Last updated: June 21, 2026
Bottom line
If you live in Virginia and need health coverage, start with Cover Virginia for Medicaid, FAMIS, and pregnancy coverage. You can also apply through CommonHelp, ask the Virginia Marketplace about private plan savings, or contact your local DSS office for help with several benefits at once.
Children may qualify for Medicaid or FAMIS even when a parent does not. Pregnant and postpartum mothers may have special coverage through Medicaid for Pregnant Women, FAMIS MOMS, or FAMIS Prenatal. If you are uninsured or waiting on an application, community health centers, free clinics, hospital financial aid, WIC, and Marketplace navigators may still help.
This page is about getting coverage and finding care. It is not medical advice. For diagnosis, medicine, treatment, or urgent symptoms, call a licensed medical provider, 911, or the nearest emergency room.
Urgent health help in Virginia
Call 911 or go to the nearest emergency room if you or your child may have a medical emergency, such as trouble breathing, chest pain, signs of stroke, heavy bleeding, severe pain, a serious allergic reaction, or a risk of self-harm.
If you are in a mental health crisis, call or text 988 Virginia for crisis support. If you are pregnant or recently had a baby and feel depressed, anxious, overwhelmed, or unsafe with your thoughts, call or text the Maternal Mental Health Hotline at 1-833-TLC-MAMA.
If you need food, housing, diapers, transportation, prescriptions, or local crisis help, search 211 Virginia and call the listed local programs before a problem grows. ASMOM also has a Virginia emergency guide for fast local help.
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.
If you need coverage
Apply for Cardinal Care, Virginia’s Medicaid and FAMIS program name. Adults ages 19 to 64 may qualify through Medicaid Expansion if they meet income rules and do not have Medicare. A national overview is in ASMOM’s Medicaid guide.
If your child needs care
Apply for Medicaid for Children or FAMIS for each child under 19. A child may qualify even if you do not. Keep every letter and report address changes so notices reach you.
If you are pregnant
Report the pregnancy when you apply. Ask about Medicaid for Pregnant Women, FAMIS MOMS, and FAMIS Prenatal. A pregnant person usually counts as more than one person in the household.
If you need care now
Call a clinic, health center, or provider while your application is pending. Ask about sliding fees, same-week visits, prescription help, and an application assister.
Quick help table
| Need | Best first step | What to ask |
|---|---|---|
| Coverage for a parent | Apply through CommonHelp or Cover Virginia. | Ask to be screened for every Medicaid group and Marketplace help. |
| Coverage for children | Apply for Medicaid or FAMIS. | Ask if each child qualifies, even if you do not. |
| Pregnancy care | Report pregnancy right away. | Ask about MPW, FAMIS MOMS, and FAMIS Prenatal. |
| No insurance today | Call a clinic or health center. | Ask about sliding fees, prescriptions, and help applying. |
| Dental pain | Check Cardinal Care Smiles. | Ask if the dentist is taking new Medicaid patients. |
| Ride to care | Call your Medicaid plan. | Ask how early to schedule transportation. |
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.
| Program or path | Who it may help | Reality check |
|---|---|---|
| Adult Medicaid | Adults ages 19 to 64 with income under the state limit and no Medicare. | Virginia says Medicaid Expansion work and community engagement rules are set to start in January 2027, so check current notices. |
| Children’s coverage | Children under 19 through Medicaid for Children or FAMIS. | Children get 12 months of protected coverage unless an exception applies, such as moving out of Virginia. |
| Pregnancy coverage | Pregnant and postpartum people through MPW, FAMIS MOMS, or FAMIS Prenatal. | FAMIS MOMS and FAMIS Prenatal usually require the person to be uninsured when applying. |
| Marketplace plans | People who do not qualify for Medicaid or FAMIS, or who need private coverage. | Open enrollment for 2026 has ended, so most people need a special enrollment reason. |
| Premium assistance | Some families with Medicaid, FAMIS, or employer health coverage options. | HIPP, HIPP for Kids, and FAMIS Select depend on cost and program rules. |
| Virginia WIC | Pregnant, breastfeeding, and postpartum parents, plus children under 5. | WIC is food and nutrition help. It is not health insurance. |
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.
| Family size | Adult Medicaid monthly | Children Medicaid monthly | FAMIS monthly |
|---|---|---|---|
| 1 | $1,836 | $1,969 | $2,727 |
| 2 | $2,489 | $2,669 | $3,697 |
| 3 | $3,142 | $3,370 | $4,668 |
| 4 | $3,795 | $4,070 | $5,638 |
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.
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.
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.
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.
- Apply online through CommonHelp or Virginia’s Insurance Marketplace.
- Call Cover Virginia at 1-833-5CALLVA. The state also lists TDD help at 1-888-221-1590.
- Use the CoverVA applications page if you need paper forms in English or Spanish.
