Virginia Medicaid (Cardinal Care) 2026: How to Apply

Cardinal Care isn't a grant, and applying costs nothing.

Cardinal Care at a Glance (November 2026)

Cardinal Care has 5 managed care plans and covers Virginians in 5 broad groups. This table is the quick version, as DMAS and Cover Virginia showed it on November 13, 2026:

Grantsights analysis of the DMAS September 4, 2026 bulletin finds 4 Virginia changes on 2 dates: October 1, 2026 (immigration status rules for non-pregnant adults) and January 1, 2027 (work rule, 6-month renewals and shorter retroactive coverage). The sections below take each in turn.

Who Qualifies for Virginia Medicaid

DMAS checks 5 main eligibility groups, and each has its own income line. According to the Cover Virginia program pages, checked November 13, 2026:

Medicaid Expansion adults (19 to 64). Adults without Medicare whose income is under 138% of poverty. Cover Virginia lists $1,836 a month or $22,025 a year for one person, including the 5% disregard, as of January 13, 2026. Parents and adults without children both use this line; household sizes up to 8 are in our Virginia income limits guide.

Children. Medicaid covers lower-income children, and FAMIS (Family Access to Medical Insurance Security) picks up children in families with more income. You don't pick one; the LDSS places your child in the right program.

Pregnancy. Medicaid for Pregnant Women and FAMIS MOMS cover pregnancy and 12 months after the birth.

Aged, blind and disabled (ABD). Virginians 65 and older, or who are blind or disabled, may get full Medicaid at 80% of poverty with a resource limit, plus nursing home and home-based long-term services for people who need that level of care.

Former foster youth. Cover Virginia says adults 18 to 26 who were in foster care and had Medicaid in any state on their 18th birthday qualify with no income limit.

Immigrants. Per the DMAS September 4, 2026 bulletin, from October 1, 2026, non-pregnant adults need a qualifying status (such as U.S. citizen, lawful permanent resident or Cuban-Haitian entrant) for full-benefit Medicaid. Others may still get Emergency Services Medicaid. Children under 19 and pregnant or postpartum Virginians aren't affected by that change.

What Cardinal Care Covers

Cardinal Care pays for doctor visits, hospital and emergency care, prescriptions, behavioral health, maternity care and long-term care for people who qualify, with 5 health plans handling most of it. Two Virginia specifics, checked November 13, 2026:

Adult dental. DMAS's adult dental page lists X-rays, exams, cleanings, fillings, root canals, gum treatment, dentures, extractions and other oral surgery for adults, through Cardinal Care Smiles. DMAS says you get covered services at no cost from a dentist who takes Medicaid. DentaQuest runs the program; call 1-888-912-3456 to find a dentist. Bring your Medicaid card or plan ID card; there's no separate dental card.

Costs. The Cover Virginia pages checked for this guide don't list premiums or copays for Expansion adults. If a provider asks you to pay at a visit, call your health plan before you pay.

The 5 Cardinal Care health plans

Cover Virginia's Health Plans page, checked November 13, 2026, lists these plans:

After you're approved, Virginia assigns you a plan and mails a letter. DMAS says you have 90 days from the date on that letter to switch to a different plan. Call the Managed Care Helpline at 1-800-643-2273 (TTY 1-800-817-6608), Monday to Friday 8:30 a.m. to 6 p.m., or change online at virginiamanagedcare.com. Your best bet is to check which plan your current doctor, pharmacy and nearest hospital take before the 90 days run out.

How to Apply for Cardinal Care

Cover Virginia lists 5 ways to apply, checked November 13, 2026:

1. Online at CommonHelp (opens in a new tab) (commonhelp.virginia.gov). CommonHelp also handles SNAP and other Virginia DSS benefits.
2. By phone with the Cover Virginia Call Center at 1-855-242-8282 (TTY 1-888-221-1590), Monday to Friday, 8 a.m. to 7 p.m. Cover Virginia says the center closed on Saturdays starting April 4, 2026.
3. In person at your local Department of Social Services, where you can drop off a paper application.
4. By mail to the Cardinal Care Correspondence Center, P.O. Box 1820, Richmond, VA 23218.
5. Through Virginia's Insurance Marketplace. If the marketplace finds you eligible for Medicaid or FAMIS, you're enrolled automatically.

Free in-person help is available from local Application Assisters listed on Cover Virginia.

Documents to gather

According to Cover Virginia's How to Apply page, have these ready:

• Full legal name and date of birth for everyone in your household.
• Social Security numbers for people applying (household members who aren't applying don't need one).
• Immigration document numbers, if any.
• Pay stubs, W-2s or other wage and tax statements from each employer.
• A self-employment expense form if you're self-employed.
• Details of other health insurance, such as Medicare or a job-based plan.

