Recertificación de Medicaid

Important changes for Medicaid Expansion members

What is changing for Medicaid Expansion Members?

Beginning January 1, 2027, a new federal law requires states to review the eligibility of Medicaid Expansion members every six months instead of every 12 months through the Medicaid renewal process. A new federal law also requires certain adults to meet or be exempt from the work requirement to qualify for Medicaid. Both changes will be phased in beginning January 2027.

Who do these changes apply to?

These changes apply only to Medicaid Expansion members. Medicaid Expansion covers adults:

• Aged 19–64
• Income below 138% FPL
• Not eligible for Medicare

Ways to Meet the Work Requirement

To meet the work requirements, you must have a qualifying activity. You may meet the requirement by fulfilling any of these actions: 

• Completing at least 80 hours per month of work, job training, community service, or a combination of these activities
• Being enrolled at least half-time in an educational program
• Having household income of at least $580 per month

Seasonal workers may average income over a six-month period.

Work Requirement Exclusions

You may not have to meet the work requirement if you:

• Are a former foster care child underage 26
• Are an American Indian or Alaska Native
• Are a veteran with a 100% disability rating
• Are pregnant or gave birth within the past 12 months
• Are a Parent, caretaker, guardian, or family caregiver of a child under 14 or a person with a disability
• Meet SNAP or TANF work requirements
• Participate in a substance use disorder treatment program
• Are currently incarcerated
• Have a serious medical or mental health condition, substance use disorder, or disability

Work Requirement Exceptions

You may qualify for an exception if you:

• Are receiving inpatient hospital or institutional care
• Are living in an area with high unemployment or a declared federal emergency/disaster
• Are traveling for yourself or your dependent outside your community for necessary medical care
• Are incarcerated within the past three months
• Are transitioning from certain Medicaid coverage into Medicaid Expansion

These changes do not apply to:

• Children
• Pregnant and postpartum individuals
• Adults with a disability
• Adults who are over age 64

Learn More at a Virginia Medicaid Town Hall

Virginia Medicaid is hosting virtual Town Halls to help you understand upcoming Medicaid Expansion eligibility and work requirement changes.

At these sessions, you can learn:

• How these changes may affect you
• Whether you may qualify for an exemption
• How reporting requirements will work
• Important implementation dates
• What resources are available to help you remain covered

Registration is required. The Town Hall will be recorded and posted online if you are unable to attend the live event or would like to view it later. For upcoming dates and registration information, visit the Virginia Medicaid Town Halls webpage.

Frequently Asked Questions (FAQ)

Learn how to renew your health care coverage every six months. Discover what type of paid or volunteer work and schooling counts as part of this community engagement requirement and more in this FAQ.

Eligibility Changes for Non-U.S. Citizen Adult Frequently Asked Questions

Non-U.S. citizens who have an eligible immigration status and meet all other eligibility requirements, such as having household income below the eligibility limit, may qualify for free health coverage from Virginia Medicaid or FAMIS.  

Starting October 1, 2026, Virginia Medicaid will begin making changes required by a new federal law that affects some noncitizen adults. One part of this law will update eligibility rules for non-pregnant; noncitizen adults enrolled in Medicaid. These changes have not started yet, and more information will be shared as federal guidance is released.
No action is needed right now. The Virginia Department of Medical Assistance Services (DMAS) will share clear, easy-to-understand information before any changes take place, so members know what to expect. As updates become available, they will be shared through official DMAS channels.

To stay informed, members are encouraged to make sure their mailing address, phone number, and email address are up to date. This helps ensure important information is received when it matters most.

Visit the DMAS website for more information.

For more information, call Cover Virginia at 1-855-242-8282 TTY: 1-888-221-1590 or visit Coverva.org.

Sentara Health Plans está en su comunidad para ayudarlo con su recertificación de Medicaid y responder preguntas sobre la elegibilidad. Siéntese con uno de nuestros especialistas de asistencia para obtener la ayuda que necesita para mantener su plan de Medicaid.

Si necesita transporte, llame al 1-877-892-3986 (TTY: 711), de lunes a viernes, de 6 a. m. a 6 p. m., con al menos cinco días hábiles de anticipación.

Bristol

EnVision Center

104 Oakview Avenue

1.º y 3.º miércoles de 11 a. m. a 1 p. m. 

Chantilly

Western Fairfax Christian Ministries

4511 Daly Drive J

2.º y 4.º martes, de 11 a. m. a 1 p. m. 

Charlottesville

Sentara Martha Jefferson Hospital

500 Martha Jefferson Drive

2.º y 4.º martes, de 11 a. m. a 1 p. m.  

Lynchburg

Park View Community Mission

2420 Memorial Avenue

1.º y 3.º martes, de 11 a. m. a 1 p. m.

Newport News

Main Street Public Library

110 Main Street

2.º y 4.º lunes, de 11 a. m. a 1 p. m.

Petersburg

The Hope Center

827 Commerce Street

2.º y 4.º martes, de 11 a. m. a 1 p. m.

Richmond

Broad Rock Branch Library

4820 Old Warwick Road 

2.º y 4.º miércoles, de 11 a. m. a 1 p. m.

Roanoke

The Rescue Mission of Roanoke

402 4th Street SE

2.º y 4.º miércoles, de 11 a. m. a 1 p. m. 

Virginia Beach

Meyera E. Oberndorf Central Library

4100 Virginia Beach Boulevard

2.º y 4.º lunes, de 11 a. m. a 1 p. m.