

How to Apply for CHIP in Virginia

For those wondering about the steps to apply for CHIP, Virginia offers various avenues for submitting an application, and those who are unsure of whether their children meet the requirements for FAMIS or FAMIS Plus can apply anyway. When applying for CHIP in VA, petitioners will need their names, Social Security Numbers, proof of immigration status (for non-citizens), federal tax details, job or income documents, policy numbers for any current health insurance and other information about taxable income for all members of the household. This includes income like unemployment benefits, Social Security benefits, pensions, retirement income and rental income. To apply for the VA Children’s Health Insurance Program by phone, residents can call 1-855-242-8282, where they will be connected to a representative who speaks their preferred language. Online applications for VA CHIP, as well as information about particular benefits and eligibility, are available on Virginia’s official website. Finally, those interested may also apply for benefits at their local Department of Social Services. Download our complimentary guide to learn more about applying for CHIP benefits.