Healthcare Assistance for Single Mothers in Virginia

Where to start

The best first step depends on who needs care. Do not guess that you earn too much. Virginia rules can change by age, income, pregnancy, disability, immigration status, household size, and whether you have other insurance.

Quick help table

Main Virginia coverage options

Virginia calls Medicaid and FAMIS “Cardinal Care.” The state uses Cover Virginia, CommonHelp, local social services offices, and the Marketplace to screen people for health coverage. The table below is a starting point, not a final decision.

2026–27 Medicaid rule changes

October 1, 2026: rules for some noncitizen adults

Some adults who are not pregnant or postpartum lost access to full-benefit Medicaid because of new federal immigration-status rules. Virginia says adult eligibility under these rules is now limited to U.S. citizens or nationals and certain groups: lawful permanent residents, Cuban or Haitian entrants, and Compact of Free Association migrants. Other rules can still apply, including waiting periods or program limits. If you got a letter, do not assume your child has also lost coverage.

Virginia says this change does not change the Medicaid or FAMIS rules for children under 19 or pregnant and postpartum people. People who cannot get full Medicaid due to immigration status may still qualify for Emergency Services Medicaid if they meet its other rules. Use Cover Virginia’s status guidance and ask for a review of your exact case. For a legal question about immigration status, speak with a qualified legal service.

January 1, 2027: expansion work rules and renewals

Virginia is preparing work and community engagement rules for certain adults in Medicaid Expansion. The start date is set for January 1, 2027. People covered by these rules may need to meet 80 hours per month through approved work, school, training, volunteering, or a mix. Some people have an exclusion or exemption. Do not guess that being a single parent alone proves you are exempt. Ask the state to check your situation.

Medicaid Expansion members will also face eligibility reviews every six months for applications and renewals starting in 2027, rather than every 12 months. These new requirements do not apply to people covered as children, pregnant or postpartum members, older adults, or certain disability-based groups. Read DMAS work-rule help and the federal changes page. Keep copies of all letters and reply by each deadline shown.

2026 income snapshot

Virginia updated its 2026 Medicaid and FAMIS income charts after the federal poverty guidelines took effect on January 13, 2026. Use this table only as a quick screen. The official application decides your case.

These are not all rules. Some people have disability, Medicare, former foster youth, pregnancy, medically needy, or long-term care rules. If you are close to the limit, apply and ask for a full review.

These 2026 amounts are monthly guidelines with Virginia’s standard 5% income disregard already reflected. A pregnant household may be counted differently. They are not the cutoffs for every Medicaid group or a promise of approval. Check the current adult income table and child income table before applying.

2027 Marketplace enrollment and savings

Virginia’s Insurance Marketplace is the place to check private health plans and financial help if Medicaid or FAMIS does not fit. Open enrollment for 2027 runs November 1, 2026, through January 29, 2027. Virginia says December 15 is the deadline for coverage starting January 1. If you need coverage before November or outside the window, ask if you qualify for a special enrollment period due to a life event, such as losing other coverage or having a baby. See the Marketplace enrollment FAQ.

New Virginia Premium Savings may help eligible people with incomes generally from 138% to 250% of the federal poverty level lower their 2027 monthly premiums. The Marketplace checks household size, income, lawful presence, plan type, and funding rules. Savings are not guaranteed, and the program does not pay medical bills directly. This is different from Medicaid’s HIPP and FAMIS Select premium assistance.

Enhanced federal premium tax credits expired after 2025. Standard federal premium tax credits may still apply in 2026 and 2027 for eligible buyers, but 2027 eligibility changes will affect some noncitizens. The Marketplace federal update explains these limits. Ask a free navigator to review your full cost, including the deductible and out-of-pocket costs, before picking a plan.

Pregnancy, postpartum, and children’s coverage

Pregnancy coverage is one of the most important places to start. Virginia says Medicaid for Pregnant Women, FAMIS MOMS, and FAMIS Prenatal can cover medical, behavioral health, and dental care during and after pregnancy. Covered services can include prenatal care, labor and delivery, prescriptions, dental care, doula services, breast pumps, and behavioral health care.

FAMIS MOMS and FAMIS Prenatal generally require the pregnant applicant to be uninsured when applying. FAMIS Prenatal may cover qualifying people regardless of immigration status or access to a Social Security number; this does not mean every applicant qualifies. Ask which pregnancy program your application is being reviewed under.

