Service Area and Enrollment

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Virginia Premier serves the six Medicaid regions in Virginia:

  • Tidewater 
  • Central 
  • Northern/Winchester 
  • Charlottesville/Western 
  • Roanoke/Alleghany
  • Southwest
Regional VA Map

Regions

  • Accomack
  • Chesapeake
  • Gloucester
  • Hampton
  • Isle of Wight
  • James City
  • Newport News
  • Norfolk
  • Northampton
  • Poquoson
  • Portsmouth
  • Suffolk
  • Virginia Beach
  • Williamsburg
  • York
  • Amelia
  • Brunswick
  • Caroline
  • Charles City
  • Chesterfield
  • Colonial Heights
  • Cumberland
  • Dinwiddie
  • Emporia
  • Essex
  • Franklin City
  • Fredericksburg
  • Goochland Greensville
  • Hanover
  • Henrico
  • Hopewell
  • King & Queen
  • King George
  • King William
  • Lancaster
  • Lunenburg
  • Mathews Mecklenburg
  • Middlesex
  • Alexandria
  • Arlington
  • Clarke
  • Culpeper
  • Fairfax City
  • Fairfax County
  • Falls Church
  • Fauquier
  • Frederick
  • Loudoun
  • Manassas Park
  • Manassas City
  • Page
  • Prince William
  • Rappahannock
  • Shenandoah
  • Warren
  • Winchester
  • Albemarle
  • Amherst
  • Appomattox
  • Augusta
  • Buckingham
  • Campbell
  • Charlotte
  • Charlottesville
  • Danville
  • Fluvanna
  • Greene
  • Halifax
  • Harrisonburg
  • Louisa
  • Lynchburg
  • Madison
  • Nelson
  • Orange
  • Pittsylvania
  • Rockingham
  • Staunton
  • Waynesboro
  • Alleghany
  • Bath
  • Bedford City
  • Bedford County
  • Botetourt
  • Buena Vista
  • Covington
  • Craig
  • Floyd
  • Franklin County
  • Giles
  • Henry
  • Highland
  • Lexington
  • Martinsville
  • Montgomery
  • Patrick
  • Pulaski
  • Radford
  • Roanoke City
  • Roanoke County
  • Rockbridge
  • Salem
  • Wythe
  • Bland
  • Bristol
  • Buchanan
  • Carroll
  • Dickerson
  • Galax
  • Grayson
  • Lee
  • Norton
  • Russell
  • Scott
  • Smyth
  • Tazewell
  • Washington
  • Wise

Open Enrollment Dates

Open enrollment is the time of year for changing health plans. The dates depend on where you live and your plan type:

Medallion Non-Expansion Members

  • Tidewater: February 19 through April 30 every year
  • Central: April 19 through June 30 every year
  • Northern/Winchester: June 19 through August 31 every year
  • Charlottesville/Western/Halifax: August 19 through October 31 every year
  • Roanoke/Alleghany: December 19 through February 28 every year
  • Southwest: December 19 through February 28 every year

Medallion Expansion Members

All regions: November 1 through December 31 every year
*You will receive a yellow letter in the mail when it is your time.

CCC Plus Members Non-Expansion

All regions: October 1, 2021 through December 31, 2021

  • Changes made by December 18, 2021 will go into effect January 1, 2022.
  • Changes made by December 19, 2021 through December 31, 2021 will go into effect February 1, 2022.

At any other time, you must have permission from DMAS. Call the CCC Plus Helpline at 1-844-374-9159 (TTY: 1-800-817-6608) for details.

CCC Plus Members Expansion

All regions: November 1, 2021 through December 31, 2021

  • Changes made by December 18, 2021 will go into effect January 1, 2022.
  • Changes made by December 19, 2021 through December 31, 2021 will go into effect February 1, 2022.

At any other time, you must have permission from DMAS. Call the CCC Plus Helpline at 1-844-374-9159 (TTY: 1-800-817-6608) for details.

Resources

By logging in to this portal, I affirm that I have read, understand and agree to abide by the following terms and conditions: 

I certify I am a health care provider, an employee of a health care provider, a business associate of a health care provider, or an employee of a business associate, and the purpose of my access to any Virginia Premier System is related to the provision or payment of health care services.

With respect to all information viewed or obtained from this site, I agree to comply with all applicable federal and state laws regarding the confidentiality and integrity of health and medical records. This includes full compliance with the Health Insurance Portability and Accountability Act of 1996 (‘HIPAA’), the HITECH Act, and the Virginia Health Records Privacy Act, and applicable regulations to these laws.

I agree to keep confidential all information related to Virginia Premier System business, including, but not limited to, quality and risk management activities as well as other confidential or personal information concerning the medical, personal, or business affairs of Virginia Premier System and its members.

I agree to notify Virginia Premier System immediately in the event that my network access has been compromised in any way and in the event of unauthorized use or disclosure of any information obtained from the Virginia Premier System network.

Need to register for a new account? Click here.

In order to register for an account, if you would like access to all group NPIs/APIs under a single Tax ID, please enter your Tax ID only. If you would like access to a specific group NPI/API instead, please enter it in the field provided. 

For expedited registration, please provide a Claim number and the Total Billed Charges on the claim when creating your account.

You will receive an email within 3-5 business days with your username and temporary password.

Please call Technical Support for help with Virginia Premier’s Provider Portal at 1-877-814-9909 or email connect@healthtrio.com. 

Virginia Premier is offering EFT services through PaySpan.

Please click here to sign-up

If you have questions or need help please, contact our Provider Services department at vphpnetdev@virginiapremier.com or by calling 804-968-1529.