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The FAMIS MOMS program began enrolling eligible pregnant woman again on December 1, 2014.  The program was suspended in December 2013 in anticipation of the Marketplace offering comparable coverage to pregnant women in Virginia.  When that coverage was determined to not be comparable or easily accessible for pregnant women, the General Assembly acted to reinstate the program.  Pregnant women who live in households with income below 200% FPL (plus a 5% income disregard) and meet all other eligibility requirements are eligible for FAMIS MOMS.  Click here for more information.


Plan First Eligibility Has Expanded

As of January 1, 2015, Plan First eligibility has expanded from 100% FPL to 200% FPL.  For more information about who is eligible for Plan First and the services covered by this program, click here.


FAMIS Coverage Now Available for Children of State Employees

State employees who are offered health coverage may choose to cover their children through their employee health insurance.  However, for many families this is a very expensive option.  Adding a dependent can increase monthly premiums by $100 or $200.  The state employee health insurance plan also requires enrollees to pay up to $40 co-pays for doctor visits.  For state employees in households with low-incomes, these costs make many parents unable to provide coverage for their children.   Previously, dependents of state employees who were eligible to enroll in the state's health plan could not receive coverage through FAMIS. Governor McAuliffe has removed this restriction as of January 1st for new state employees, and existing state employees will be able to enroll their eligible children in FAMIS during their open enrollment period in 2015.  If you are a state employee, or know a state employee who may have FAMIS eligible children, tell them to ask their state HR representative for more information. 

GAP Program Begins for Virginians with Serious Mental Illnesses

The Governor's Access Plan for the seriously mentally ill (GAP) is another component of Governor McAuliffe's Healthy Virginia Plan.  The GAP initiative aims to offer a targeted set of benefits to 20,000 Virginians who have income less than 95% (plus 5% income disregard) of the federal poverty level and suffer from serious mental illness.  The Department of Medical Assistance Services is rolling out this new coverage option as of January 12, 2015.  For more information, click here.

FFM Transfers Now Being Processed by Cover Virginia

The Department of Medical Assistance Services is in the process of expanding the responsibilities of Cover Virginia to include a Centralized Processing Unit that will determine eligibility for Medicaid and FAMIS applications.  The first phase of this expansion occurred in November 2014 with the new Cover Virginia CPU processing and determining eligibility for all applications that are transferred to Virginia as likely Medicaid or FAMIS eligible by the Federally Facilitated Marketplace (  The next phase of the Cover Virginia CPU expansion is occurring in early 2015 and will include the CPU determining eligibility for the following:
  • Telephone applications submitted through the Cover Virginia Call Center
  • Online Health Care Coverage only applications submitted through CommonHelp*
(*Note: If applicants have other active benefits (SNAP, TANF, etc.) through DSS, their local Department of Social Services will determine eligibility, not the Cover Virginia CPU.If these applications are approved and enrolled by the CPU, they will be transferred to the enrollee's local Department of Social Services for ongoing case maintenance and renewal processing. 


Marketplace Open Enrollment Ends February 15th

Reminder!  The open enrollment period for individuals to buy health insurance in the Federal Marketplace (or ends on February 15, 2015.  After that date, you may still be eligible to buy health insurance through the Marketplace if you qualify for a Special Enrollment PeriodFor more information on enrollment through the Marketplace, click here  


FAMIS Program Enrollment as of January 1, 2014 (most recent data available):

  • 61,430 children are enrolled in FAMIS (including 193 in FAMIS Select);
  • 516,204 children are enrolled in FAMIS Plus (including the CHIP Medicaid Expansion);
  • 174 pregnant women are enrolled in FAMIS MOMS;
  • 15,944 pregnant women are enrolled in Medicaid for Pregnant Women; and
  • 76,756 men and women are enrolled in Plan First.
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