For example, one applicant in Roanoke who's 41, lives alone and makes $1,700 a month driving deliveries falls under Cover Virginia's one-person line of $1,836. She'd apply on CommonHelp with her last month of earnings and her expense form. If DMAS needs more, she'll get a letter, and Cover Virginia warns the application may be denied without a reply.

After You Apply: Letters, Backdating and Renewal

Federal rules give Virginia up to 45 days to decide an application, or 90 days for one based on disability, under 42 CFR 435.912. If DMAS or your LDSS needs proof, you'll get a letter; you can answer online, by fax (1-888-221-9402), by mail or at your LDSS.

Retroactive coverage: Today, Virginia can cover up to 3 months before the month you apply, if you qualified in those months. The DMAS bulletin of September 4, 2026 sets the 2027 change:

If you've had a hospital stay or ER bill since August, applying before January 1 keeps the longer window open.

Renewal: Virginia renews Cardinal Care every year for now. Your LDSS first tries to renew you automatically; if it can, you'll get a letter saying you're covered for another year. If not, a paper renewal form comes in the mail. Renew at CommonHelp ("Renew my benefits"), by calling 1-855-242-8282, or by returning the form to your LDSS. Cover Virginia says if you don't complete your renewal, you'll lose your coverage and get a notice with appeal rights and a marketplace referral.

Virginia's 2027 Work Requirement and 6-Month Renewals

DMAS will start the federal work requirement on January 1, 2027, only for Medicaid Expansion adults. Per the DMAS Federal Work Requirements page and its September 2026 FAQ, checked November 13, 2026:

• Who: Expansion adults 19 to 64, under 138% of poverty, not eligible for Medicare. Children, pregnant and postpartum Virginians, adults with a disability and people 65 and older aren't covered by it.
• What counts: at least 80 hours in a month of work, job training, school or volunteering (any mix), or school at least half time, or at least $580 a month in income.
• Which month: applicants show it for the month right before they apply. Current members show it for at least 1 month since their last renewal. DMAS's own example: a member covered April 1, 2026 to March 31, 2027 needs 1 qualifying month since April 1, 2026.
• Start points: applications filed on or after January 1, 2027, and renewals scheduled for March 31, 2027 or later.
• Proof in 2027: DMAS says that in most cases, your answers on the application or renewal (self-attestation) will be enough in 2027, with no medical records needed for a disability exemption. Additional proof requirements start in 2028.
• Exemptions DMAS lists include parents or caregivers of a child under 14 or of a person with a disability; pregnant and postpartum members (12 months); serious medical or mental health conditions, disabilities and substance use disorders; people who left foster care at 18 and are 25 or younger; members of federally recognized tribes; veterans rated 100% disabled; people recently released from incarceration; and people in high-unemployment or federal disaster areas. Hardship exemptions for inpatient stays and travel for serious medical care are planned, with details to come.
• Notices: DMAS says Expansion members got a notice by mail, text or email by September 30, 2026, and approval notices will describe the rule starting January 2027.

Six-month renewals: for applications and renewals started on or after January 1, 2027, Expansion members are reviewed every 6 months instead of 12. American Indians and Alaska Natives are exempt. Under DMAS's example, a member renewed for April 1 to September 30, 2027 must show another qualifying month before the September review.

Not yet settled: DMAS says its FAQ reflects current understanding and may change with more federal guidance; it hasn't posted how the 2028 proof rules will work.

What DMAS Doesn't Tell You

DMAS publishes more detail than many states, but 5 Virginia gaps still catch people:

1. The September 2026 notice went to all Expansion members. DMAS says many of them will be exempt. Getting the notice doesn't mean you'll have to log hours.
2. Your plan choice has a 90-day clock. Cover Virginia's Health Plans page doesn't say when you can switch after those 90 days, so check your doctors before the letter's window closes, not after.
3. Self-attestation in 2027 isn't permanent. DMAS says additional requirements apply in 2028. Keep pay stubs, school enrollment letters and volunteer logs anyway.
4. Backdating has to be asked about. Tell CommonHelp or your LDSS about unpaid medical bills from the 3 months before you apply; until January 1, 2027, that window is still 3 months.
5. Two document emails exist. Cover Virginia's apply and renewal pages list different email addresses for sending papers. Uploading in CommonHelp avoids the mix-up and gives you a record.