Medicaid for Pregnant Women and FAMIS MOMS provide 12 months of protected postpartum coverage after the pregnancy ends. FAMIS Prenatal provides 60 days after the pregnancy ends. FAMIS Prenatal may help some pregnant people regardless of immigration status, but the application must be filed no later than the month the pregnancy ends.

Virginia says babies born to Medicaid for Pregnant Women or FAMIS MOMS members are generally enrolled in Cardinal Care for their first year. Babies born to FAMIS Prenatal members need a faster separate eligibility review. Report the birth to Cover Virginia or your local DSS and ask for the baby’s coverage number. FAMIS Prenatal cannot be approved if the application is filed after the month the pregnancy ends.

For children under 19, Medicaid and FAMIS can cover doctor visits, hospital care, prescriptions, behavioral health care, dental care, and other covered services. Children in Medicaid and FAMIS usually receive 12 months of continuous coverage, but you should still report address changes and respond to letters.

Pair health coverage with food and nutrition support. ASMOM’s Virginia WIC guide explains WIC next steps, and the pregnancy help guide lists support paths for pregnancy, birth, and newborn needs.

If you are uninsured, waiting, or over income

You may still have care options if Medicaid is pending or denied. Call before you go, because each clinic sets its own services, fees, documents, and appointment rules.

• Community health centers: Use the HRSA clinic locator to find health centers. HRSA says these centers serve people with or without insurance and use a sliding fee scale based on ability to pay.
• Free clinics: Search the free clinic finder from the Virginia Association of Free and Charitable Clinics. Not every area has a clinic, and services vary.
• Navigator help: Enroll Virginia offers free, unbiased help with Medicaid, FAMIS, and Marketplace applications. Navigators can help you compare steps, not sell you a plan.
• Cancer screening: Virginia’s Every Woman’s Life program helps eligible uninsured Virginia residents get breast and cervical cancer screening.
• Local help: ASMOM’s Virginia community help guide can help you look for clinics, food, diapers, shelters, and local nonprofits.

How to apply

Virginia lists several ways to apply. Online is often fastest, but phone, paper, and local DSS help matter if you have internet trouble, language needs, disability access needs, or papers that need an explanation.

1. Apply online through CommonHelp or Virginia’s Insurance Marketplace.
2. Call Cover Virginia at 1-833-5CALLVA. The state also lists TDD help at 1-888-221-1590.
3. Use the CoverVA applications page if you need paper forms in English or Spanish.
4. Ask your local DSS office for help if you also need SNAP, TANF, child care, or energy help. Use ASMOM’s Virginia SNAP guide and Virginia child care page for related steps.

Using your coverage after approval

After approval, watch your mail and your online account. You may need to pick a managed care plan, choose a primary care doctor, or answer renewal letters. The Cardinal Care choices site can help members compare plan choices and contact the enrollment broker.

Dental care

Virginia Medicaid and FAMIS dental coverage is through Cardinal Care Smiles. DMAS says the program is managed by DentaQuest. Call DentaQuest at 1-888-912-3456, use the DMAS dental page, and confirm the dentist still accepts your plan before the visit.

For help with clinics, children and urgent dental costs, use ASMOM’s Virginia dental guide. A clinic may have limited appointments even if the state covers the service.

Rides to appointments

Medicaid transportation may help if you have no other way to reach covered care. DMAS says fee-for-service members use Modivcare, while managed care members call their plan. Read the DMAS ride page and schedule early when you can.

Other needs that affect health

Health problems often come with food, rent, child care, and utility stress. For related Virginia help, check ASMOM’s Virginia housing help, Virginia transportation, and Virginia baby gear pages.

What to do if you are denied or delayed

If the state asks for proof, send it as soon as you can. Keep copies, screenshots, fax receipts, upload confirmations, and the name of anyone you speak with. If you call, write down the date, time, and what you were told.

If Medicaid or FAMIS is denied, reduced, or closed, read the notice. DMAS says applicants and members have the right to appeal certain actions, and the appeals resources page explains next steps. If you lost coverage because of a missed renewal or proof request, DMAS says you may have 90 days after coverage loss to return renewal paperwork.

Use the deadline on your notice. A benefit-coverage appeal and a health-plan service appeal may use different steps. If a plan denies a treatment or medicine, call the plan and ask for the appeal instructions for that decision. For an eligibility denial or closure, ask the state how to file an appeal or hearing request. Keep a copy of your request and the date sent.

For a broader benefits problem, use ASMOM’s benefits problem guide. If the problem could affect housing, food, safety, or medical care this week, call 211 or your local DSS office and ask what urgent help is available.