The Virginia (VA) Medication Assistance Program (MAP) provides access to life-saving medications for the treatment of HIV and related illnesses for low-income clients through the provision of medications or through assistance with insurance premiums and medication co-payments. The program is primarily supported with federal Ryan White (RW) Treatment Extension Act Part B grant funding, which is distributed by a formula based on living HIV and AIDS cases to all states and territories in the United States. VA MAP provides insurance cost support or directly purchased medications through four service options: Direct Medication Assistance Program; the Medicare Prescription Assistance Program; the Insurance Continuation Assistance Program; and the Health Insurance Marketplace Assistance Program.
CONSUMER NEEDS ASSESSMENT FOR COVID-19 RESPONSE
In response to the Health Resources and Services Administration (HRSA) the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded $90 million for Ryan White HIV/AIDS Program recipients across the country to prevent, prepare for, and respond to coronavirus disease 2019 (COVID-19). This funding is provided by the fiscal year 2020 Coronavirus Aid, Relief and Economic Security (CARES) Act. As a result, the Virginia RWHAP B program is asking feedback directly from consumers in a needs assessment. This will help guide VDH efforts to support consumers during this pandemic. Please click the link here to be taken to the Consumer Needs Assessment for COVID-19 Response.
VA MAP UPDATES, PER THE COVID-19 PANDEMIC
VA MAP, in continuously keeping abreast of the ongoing COVID-19 situation, is ensuring that clients, throughout all VA MAP programs, are able to maintain continuity of needed services. Below is regularly updated information regarding any updates to VA MAP programs, as well as what is being done to maintain complete and continued assistance.
UPDATES FOR PROVIDERS REGARDING VA MAP OPERATIONS AMID COVID-19
The Virginia Medication Assistance Program (VA MAP) requests that if you have not yet set up access to the Secure File Transfer Protocol (SFTP) folders (Cerberus), please contact Cristina Gorman (email@example.com). The STFP folders are a secure method to send VA MAP eligibility applications, as well as any supporting documentation (Proof of Residency, Income, Insurance cards, etc.). VA MAP will be using this secure folder structure going forward until it is replaced by VDH’s new client level data system that will permit direct upload of applications and supportive documentation. While many sub-recipients have gained SFTP folder access, VA MAP is still receiving faxes, rather than STFP uploads. VA MAP requests that everyone begin submitting all eligibility documents using their assigned STFP Folder. For sub-recipients that have a complex agency structure that does not easily accommodate or allow SFTP folders, we understand you will need to continue to fax documentation until the new client level data system is available or we are eventually able to establish secure folders for your agency.
Assistance for Clients Who Have Employer Based Coverage - Letter (April 29, 2020)
Home Delivery of Medication due to COVID-19 for Direct MAP Clients (April 24, 2020)
COVID-19 RESPONSE FOR VA MAP (March 12, 2020)
For more information about coronavirus in Virginia, please use this link to the Virginia Department of Health, www.vdh.virginia.gov/coronavirus. Up-to-date information on the status of the virus outbreak is available from the Centers for Disease Control and Prevention (CDC).
For other medication access concerns or questions related to eligibility, contact the VA MAP hotline toll free at 1-855-362-0658.
If you are a medication access site and have any questions related to placing medication orders for clients on the Direct Medication Assistance Program (Direct MAP), please call Central Pharmacy at 804-786-4326.
If you are a Ryan White Part B provider and have questions about services other than medication access, please contact your HIV Services Coordinator.
Updated VA MAP Application Forms in Response to COVID-19
For PDF Applications, Recertifications, and Medical Certification Forms - after download, click the "Fill & Sign" option in order to fill out and save the complete form to your desktop.