- 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.
Papers to gather
- Names and birth dates for people in your household.
- Social Security numbers or immigration document numbers for people applying, unless an exception applies.
- Recent pay stubs, benefit letters, self-employment records, or tax information.
- Current health insurance cards, employer offers, and policy numbers.
- Pregnancy due date or delivery date, if this applies.
- Mailing address, phone number, email, and a safe way to receive notices.
For a wider paperwork list, use ASMOM’s documents checklist before you send forms.
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.
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.
Common mistakes to avoid
- Do not ignore mail. A missed proof request or renewal letter can stop coverage.
- Do not self-deny. Rules differ for adults, children, pregnancy, disability, and former foster youth.
- Do not assume every doctor takes your plan. Call the office before the visit.
- Do not wait on dental pain. Ask DentaQuest, a health center, or a clinic about the soonest opening.
- Do not use old income charts. Cover Virginia updates numbers when federal poverty levels change.
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.
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.
Backup options when one path fails
Health coverage is not all-or-nothing. If Medicaid is not approved, you may still have Marketplace savings, clinic discounts, WIC, prescription help through a clinic, school-based services for a child, or hospital financial assistance.
If a medical bill is already in collections, ask the provider or hospital for an itemized bill, financial assistance, and a pause on collections while your coverage or charity-care request is reviewed. If a health problem is connected to disability or special needs, ASMOM’s disability help guide can help you sort next steps without guessing eligibility.
Phone scripts
Calling Cover Virginia
“Hi, I live in Virginia and need health coverage for myself and my children. Can you screen us for Medicaid, FAMIS, pregnancy coverage if it applies, and Marketplace options if we do not qualify?”
Calling a clinic
“Hi, I do not have insurance right now, or I am waiting on Medicaid. Do you see uninsured patients? Do you have sliding fees, prescription help, or someone who can help me apply for coverage?”
Calling your health plan
“Hi, I need help finding a primary care doctor, dentist, or ride to a covered appointment. Can you tell me which providers are taking new patients and how early I must schedule transportation?”
Calling about a notice
“Hi, I received a Medicaid or FAMIS notice and I do not understand it. Can you explain the reason, what proof is missing, the deadline, and how I can appeal or reopen the case if possible?”
Resumen en español
Si eres madre soltera en Virginia y necesitas seguro médico, empieza con Cover Virginia, CommonHelp o tu oficina local de servicios sociales. Tus hijos pueden calificar para Medicaid o FAMIS aunque tú no califiques. Si estás embarazada, pregunta por Medicaid para embarazadas, FAMIS MOMS y FAMIS Prenatal.
Si no tienes seguro ahora, llama a una clÃnica comunitaria, una clÃnica gratuita o un centro de salud. Si tienes una crisis de salud mental, llama o manda texto al 988. Guarda cartas, fechas, comprobantes y nombres de las personas con quienes hables.
FAQ
Can single mothers in Virginia get free health insurance?
Some single mothers, parents, children, and pregnant people qualify for Medicaid or FAMIS with no monthly premium. Eligibility depends on income, household size, age, pregnancy, disability, immigration rules, Medicare status, and other facts. Apply for a full review instead of guessing.
How do I apply for Virginia Medicaid or FAMIS?
You can apply online through CommonHelp, by phone with Cover Virginia, through Virginia’s Insurance Marketplace, with a paper application, or through your local DSS office. If you also need SNAP, TANF, child care, or energy help, DSS and CommonHelp can screen other benefits too.
What if my income is too high for Medicaid?
Check Virginia’s Insurance Marketplace, free navigators, community health centers, free clinics, hospital financial assistance, WIC, and premium assistance if employer coverage is available. Children may still qualify even when a parent does not.
Does Virginia Medicaid cover dental care?
Virginia Medicaid and FAMIS dental benefits are handled through Cardinal Care Smiles, which is managed by DentaQuest. Covered services and provider openings can vary, so call before making an appointment.
Can Medicaid help with rides to medical appointments?
Virginia Medicaid may cover non-emergency transportation when you have no other way to get to covered care. Managed care members should call their health plan. Fee-for-service members should follow DMAS transportation instructions.
Last updated: June 21, 2026. Next review: September 21, 2026.
About this guide
This guide uses official federal, state, local, and other high-trust nonprofit and community sources mentioned in the article.
A Single Mother is independent and is not a government agency, benefits office, lender, law firm, medical provider, or tax advisor.
Program rules, funding, local availability, and eligibility can change. Always confirm details with the official program before you apply or make decisions.
Verification: Last verified June 21, 2026, next review September 21, 2026.
Corrections: If you see something wrong or outdated, email suggestions@asinglemother.org.
Disclaimer: This article is for general information only. It is not legal, financial, medical, tax, immigration, disability, safety, or government-agency advice.