Medallion Medicaid

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. 

Open Enrollment

Enrollment is currently available for Medallion 4.0 Non-Expansion members in the following regions:

Central: April 19, 2020 – June 30, 2020
Northern: June 19, 2020 – August 31, 2020

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.

Enroll Now

If you think you might be eligible for Medicaid, there are several ways that you can apply. You can:

  1. Apply online at commonhelp.virginia.gov
  2. Call Cover Virginia at 1-855-242-8282
  3. 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 schedules free transportation to and from medical visits, health and wellness events, and education sessions. Call us at 1-855-880-3480 (TTY: 711), Monday – Friday, 8 am – 8 pm to set up a ride. (Note: Trips need to be set up at least 5 business days beforehand. Weekends and holidays do not count toward these days.)
Virginia Premier covers medications that are prescribed by your doctor, including some over-the-counter drugs with a prescription. Learn more about pharmacy benefits.
  • Virginia Premier offers new users a free cell phone. Members also get 350 free voice minutes per month, unlimited free texts, and at least 1GB data allowance each month.
  • 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, visit our member’s page.

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 online directory of free and reduced-cost community-based organizations. 

Virginia Premier members can use Aunt Bertha’s online search tool to get help with housing, employment, transportation, food and more. Just plug in your ZIP code and you’ll be connected with local resources and programs that are ready to lend a hand.

It's time to put your health care first.

Nobody will put your health first like you will. That’s why we’re here to help you take charge of your own health care. With all of our health plans, we work alongside you to make navigating your care simple, and healthy living easy.

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.
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