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VA Medicaid Non-Financial Eligibility Requirements

In order to determine non-financial eligibility, applicants for Medicaid in Virginia are required to:

·             Provide proof of citizenship or legal presence in the U.S. (certain individuals who were Medicaid eligible in June 1997 are exempt from this requirement).

·             Provide his/her Social Security number (SSN) as well as the SSNs of any children for whom Medicaid is requested, or must provide proof of application for an SSN, unless the applicant is an illegal alien or a child under age 1.

·             Confirm they are Virginia residents.

·             Confirm U.S. citizenship or provide proof of alien status eligibility.

·             Assign rights to medical benefits from potentially liable insurers and other third parties to the Department of Medical Assistance Services (DMAS), and cooperate with the agency in obtaining medical support and payments from, or derived from, the absent parent(s) of a child for whom the individual is applying.

·             Apply for other benefits (because Medicaid is a "last pay" medical assistance program, an individual must take all necessary steps to apply for and obtain any annuities, pensions, retirement, and disability benefits to which he/she is entitled).

·             Meet institutional status requirements (cannot be an inmate of a public institution, or a patient in an institution for the treatment of mental diseases (IMD), unless under age 22 and receiving inpatient psychiatric services).

·             Apply to the Health Insurance Premium Payment Program (HIPP), if the individual is otherwise eligible for Medicaid, is a member of an assistance unit which contains an individual employed more than 30 hours per week, and is eligible for coverage under an employer's group health plan.

·             Satisfy the covered group requirements.

See also:

Virginia Medicaid Eligibility

Source:

Some information for this topic was drawn from the Department of Medical Assistance Services (DMAS) Medicaid Handbook.

Additional information for this topic was drawn from Chapter M02 of the Department of Social Services (DSS) Medicaid Manual.

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