Common Mistakes and Red Flags

Most Virginians who lose Cardinal Care miss a step rather than earn too much. Watch for these:

• A common mistake: an old address on file. DMAS asks members to keep contact details current at commonhelp.virginia.gov or by calling 855-242-8282. Renewal forms sent to an old address still count as sent.
• Not opening the paper renewal form. It's only mailed when the automatic renewal fails, so getting one means DMAS needs something from you.
• Unreported income changes. A raise can move you from Medicaid Expansion to the marketplace (compare it with the Virginia Medicaid income chart). Report it on CommonHelp rather than waiting for renewal.
• Applying for the wrong program. Virginians 65 and older with Medicare should ask about ABD Medicaid and Medicare Savings Programs, not Expansion.
• Red flag: anyone charging to apply or "speed up" Cardinal Care. Cover Virginia, CommonHelp and Application Assisters are free. Texts asking for a card number to keep coverage aren't from DMAS.
• Underestimating gig hours. A rideshare driver logging 15 hours a week may fall under 80 hours a month; check whether earnings top $580 that month instead.

Other Help in Virginia If Cardinal Care Says No

Virginia has 3 usual next steps after a denial. Appeal by the deadline on your notice if you think the LDSS got your income or household wrong. Look at Virginia's Insurance Marketplace for tax credits if you're over the line. And if you're over 65 or disabled, ask about Medicare Savings Programs and long-term services.

CommonHelp screens for food and heating help too. See our Virginia food stamps guide and Virginia SNAP benefits guide for food help, and our Virginia energy assistance guide for heating and cooling bills. Pregnant Virginians and parents of young children can add WIC; see the national WIC income limits guide. For rent, see rental assistance programs. To compare Virginia with other states, read our Medicaid income limits guide, and try the Grantsights eligibility checker for other programs your household may fit.

It's worth applying on CommonHelp before January 1, 2027 if you've been putting it off: the 3-month backdating window and the pre-work-rule application month both end then.

FAQ: Virginia Medicaid and Cardinal Care

How do I apply for Medicaid in Virginia?

Apply online at commonhelp.virginia.gov, by phone through Cover Virginia at 1-855-242-8282 (Monday to Friday, 8 a.m. to 7 p.m.), at your local Department of Social Services, by mailing a paper form to the Cardinal Care Correspondence Center in Richmond, or through Virginia's Insurance Marketplace. If the marketplace finds you eligible for Medicaid or FAMIS, it enrolls you automatically.

What is Cardinal Care?

Cardinal Care is the name DMAS uses for Virginia Medicaid and FAMIS together. Most Cardinal Care members get their care through one of 5 health plans: Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Humana Healthy Horizons in Virginia, Sentara Community Plan and UnitedHealthcare Community Plan.

When do Virginia's Medicaid work requirements start?

January 1, 2027, for Medicaid Expansion adults 19 to 64. DMAS says the rule covers people applying on or after that date and current members with a renewal scheduled for March 31, 2027 or later. They'll need 80 hours a month of work, training, school or volunteering, half-time school, or $580 a month in income, unless an exemption applies.

Does Virginia Medicaid cover dental for adults?

Yes. Cardinal Care Smiles, run by DentaQuest, covers adult X-rays, exams, cleanings, fillings, root canals, gum treatment, dentures, extractions and other oral surgery. DMAS says covered dental care is at no cost when you use a dentist who takes Medicaid; call DentaQuest at 1-888-912-3456 to find one.

How far back can Virginia Medicaid cover bills?

Up to 3 months before the month you apply, if you qualified in those months. DMAS's September 4, 2026 bulletin says that from January 1, 2027, retroactive coverage drops to 1 month for Medicaid Expansion adults and 2 months for other groups.

How often do I renew Virginia Medicaid?

Once a year for most members. DMAS says Medicaid Expansion members move to reviews every 6 months for applications and renewals started on or after January 1, 2027, with American Indians and Alaska Natives exempt. Renew at commonhelp.virginia.gov, by calling 1-855-242-8282, or by returning the paper form to your local DSS.

Did Virginia expand Medicaid?

Yes. Virginia's Medicaid Expansion covers adults 19 to 64 without Medicare who have income under 138% of the poverty level, which Cover Virginia lists as $1,836 a month for one person as of January 13, 2026. That's also the group the 2027 work rule and 6-month renewals apply to.

Sources

1. Cover Virginia: How to Apply (opens in a new tab), checked November 13, 2026
2. Cover Virginia: Adults 19-64 Years Old (opens in a new tab), checked November 13, 2026
3. Cover Virginia: Health Plans (opens in a new tab), checked November 13, 2026
4. Cover Virginia: Renewing coverage (opens in a new tab), checked November 13, 2026
5. DMAS: Federal Work Requirements (opens in a new tab), checked November 13, 2026
6. DMAS: Federal Medicaid Work Requirement FAQs (opens in a new tab), updated September 2026
7. DMAS bulletin: Virginia HR 1 work, renewal and noncitizen changes (opens in a new tab), September 4, 2026
8. DMAS: Dental for Adults (opens in a new tab), checked November 13, 2026
9. Federal Register: Medicaid community engagement rule (opens in a new tab), June 3, 2026
10. eCFR: 42 CFR 435.912 (opens in a new tab)