VA MAP Application Form (April 2020)
VA MAP Application Form - Spanish (April 2020)
Recertification Application (April 2020)
Recertification Application - Spanish (April 2020)
Self Attestation Form (April 2020)
Self Attestation Form - Spanish (April 2020)
Medical Certification Form (April 2020)
VA MAP Enrollment Numbers (as of May 13, 2020)
- Direct Assistance: 2,524
- Medicare Prescription Assistance Program: 867
- Insurance Continuation Assistance Program: 1001
- Health Insurance Marketplace Assistance Program (clients in ACA): 1,876
- Total VA MAP Clients: 6,272
Hepatitis C/HIV Co-Infected Treatment Assistance Program Enrollment Numbers (as of April 2018)
- Number of clients that have accessed program: 94
- Number of clients that have completed treatment: 85
- Number of clients in treatment: 3
Clinical Support and Policy Development
In 1996, an VA MAP (ADAP from 1996 to 2019) Advisory Committee was created. The committee is comprised of HIV/AIDS medical providers, a pharmacist, and consumers. The committee advises VDH on changes to the formulary, changes in eligibility criteria, adherence issues, and educational concerns. The committee reviews data on VA MAP utilization and assess budgetary implications of trends and program changes.
For more information about the committee, please see the VA MAP Advisory Committee Scope.
VA MAP Quarterly Call
Questions or comments? Medication Eligibility Hotline 1-855-362-0658
This page was last updated on 2020-04-22
Please read these updates and help us with the listed action steps. If you have any questions, please call the VDH Medication Hotline at 1-855-362-0658.
Virginia Medicaid offers several low-cost and no-cost health coverage programs for eligible children, pregnant women and adults, including individuals with disabilities. To find out more about each program, follow the links below.
Monthly Eligibility by Program
You may qualify for health coverage from Virginia Medicaid if your household’s monthly income is at or below the following amounts.
|HOUSEHOLD SIZE||MEDICAID FOR CHILDREN UNDER AGE 19 & PREGNANT WOMEN||MEDICAID FOR ADULTS AGE 19-64||FAMIS FOR CHILDREN UNDER 19, FAMIS MOMS FOR PREGNANT WOMEN & PLAN FIRST|
2020 Income Guidelines as of January 17, 2020
For further information, please see Cover Virginia - Our Programs.
Cubre Virginia is Live!
CubreVirginia.org, a one-stop-shop for Spanish-speaking Virginians seeking information about low- and no-cost health coverage, was launched this month.
We have made incredible progress over the past year in our outreach to non-native English-speaking Virginians. The CubreVirginia website is an important step in our ongoing work to ensure that all eligible men, women and children have access to information about high-quality health coverage in their native language.
Like the English-language Cover Virginia website, coverva.org, cubrevirginia.org is a consumer-friendly source of information for visitors interested in learning who is eligible for FAMIS and Medicaid, what services are covered, and how they can apply for coverage. Additional languages are available through Google Translate.
Both websites feature an eligibility screening tool- a popular, easy-to-use online assessment to help users understand the income requirements to receive Medicaid coverage. The two websites also provide helpful information for individuals who are seeking to apply for coverage on the federal Marketplace. Open enrollment for the Marketplace began on November 1.
Cover Virginia has attracted more than 2 million views since its launch in 2013. The website is a recognized and trusted source of information for potentially eligible individuals, existing Medicaid members and health care advocates.
- Follow Cover Virginia on Facebook and Twitter for the latest Virginia Medicaid updates.
- Open Enrollment for the Federal Marketplace is happening until December 15. Cover Virginia has resources about the Marketplace available here. Remember, Virginians can apply for Medicaid at any time during the year.
- Medicaid coverage needs to be renewed every year. For more information, visit the Cover Virginia renewal page.
Medicaid Expansion Enrollment Updates
If ADAP paid your Affordable Care Act (ACA) Marketplace Health Insurance Plan premiums and medication co-payments in 2018 and now you may have Medicaid, read carefully to learn more about how to get your medications in 2019. Contact the ADAP team at 1-855-362-0658 if you have questions
If you are newly enrolled in Virginia Medicaid, you need to go to Healthcare.gov at https://www.healthcare.gov/ or call 1-800-318-2596 (TTY: 1-855-889-4325) and stop your ACA Marketplace plan. If you do not take this action, your ACA Marketplace plan may have been automatically renewed for 2019, but now you will not get help with costs. ADAP stops paying your premiums and medication co-pays because you can get your medications using Medicaid. Please send a copy of your Medicaid letter or card to Virginia Department of Health, James Madison Building, 1st floor, 109 Governor Street, Richmond, VA 23219 or fax to (804) 864-8050. Call Benalytics at 855-483-4647 if you need help cancelling your ACA Marketplace plan. Begin using your Medicaid insurance card to get your medications and health care services.
