Virginia's Insurance Marketplace was created to help connect Virginians to the health insurance coverage that best meets their needs and circumstances, regardless of what types of coverage they qualify for or how they apply. With Virginia's Insurance Marketplace, this connected approach will lead you to the optimal solution. You can apply whether or not you qualify for Medicaid with one of two options:
Option One: Virginians who are interested in applying for healthcare coverage but are not sure if they qualify can go to CoverVA and complete a quick screening. The CoverVA screening will tell individuals which program they may qualify for based on their responses to the screening questions. If an individual is screened as potentially eligible for healthcare insurance coverage through Virginia's Insurance Marketplace and not Medicaid, they will be directed to apply through the www.marketplace.virginia.gov link on the screening results page.
Regardless of the results of the screening, individuals may choose to apply for healthcare coverage through the CoverVA website. If the individual is determined ineligible for Medicaid (called Medical Assistance in VA), their information will be transferred to either Virginia's Insurance Marketplace or the the Family Access to Medical Insurance Security Plan (FAMIS), which covers uninsured children under 19.
Option Two:
Submit or update your application at with Virginia's Insurance Marketplace.
- If you were found ineligible for Medicaid by DMAS, your account was transferred to the Marketplace. You can come directly to the Marketplace to claim your account, update any information, and shop for coverage. At www.marketplace.virginia.gov and click the yellow box “Get Covered” at the top of the Virginia's Insurance Marketplace home page.
- If you are a new consumer, you can apply directly at the Marketplace. The Marketplace will evaluate your application for both Medicaid and Qualified Health Plan (QHP) coverage, as well as eligibility for financial savings.
- If the Marketplace determines that you are eligible for Medicaid, we will send you an eligibility determination notice (EDN) and transfer your information directly to DMAS for enrollment. DMAS will then contact you directly to provide you with enrollment information.
- If the Marketplace finds that you may be eligible for Medicaid, but cannot confirm eligibility, your account will be transferred to Medicaid for a full evaluation. Medicaid will then contact you directly and process your application. Medicaid eligibility determinations may take 45-90 days, depending on circumstances. While you wait for the Medicaid determination, you may be eligible to purchase a QHP and take advantage of financial savings to avoid a gap in coverage. If Medicaid finds that you are eligible and enrolls you in coverage, they will contact the Marketplace and any financial savings, and health plan will be canceled to avoid duplicate coverage.
If you need help setting up your Virginia's Insurance Marketplace account or the application process, you can call Virginia's Insurance Marketplace at 1-888-687-1501.
If you have questions about the CoverVA screening process or Medicaid in general, you can call the Statewide Customer Service Center at 833-5CALLVA to get more information.
No matter how you choose to apply, Virginia's Insurance Marketplace will work with you to find the best, most affordable and comprehensive health coverage.