Virginia Premier Medallion 4 and CCC Plus Members
When you trust Virginia Premier for health coverage, you benefit from more than 20 years of experience providing quality programs and services.
The Virginia Premier Elite Family (Medallion FAMIS) plan helps ensure children receive the healthcare needed from infancy their teenage years. FAMIS coverage includes in-network doctor visits, emergency care and prescriptions. There are no copays during the COVID-19 public health emergency. There are no monthly premiums. Healthy living is easier with extra benefits like our 24/7 Nurse Advice Line, incentives for well visits and special wellness programs for kids and teens. En español.
To qualify for Virginia Medicaid, the child must:
- Be under age 19
- Live in Virginia
- Be a U.S. citizen or lawfully residing immigrant
- Live in a family meeting Virginia’s income rules
Applying for Medicaid in Virginia is open all year long. There are several ways to apply:
- Online: Visit commonhelp.virginia.gov
- Phone: Call Cover Virginia at 1-855-242-8282
- In Person: Visit your local Department of Social Services (DSS). Office locations.
How to Choose Virginia Premier
The Department of Medical Assistance Services (DMAS) will send a letter with an automatic health plan assignment when the child’s application goes through.
If Virginia Premier is already listed as the health plan in the letter, the member ID card will be mailed separately.
If Virginia Premier was not assigned, it is easy to switch to us. Here’s how:
- Call the Managed Care Help Line at 1-800-643-2273 (TTY/TDD: 1-800-817-6608).
- Have the child’s Medicaid ID number on hand.
- Tell them you want to switch the health plan to Virginia Premier.
You have up to 90 days to switch. After that, you may switch to Virginia Premier when it is time for open enrollment where you live. View regions.
Virginia Medicaid FAMIS Coverage Plus Virginia Premier Extra Benefits
Here are just some of the benefits offered from Virginia Premier Elite Family.
- Members get access to quality doctors and medical facilities through the Virginia Premier provider network. Check our Provider Directory search tool to find doctors and specialists or pharmacies, urgent care centers and hospitals in your area.
- Urgent Care: Urgent care visits for serious medical conditions that are not life threatening are covered.
- Emergency Care: Hospital visits for emergencies and anything life threatening are covered, including transportation.
- Chronic Disease Management: A dedicated registered nurse offers personal coaching to help manage chronic conditions. The nurse can help with taking advantage of benefits, connecting to services and developing an action plan to manage symptoms.
- Behavioral health services: Services and treatment options for conditions such as depression, anxiety or other mental health issues.
- Eye exam and lenses every 24 months. Up to $100 credit for frames or contacts every 48 months.
- Diabetic Members: Eye exam every 12 months. Lenses and frames covered in full every 24 months.
- Virginia Premier covers medications prescribed by your doctor, including some over-the-counter drugs with a prescription. Learn more.
- Virginia Premier’s Nurse Advice Line is ready to help when medical advice is needed right away.
- A registered nurse will always answer.
- Call 1-800-256-1982 (TTY: 711) 24-hours a day, seven days a week.
- Free Smartphone: One free smartphone per member household with 4.5 GB of data, unlimited texts and 350 voice minutes each month. Calls to Virginia Premier are also free. SafeLink Wireless®
- Health and Wellness Programs: Premier Wellness is our free program for members covering nutrition, exercise, wellness and living smoke-free.
- Healthy Eating Program: Learn about food labels, portion control and meals that help lower cholesterol and blood pressure. Includes online tools, food trackers and classes.
- Fitness Program: A Health Educator will recommend physical activity unique to your needs. Includes a pedometer to track steps, exercise bands and online tools.
- Access to CVS MinuteClinic®: Services include vaccines, screenings, physicals and monitoring chronic conditions. Diagnosis and treatment of minor illnesses, injuries or skin conditions also offered.
- Chronic Care Management: Registered nurse and text message programs to manage chronic conditions such as diabetes and asthma.
- Chronic Disease Management Education: Virginia Premier covers the cost of disease self-management classes. Eligible conditions include heart disease or heart failure, diabetes and asthma.
- Healthy Footsteps℠: Virginia Premier’s program supporting the growth of children from birth to age 12. Includes milestone messages and reminders for check-ups, shots and dental visits.
- Health Self℠: Virginia Premier’s screening, diagnosis and treatment program for teens and young adults. It includes check-up reminders and educational messages.
- Sports Physicals: Members under age 21 can get screened once a year before taking part in sports. Also for members currently or formerly in foster care, up to age 26.
Potentially up to $25 in gift cards per health and wellness goal up to the yearly max, pending eligibility confirmation.*
- Adult flu vaccinations
- Well-child visit and immunizations
- Well-adolescent visit and immunizations
- Breast cancer screening (women age 40 and up)
- Cervical cancer screening (Pap test)
- Colorectal cancer screening (age 45 and up)
- Joining our Healthy Heartbeats Program for pregnancy care
- First prenatal visit
- Postpartum checkup
*List of health and wellness goals are subject to change.
- Healthy Heartbeats Program: Our team works closely with you to help you have a healthy pregnancy and baby.
- Gift Card Rewards: Earned for joining Healthy Heartbeats, having prenatal visits and a postpartum visit 7–60 days after giving birth.
- Baby Showers: Have fun and learn about pregnancy and helpful resources. Includes a diaper bag raffle. All attendees get a care package.
- Text4Baby: Free text messages with health tips about pregnancy, birth and your baby’s first year.
- Supplies and services: Free breast pump, lactation consultant, prenatal classes, parenting classes and family planning.
- Safe sleep education program.
All Virginia Premier members have access to our online member portal. It is an easy way to:
- Check benefit information
- Complete your new member screening
- Take a Health Risk Assessment
- Use the Health Tracker tools
- Communicate with a Health Educator
- Reference a health library
- Search health topics
For a full list of each plan’s benefits, see our Medallion/FAMIS Member Handbook (PDF).
You may also contact our Member Services department at 1-800-727-7536 (TTY: 711) with any questions, Monday through Friday, 8:00 to 8:00 pm.
Already a Member?
Take advantage of the resources available. Visit our member’s page.
Report personal info changes. The state needs to know when a child’s address, phone number or household’s income changes. First, contact your local Department of Social Services office and let them know about the changes. Then, tell Virginia Premier by calling Member Services at 1-800-727-7536 (TTY: 711) Monday through Friday, 8:00 am to 8:00 pm.
Time to renew? The state will send a letter in the mail when it is time to renew the child’s Medicaid coverage for the year. The letter will explain what steps to take, if any. The state may process many renewals automatically. During the COVID-19 public health emergency, FAMIS members will not lose coverage for failing to submit renewal paperwork.
Free and Reduced-Cost Services Near You
There’s more to staying healthy than just seeing the doctor. That’s why we’re partnering with Aunt Bertha, the nation’s largest free online directory of community organizations.
Virginia Premier members can use Aunt Bertha’s online search tool to get help with housing, employment, transportation, food and more. Just enter your ZIP code to find local resources and programs that are ready to lend a hand.
Helping People is What We Do Best
Questions? We have a friendly team of experts just a phone call away. Call 1-800-727-7536 (TTY: 711) Monday through Friday 8:00 am to 8:00 pm. We also offer free translator services.