If you received a notice stating that your Medicaid application has been referred to Virginia for review, you are being evaluated for Medicaid benefits. Continue your ACA Marketplace plan until you receive a final decision from Virginia stating that you are eligible for Medicaid. ADAP keeps paying your premiums and medication co-pays until you are enrolled in Medicaid. Please mail a copy of your ACA Marketplace premium information and card to Virginia Department of Health, James Madison Building, 1st floor, 109 Governor Street, Richmond, VA 23219 or fax to (804) 864-8050.
If you have not received mail from Virginia Medicaid, or it has been misplaced, call the Cover Virginia Call Center at 1-855-242-8282 (TDD: 1-888-221-1590). Their hours are Mon - Fri: 8:00 am to 7:00 pm and Sat: 9:00 am to 12:00 pm. They can answer any questions you may have about your plan status. You can also go to their website at coverva.org. If you are having a hard time accessing medications or medical services, reach out to your Medical Case Manager, Social Worker or other advocate for help.
If the final decision from Virginia is that, you are NOT eligible for Medicaid, continue your ACA Marketplace plan and update your Marketplace application with any changes (such as a change in your household size or income). If you already ended your ACA Marketplace plan, you may qualify for a Special Enrollment Period to enroll in ACA Marketplace coverage with financial assistance. Go to Healthcare.gov at https://www.healthcare.gov/ or call 1-800-318-2596 (TTY: 1-855-889-4325) to update your Marketplace application or apply during a special enrollment period. You have 60 days from the date of your denial of Medicaid eligibility to enroll using the Special Enrollment Period, if eligible. Please mail a copy of your Marketplace premium information and card to Virginia Department of Health, James Madison Building, 1st floor, 109 Governor Street, Richmond, VA 23219 or fax to (804) 864-8050 so that ADAP can continue paying your premiums and medication co-pays.
For questions about Medicaid, call Cover Virginia Call Center at 1-855-242-8282 (TDD: 1-888-221-1590). Virginia Department of Social Services Enterprise Call Center at 1-855-635-4370 can also help with Medicaid and other benefits.
Are you ready for Medicaid Expansion? Visit this page frequently for the latest enrollment updates.
Virginia Medicaid Expansion Enrollment Resources
- Medicaid Expansion Flyer for Marketplace Members
- Enrollment Pathways Toolkit
- Virginia Medicaid Expansion and 2019 ACA Open Enrollment
The Department of Medical Assistance Services (DMAS) has posted the following informational updates regarding Medicaid Expansion:
- December 19: Medicaid cards mailed to new members
- December 26: Letters sent assigning new members to health plans, giving them 90 days from January 1 to decide whether to keep that plan or choose a different one
- January 1, 2019: Coverage begins for newly eligible adults
You and your family might qualify for Virginia Medicaid’s new health insurance. The new health benefits start on January 1, 2019. Virginia Medicaid sent letters in yellow and white envelopes to people who will get this new insurance. If you have Plan First and GAP, Medicaid will automatically enroll you. If you have SNAP or are a Parent of a Child with Medicaid, you can answer three easy questions to sign up. Cover Virginia can help you sign up online https://www.coverva.org/expansion or phone at 1-855-221-1590. TDD users dial 1-888-221-1590. If you got a letter from Medicaid but lost it, Cover Virginia can tell you whether Medicaid sent you a letter. You can sign up for this new Medicaid insurance any time!
If you had Marketplace insurance last year, you might qualify for this new low to no-cost insurance that will cover your medicines, your doctor and lab visits, and other services. Call Benalytics at 855-483-4647 and they can help you find out which insurance you can get and help you enroll.
Not sure which steps to take? Call the ADAP Hotline at 1-855-362-0658.
