Empowering your family's healthcare
Virginia’s updated Medicaid program, Medallion 4.0, focused on making your care more personal and community-focused, something we know a little about.
To choose or switch back to Virginia Premier, call 1-800-643-2273 or visit the Virginia Managed Care website.
For over 20 years, Virginia Premier has provided high-quality Medicaid coverage to the individuals and working families of Virginia. And we’re continuing to do so with Virginia Premier Elite Individual, our Medallion Medicaid plan.
Virginia Premier Elite Individual makes healthy living easy by offering affordable care, no-referral specialist visits, and unique benefits such as our 24/7 Nurse Advice Line and no-cost cell phone.
Are you eligible?
To be eligible, or able to get Medicaid, you must be a resident of the state of Virginia, a U.S. national, citizen, permanent resident, or legal alien, and meet the state’s income requirements. You can find out if you’re eligible by answering a few questions through Cover Virginia’s screening tool. Click here to learn more.
If you think you might be eligible for Medicaid, there are several ways that you can apply. You can:
- Apply online at commonhelp.virginia.gov
- Call Cover Virginia at 1-855-242-8282
- Visit the local office of the Department of Social Services (DSS) in person (you can find their offices here.)
How to choose Virginia Premier
When you apply, let the state know that you want Virginia Premier to be your health plan.
If you receive a letter from the Department of Medical Assistance Services (DMAS) and you are not assigned to Virginia Premier, you can still switch to the plan you want. Within 90 days of your assignment, you can switch plans by calling the Managed Care Help Line at 1-800-643-2273 (TTY/TDD 1-800-817-6608). Have your Medicaid ID number ready and tell them you want to switch to Virginia Premier.
Learn more about your benefits with Virginia Premier
Here are just some of the benefits you get with Virginia Premier’s Medallion Medicaid plan.
- Members under 21 years can get one oral exam and one cleaning per year, as well as one set of bite wing x-rays.
- Eligible members get an exam, lenses, and $100 credit towards frames or contacts every 48 months. Eligible members include those under 21 years of age, members who have not received service in the past 24 months, and members with diabetes who have not received this service in 12 months.
All Virginia Premier members have access to our online member portal. This is a safe and secure tool that gives members quick and easy access to:
- Check benefit information
- Take a Health Risk Assessment
- Use the Health Tracker tools
- Communicate with a Health Educator
- Reference a health library
- Search health topics
- Complete an Initial Brief Screening
- Through Virginia Premier’s provider network, members get access to quality care and health professionals for their doctor visits and hospital services. To learn more about our provider network, or to see if your doctor or hospital is partnered with us, see our Provider Directory.
- Members also get access to emergency and urgent care services for serious medical conditions and life-threatening situations which require care right away. This includes transportation to the emergency room.
- Our Chronic Care Management program offers personal coaching with a Registered Nurse to help you manage chronic conditions. Your nurse can help you take advantage of your benefits and connect you with other services. You will develop an Action Plan to manage symptoms, know when to call the doctor, avoid problems and help you feel better.
- Virginia Premier’s Nurse Advice Line is ready to help for when you need medical advice right away! Call 1-800-256-1982 (TTY:711), 24/7. Your call will always be answered by a registered nurse.
- Through our prenatal care program, Healthy Heartbeats, our staff works closely with you over the phone or in your home to help you have a healthy pregnancy and a healthy baby. Have fun and learn with other moms at baby showers, and earn incentives for taking care of yourself.
Additional supplies and services for pregnant members include a breast pump, lactation consultant, prenatal classes, parenting classes and family planning.
- Need a ride? Virginia Premier offers our own safe transit to and from medical visits, health and wellness events, education sessions and pharmacy visits to fill your prescriptions.
Call us at 1-800-727-7536 (TTY: 711), Monday – Friday, 8 am – 8 pm to set up a ride. (Note: Trips need to be set up at least 3 business days beforehand. Weekends and holidays do not count toward these days.)
- Virginia Premier offers new users a free cell phone through Lifeline. Members also get 350 free voice minutes per month, unlimited free texts, and at least 1GB data allowance each month.
- Gym memberships are available at participating fitness facilities for all members older than 13 years of age.
- Health and Wellness programs, including smoking cessation and nutrition education, are available to all members.
- Free, yearly sports physicals for members under 21 years of age and members in foster care up to 26 years of age.
For a full list of each plan’s benefits and details, see our Medicaid Member Handbooks:
You can also contact our Member Services department at 1-800-727-7536 (TTY: 711) with any questions.
Already a member?
We’re glad you chose Virginia Premier as your health plan! We look forward to getting to know you better and helping you meet your health goals.
To learn more about the resources available to you, click here to visit our member’s page.
We understand that many factors contribute to a person’s overall health. That’s why we work hard to connect our members to resources in the community.
To learn more about community resources near you, visit Aunt Bertha
It's time to put your health care first.
If you have been assigned to a Medallion 4.0 plan that is not Virginia Premier, you can switch to us by calling Virginia Managed Care at 1-800-643-2273 or visiting virginiamanagedcare.com.