Medical Debt and Health Coverage in Virginia
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If you have medical bills you cannot pay, you may qualify for Medicaid or FAMIS. These health coverage programs can help cover your bills, reduce what you owe, or even cover other bills you had from before you applied.
Many people do not realize they qualify. You do not need to be unemployed or have no income. Working people can qualify too.
What are Virginia Medical Assistance programs?
Virginia has several Medical Assistance programs. The main ones are Medicaid and FAMIS.
FAMIS is specifically for children and pregnant people. Each program has different rules about who can join and what it covers.
These programs are sometimes grouped together as "Medicaid," but they are not all the same. Virginia uses the term "Medical Assistance programs" to refer to all of them together.
These programs don't just help you with debt, they provide health benefits so you can continue getting care.
Do I qualify?
Most programs look at your income and family size. Some programs also look at your age, disability status, or whether you are pregnant.
You might qualify even if you think you earn too much. Apply and let the program decide.
How do I apply?
You can apply online through the official Virginia application portal: Applying for Medicaid, DMAS.
If you want free help applying, trained assisters are available: Find help in your area with Enroll Virginia.
If you are denied and want to appeal, contact your local legal aid office: virginialawhelp.org/get-legal-help.
Read more: Getting Health Coverage in Virginia. This article explains the main programs and how to find the right one for you.
Can I still get medical bills if I have Medicaid?
In most cases, no, you cannot get medical bills if you have Medicaid.
When a provider accepts Medicaid, they must accept what Medicaid pays as payment in full. They cannot bill you for the difference. This is called "balance billing," and it is not allowed.
You may still owe a small copayment or coinsurance in some cases. But if you did not receive a notice about a copay, you generally should not be getting a bill.
What should I do if I get a bill anyway?
Sometimes providers make billing mistakes. If you get a bill and you have Medicaid, here is what to do:
- Call the hospital billing department. Tell them you have Medicaid.
- Make sure they have your correct Medicaid information and are billing Medicaid directly.
- If you also have private insurance, make sure the private insurer is billed first. Medicaid is always billed last.
If they still say you owe money, ask about their financial assistance policy. Learn more: Get Relief from Hospital Bills, Dollar For.
You can also learn more about financial assistance policies and standard charges for major Virginia hospital systems: Data Analytics and Health Care Transparency Tools, VHHA.
Can Medical Assistance cover my old bills?
In some cases, yes. Retroactive coverage may be available to cover medical bills from before you applied. The availability and timeline of retroactive coverage will depend on the type of coverage you have, and if you met eligibility criteria in the months before when you applied. If you have questions about whether you are eligible for retroactive coverage, contact Cover Virginia or your local DSS office for more information.