FAMIS-PLUS, FAMIS AND FAMIS MOMS

FAMIS-Plus (Medicaid), FAMIS and FAMIS MOMS are state health insurance programs for children, teens, and pregnant women.

To get FAMIS, FAMIS-Plus or FAMIS MOMS:

• Your child must live in Virginia (even if not living with you) and must be under age 19.
• You must have a low income. For example:

Number of people in your family	Your income each month must be less than:*
1	$1,915
2	$2,585
3	$3,255
4 or more	For each additional person, add $670 to the number just above

Attention: If your income is a little higher than the numbers below, you should still apply. Some of your income may not count.

* These are the numbers for 2013. They will go up a small amount each year.

• Your income can be higher if:
  • you have very high medical bills,
  • you have work income, or
  • you pay for child care.

Your child must be a U.S. citizen or meet certain immigration requirements for these programs.

FAMIS-Plus pays for all the health care your child needs. FAMIS-Plus may also pay for medical care your child got in the three months before you apply.

FAMIS and FAMIS MOMS pay for:

• Prescriptions
• Doctor’s visits
• Hospital stays, and
• Some other health care services.

You may have to pay a few dollars for some FAMIS and FAMIS MOMS services.

To apply for FAMIS-Plus, FAMIS, FAMIS MOMS:

• Call 866-873-2647. Or go online to www.famis.org.

To keep getting Medicaid and FAMIS benefits:

FAMIS or the Department of Social Services will send you a form. Fill out the form and return it right away so your health insurance does not get cut off.

If your child lives in Fairfax County:

• The Medical Care for Children Partnership pays for some medical and dental care.
• Your child’s immigration status does not matter.
• You must have a low family income (for example, $4,070 a month for a family of three in 2013).
• You may have to pay a few dollars for some services.
• Call 703-385-3267. Or go to www.fairfaxcounty.gov/dfs/ss/mccp.

If your child lives in Prince William County, Manassas or Manassas Park:

• The Pediatric Primary Care Project pays for some medical care.
• Your child’s immigration status does not matter.
• You must have a low income (for example, $4,070 a month for a family of three in 2013).
• You may have to pay a few dollars for some services.
• Call 703-792-7348.

If your child needs a kidney transplant or dialysis, or has Lou Gehrig’s disease (ALS):

• Call the Social Security Administration at 800-772-1213 to apply for Medicare.
• FAMIS-Plus can help you pay your child’s Medicare costs. This part of FAMIS-Plus is called QMB or SLMB. Call 866-873-2647 and ask how to apply.

If your child has HIV or AIDS:

• You may be able to get free HIV medicines from the Virginia AIDS Drug Assistance Program (ADAP).

Consider buying private health insurance for your child:

• This can cost a lot.
• When you apply, you will have to answer questions about your child’s health. Your child may need a physical exam.
• If your child is under 19, the insurance company cannot turn your child down because of a health problem your child had before you applied. This is called a pre-existing condition.
• If your child is over 19, the insurance company may turn your child down because of a pre-existing condition. Even if your child is accepted, the insurance may not cover your child’s pre-existing condition. Make sure to ask whether the insurance will pay for all the services your child needs.
• If your child has a pre-existing condition and has not had insurance for 6 months, he or she may qualify for the Pre-Existing Condition Insurance Plan (PCIP). Call 866-717-5826 or visit www.pcip.gov.
• For health insurance companies and plans for Northern Virginia residents, call the Virginia Bureau of Insurance at 800-552-7945.

Children who are not U.S. citizens can get health care and health insurance in Virginia. Applying will not hurt your immigration status or your child’s. Parents’ immigration status does not matter when applying for insurance for your child.

If your child meets the other requirements for getting FAMIS-Plus or FAMIS, your child probably can get benefits if:

• your child is a Legal Permanent Resident, or
• your child is a refugee, or
• your child is an asylee.

Some other immigrants can also get FAMIS-Plus or FAMIS. Call FAMIS at 866-873-2647. Or call Legal Aid at703-778-6800.

Some immigrants can get other programs:

• If your child lives in Fairfax County, call the Medical Care for Children Partnership at 703-385-3267. Or go to www.fairfaxcounty.gov/dfs/ss/mccp.
• If your child lives in Prince William County, Manassas or Manassas Park, call the Pediatric Primary Care Project at 703-792-7348.

If your child cannot get other insurance, find out about Emergency Medicaid:

• Emergency Medicaid covers the birth of your child and most medical emergencies. Call the Department of Social Services at 800-552-3431 or visit Virginia’s Medical Assistance Programs.
• Your child’s immigration status does not matter.
• Your child must live in Virginia and meet all other Medicaid requirements.

For free and low-cost health clinics:

• Visit Northern Virginia Health Services Coalition at www.novaclinics.org.

For legal help:

• Call Legal Services of Northern Virginia at 703-778-6800.
• If you do not qualify for legal aid help, call the Virginia Lawyer Referral Service at 800-552-7977. The lawyers they refer you to may charge a fee. Tell them that you have a low income or ask for a reduced fee.

If your child has a disability:

• Call the Virginia Office for Protection & Advocacy at 800-552-3962.

For help finding care in Fairfax and Loudoun Counties and the City of Alexandria:

• Call the Partnership for Healthier Kids at 703-698-2550.

For help for children with certain illnesses deal with the health care system:

• Patient Advocate Foundation’s Virginia Cares Uninsured Program. Call 800-532-5274.
• The Virginia Department of Health Bleeding Disorders Program. Call 804-827-3306.
• The Virginia Department of Health Child Development Services Program. Call 540-891-3151.