Medallion Medicaid - Virginia Premier

Medallion Medicaid

Empowering your family's healthcare

Make Virginia Premier your health plan.

or call toll-free: 1-800-643-2273 (TTY: 711)

For over 20 years, Virginia Premier has provided high-quality Medicaid coverage to individuals and families in Virginia.

The Virginia Premier Elite Individual (Medallion) plan makes healthy living easy with affordable care. Medicaid coverage includes doctor visits, emergency care and prescriptions. There are no referrals to see a specialist and you get extra benefits like our 24/7 Nurse Advice Line and a free cell phone. En español.

Are you eligible?

To qualify for Virginia Medicaid, you must:

  • be a resident of Virginia
  • be a U.S. citizen, permanent resident, or legal alien
  • meet Virginia’s income requirements

It is easy to check if you may qualify. Just answer five quick questions in the Cover Virginia Eligibility Screening Tool. The tool will not ask you for your name or contact info.

Apply Now

You may apply for Medicaid in Virginia anytime of the year. Use the option best for you.

How to choose Virginia Premier

When your application goes through, the Department of Medical Assistance Services (DMAS) will send you a letter.

The letter will automatically assign you to a health plan. If it already says Virginia Premier, great! Your member ID card is on the way. If it is a different plan, it is simple to switch to Virginia Premier. Here’s how:

  • Call the Managed Care Help Line at 1-800-643-2273 (TTY/TDD: 1-800-817-6608).
  • Have your Medicaid ID number on hand.
  • Tell them you want to switch your health plan to Virginia Premier.

You have up to 90 days to switch. After that, you may switch to Virginia Premier when it is open enrollment where you live. View regions.

Virginia Medicaid coverage plus Virginia Premier extra benefits

When you become a Virginia Premier member, you get more than basic Medicaid alone. Our extra benefits are a special mix to help address your health and your social needs. Here are just some of the benefits offered to you when you choose Virginia Premier as your Medicaid plan.

  • Members get access to quality doctors and medical facilities through the Virginia Premier provider network. To see if your doctor, specialists or hospital is included in our network, check our Provider Directory search tool.
  • 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: Members with chronic conditions like diabetes, heart disease and asthma get personal coaching from a registered nurse. Your nurse will work with you to create an Action Plan to manage your symptoms, know when to call the doctor, avoid problems and help you feel better.
  • Behavioral health services: Services and treatment options for people with mental health conditions such as depression, anxiety or other mental health issues.

Members under 21 years old can get one oral exam and one cleaning per year, as well as one set of bite wing X-rays.

Dental services for adults age 21 and up are included with Virginia Medicaid coverage as of July 1, 2021. Coverage includes:

  • Cleanings, exams and X-rays
  • Fillings
  • Root canals
  • Dentures and partials
  • Tooth extractions and other oral surgeries
  • Gum related treatment
  • Other general services

 Not covered: braces and bridges.

Exam, lenses, and up to $100 credit for frames or contacts every 24 months for non-diabetic members and every 12 months for diabetic members.

  • Need a ride? Virginia Premier schedules free transportation to and from medical visits.
  • Trips need to be set up at least five business days beforehand. Weekends and holidays do not count toward these days.
  • Call us at 1-855-800-3480 (TTY: 711), Monday through Friday, 6:00 am to 6:00 pm to set up a ride.

Virginia Premier covers medications prescribed by your doctor, including some over-the-counter drugs with a prescription. Learn more about pharmacy benefits.

  • Virginia Premier’s Nurse Advice Line is ready to help at any time when you have medical questions.
  • A registered nurse will always answer your call.
  • Call 1-800-256-1982 (TTY: 711) 24-hours a day, seven days a week.
  • Free Cell Phone: Members get a free cell phone with 350 voice minutes, 4.5 GB of data, and unlimited free texts each month.
  • Health and Wellness Programs: Premier Wellness is a free program for members covering nutrition, exercise, wellness, and being smoke-free.
  • Healthy Footsteps: Virginia Premier’s program supporting the healthy development of children.
  • Health Self: Virginia Premier’s screening, diagnosis and treatment program for teens and young adults.
  • Sports Physicals: Free for members under age 21 and members in foster care up to age 26 every year.
  • Healthy Heartbeats Program: Our team works closely with you over the phone or in your home to help you have a healthy pregnancy and a healthy baby through our award-winning Healthy Heartbeats program.
  • Baby Showers: Have fun and learn about healthy pregnancy tips and resources. There is a diaper bag raffle and all attendees get a care package full of baby basics.
  • Healthy Incentives: Earn incentives for taking care of yourself.
  • Text4Baby: Free text messages with health tips helping you through pregnancy, birth, and your baby’s first year.
  • Supplies and services: Members have access to a free breast pump, lactation consultant, prenatal classes, parenting classes and family planning.
  • 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 the plan details and benefits, see our Medallion/FAMIS Member Handbook (PDF).

You may also contact Member Services at 1-800-727-7536 (TTY: 711) with any questions, Monday through Friday, 8:00 am to 8:00 pm.

Already a member?

Take advantage of the resources available to you. Visit our member’s page.

Keep your info updated. The state needs to know when your address, phone number, income, or the number of people in your household 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? Look for a letter in the mail from the state when it is time to renew your Medicaid coverage for the year. The letter will let you know the steps you need to take, if any. The state may process many renewals automatically (During the COVID-19 public health emergency, Medallion members will not lose coverage for failing to submit renewal paperwork).

Free and reduced-cost services in your community

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.

¿Tiene preguntas? Contamos con un equipo amable de expertos a solo una llamada de distancia. Llame al 1-800-727-7536 (TTY: 711) de lunes a viernes, de 8:00 a. m. a 8:00 p. m. También ofrecemos servicios gratuitos de traducción.