What Makes You Eligible to be a Member?

When you apply for Medical Assistance, you are screened for all possible programs based on your age, income, and other information. To be eligible for a Medical Assistance Program, you must meet the financial and non-financial eligibility conditions for that program. Please visit the Virginia Department of Social Services’ (VDSS) Medicaid Program page for eligibility details and/or the VDSS Medicaid Forms and Applications page for an application or other Medicaid form details.

You are eligible for Managed Care when you have full Medicaid benefits, and meet one of the following categories:

  • Children under age 21
  • Foster Care or Adoption Assistance Child under age 26
  • Pregnant women including two months post-delivery
  • Parent Caretakers

Medicaid eligible persons who do not meet certain exclusion criteria must participate in the program. Enrollment is not a guarantee of continuing eligibility for services and benefits under the Virginia Medical Assistance Services Program.

Medicaid Expansion

Medicaid Expansion is coming to Virginia in January 2019. More information will be available soon.

Optima Family Care