Get Latest WorkWORLD

VA FAMIS

FAMIS is a Virginia medical insurance program. It is not Medicaid and it is not an entitlement (which means that if the allocated funds are exhausted, no additional families will be enrolled). FAMIS stands for: Family Access to Medical Insurance Security Plan. It covers uninsured low-income children under age 19 who are not eligible for Medicaid because of excess income and whose gross family income is less than or equal to 200% of the Federal Poverty Level (FPL) for the size of the family assistance unit. (There are no resource limits.)

Assistance Unit Size: The Medicaid rules for determining the size of the assistance unit do not apply. The assistance unit consists of:

·             The child applicant under age 19;

·             The parent(s) and stepparent who live in the home with the child; and

·             Any siblings, half-siblings, and step-siblings under age 19 who live in the home with the child.

An unborn child of a pregnant child is not counted in determining the assistance unit size. To be eligible the child must be uninsured, and not an inmate of a public institution or a patient of an institution for mental diseases.

Premiums and Co-Pays: There are no premiums for FAMIS coverage. Small co-payments, usually $3 to $5, are required for many services and prescriptions. Well-baby and well-child check-ups do not require co-payments.

Additional Information

The Commonwealth of Virginia operates a consumer-oriented website that offers comprehensive information about FAMIS in both English and Spanish. In addition to general information, specific information about covered services, eligibility, enrollment, etc. is provided. The complete FAMIS Member Handbook is also available to view, and you can download application and verification forms. Visit the FAMIS website at:
http://www.famis.org/

Information about FAMIS is also available by phone at the toll-free number 1-866-873-2647. TDD users only may call the toll-free number 1-888-221-1590.

See Also:

A different program with a similar name, FAMIS Select, provides an alternative for families with children approved for FAMIS who have access to private or employer-sponsored coverage. If the family elects to participate in FAMIS Select, they receive up to a $100 per month to help pay for the cost of covering the child in a private or employer's health plan instead of through FAMIS. The child then receives the health care services provided by the private/employer-sponsored health plan and the family is responsible for any costs associated with that policy. In some cases, the premium assistance payment provided by SCHIP funds helps the family afford coverage for the entire family.

Further information about the FAMIS Select program is available in the Virginia HIPP - Health Insurance Premium Payment Program - Medicaid topic.

Source:

Information for this topic was drawn from Chapter M21 of the Department of Social Services (DSS) Medicaid Manual, and from the FAMIS website at:
http://www.famis.org/

WorkWORLD™ Help/Information System

   Share/Save: Click the button or link at left to select your favorite bookmark service and add this page.

This is one topic from the thousands available in the WorkWORLD™ software Help/Information System.
Complete information about the software is available at: http://www.WorkWORLD.org