If you have an ACA plan, and have not received your health insurance card to access medications, please contact the Virginia Medication Assistance Program (VA MAP) at 855-362-0658. Temporary medication access is available.
Before and during the Affordable Care Act (ACA) Open Enrollment period, documents and announcements of interest and importance to Virginia Medication Assistance Program (VA MAP) clients and stakeholders will be posted below.
Open Enrollment for 2020
*Important Announcement - 2020 ACA Open Enrollment has been Extended!*
Virginia Medication Assistance Program clients can still sign up for health insurance through Healthcare.gov! As of December 16, 2019, the deadline to apply for healthcare on the ACA Healthcare Exchange has been extended through 3:00 AM (Eastern Standard Time), on Wednesday, December 18th. Applicants who enroll before 3:00 am on December 18th will be able to get coverage that begins on January 1, 2020. For further information, please visit the Centers for Medicare & Medicaid Services website.
If you are a Virginia Medication Assistance client and need help enrolling in health insurance, call Benalytics at (1-855-483-4647) or the VA MAP Medication Eligibility Hotline at (855) 362-0658.
*Note - Benalytics is continuing to enroll eligible VA MAP clients in ACA coverage during the extension until Wednesday, December 18, 2019.
*Note - Benalytics will be opened on Sunday, December 15, 2019.*
*Note - The deadline to submit all ACA enrollment worksheets and supporting documentation is Thursday, December 19, 2019 by 5 p.m.*
For information pertaining to Open Enrollment dates for those with Medicare and Marketplace coverage, as well as those covered under Medicaid Expansion, and contact information for enrollment, re-enrollment, or any other questions and concerns, please see:
- 2020 Open Enrollment Announcement - English
- 2020 Open Enrollment Announcement - Spanish
- 2020 Open Enrollment Letter (November 2019)
Below is a list of VA MAP's Enrollment Assistance Partners. Please be aware, that some agencies will only enroll their current clients, so be sure to call ahead to better ascertain which site is able to offer the best assistance.
- VA MAP Enrollment Assistance Partners (October 2019)
For a copy of the 2020 VA MAP Insurance Enrollment worksheet, as well as a list of all 2020 Health Care Marketplace Plans supported by VA MAP, please see:
- VA MAP 2020 Insurance Enrollment Worksheet - Word Document (October 2019)
- VA MAP 2020 Supported Marketplace Plans (October 2019)
Below are reminder letters, regarding Medicare open enrollment, for all clients currently enrolled in the VA MAP Medicare Prescription Assistance Program, or MPAP.
Page last updated: 01/08/2020
Hurricane Preparedness 2020
In preparation for the upcoming 2020 hurricane season, June 1 through November 30, the Virginia Ryan White HIV/AIDS Part B (RWHAP B) program asks all of its partners and consumers to be prepared ahead of time. To assure adequate medication supplies, we ask all providers and consumers to assess medication refill needs before any storm affects Virginia. If consumers access medications at local health departments, mail order, or retail pharmacies, encourage and help them have peace of mind and get refills now. People Living with HIV (PLWH) may be displaced within Virginia if a region is impacted (particularly those in eastern and central regions), and others may be from out-of-state if they evacuate to Virginia. To help everyone be prepared, VDH has created new tabs on the Ryan White program sites for "Hurricane/Emergency Preparedness." You will find information, policies, procedures, and forms to help PLWH who need emergency services during such events. If you need to provide emergency services to clients during or after a hurricane, the information you need is in a convenient location on this page, as well as the HIV Care Services web page. Stay safe and please reach out to the RWHAP B team if you have any question or need additional information.
It is important for each of us to be prepared to protect ourselves as well as our loved ones during this hurricane season. VDH has created Social Media Took Kits for Hurricane Preparedness.
Click on the following link for pre- and post-event information on severe weather preparedness and safety information.
VA MAP and VA Ryan White HIV/AIDS Programs Part B Clients
Health Departments and Sub-recipients
- Fax Cover Sheet - Hurricane Preparedness for Health Departments with VA MAP Clients
- Prescription Order Form
- Hurricane Preparedness for RWHAP Sub-recipients