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VA Medicaid Benefits

Medicaid is a federal program that provides benefits for medical services to certain low-income individuals in the United States. These individuals include Supplemental Security Income recipients, some Medicare beneficiaries, and pregnant women and children who possess a family income less than 133 percent of the federal poverty level. Services included in Virginia's Medicaid benefits include medical services, medical transportation services and dental care for recipients under age 21.

  1. Medical Services

    • Medicaid recipients are entitled to a number of medical services. Most medical services covered by Virginia's Medicaid benefits require a copayment that generally ranges from $1 to $3. Inpatient hospital admissions come with a $100 copayment. Medicaid recipients exempt from copayments include individuals under age 21 and patients in long-term care nursing facilities. Services such as family planning and emergency room benefits don't require a copayment. Covered medical services include laboratory and X-ray services, inpatient hospital stays, mental heath care, prescription medication, physical therapy and transplant services. Medicaid recipients under age 21 are also entitled to dental care services.

    Long-Term Care

    • Medicaid covers a beneficiary during her stay in a facility for a physical or mental condition that requires a nurse's supervision and daily assistance. If the facility is classified as a chronic disease hospital, Virginia's Medicaid guidelines permit a beneficiary to stay at one of of two hospitals: The Hospital for Sick Children in Washington, D.C., and the Lake Taylor Hospital in Norfolk, Virginia. Mentally disabled Medicaid recipients are covered for hospital or training center stays unless they are considered medically needy and the facility is an intermediate-care facility for the mentally disabled. Medicaid covers care facilities for recipients suffering from a mental illness unless she is age 65 or older and deemed medically needy. Virginia guidelines also provide coverage for recipients in need of a rehabilitation hospital or nursing facility that provides intermediate-care service or skilled nursing.

    Transport

    • Virginia Medicaid benefits offer recipients nonemergency medical-related transport through the Virginia Department of Medical Assistance. The service is provided at all hours, for every day of the week and requires notice by phone at least two days in advance unless it is an urgent trip. Urgent trips are used for patients who suddenly develop an illness and obtain an appointment with a doctor in less than two days. If the Medicaid recipient maintains the same appointment times and days on a weekly basis, she may place a standing order for those days that replaces the need for her to call for each trip. This service requires a preauthorization from a Medicaid service provider.

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