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New FAMIS Prenatal Coverage for Pregnant Individuals Previously Ineligible Due to Immigration Status

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Effective Date:

All Providers Participating in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations
Karen Kimsey, Director Department of Medical Assistance Services (DMAS)

The purpose of this bulletin is to alert Medicaid and FAMIS providers and managed care organizations to a change in Virginia policy that was made in the 2021 Special Session I Appropriations Act, which extends FAMIS Prenatal coverage to certain individuals who were previously ineligible.

In accordance with Item 312.H. of the Act, as of July 1, 2021, pregnant individuals of any age who do not meet other covered groups due to their immigration status may be eligible for this new coverage from the time the pregnant individual applies through sixty (60) days postpartum. All other eligibility requirements must still be met. Individuals enrolled in the FAMIS Prenatal Coverage will receive the same coverage as FAMIS MOMS and will be enrolled in managed care in the same manner as other pregnant individuals.

Individuals are encouraged to apply in one of the following ways for an eligibility determination:

How to Apply for Health Insurance Programs in Virginia

Apply online at CommonHelp

Go to


Call 1-855-242-8282 (toll free).

Translation and interpreter services are available.


Through their local department of social services.

Go to for contact information.




Virginia Medicaid Web Portal Automated Response System (ARS)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

Medicall (Audio Response System)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

1-800-884-9730 or 1-800-772-9996


Service authorization information for fee-for-service members.


Provider Appeals

DMAS is launching an appeal portal in late May 2021.  You can use this portal to file appeals and track the status of your appeals.  Visit the website listed for appeal resources and to register for the portal.


Managed Care Programs

Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE).  In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider.  The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals.

Medallion 4.0

CCC Plus


Magellan Behavioral Health

Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members.

For credentialing and behavioral health service information, visit:, email:,or

Call: 1-800-424-4046


Monday–Friday 8:00 a.m.-5:00 p.m.  For provider use only, have Medicaid Provider ID Number available.



Aetna Better Health of Virginia


Anthem HealthKeepers Plus


Magellan Complete Care of Virginia

 1-800-424-4518 (TTY 711) or 1-800-643-2273

Optima Family Care


United Healthcare


1-844-752-9434, TTY 711

Virginia Premier

1-800-727-7536 (TTY: 711),