Rights and Responsibilities

You have the right to...

• File an application for health coverage.
• Receive written information about specific eligibility rules and policies.
• Have a decision made promptly, within the limits set by state and federal rules.
• Receive a written notice of the decision.
• Have your personal and health information kept private.
• Receive advance notice of actions that end or reduce your coverage.
• Appeal any action, such as:
  • Any decision denying, ending or reducing Medicaid eligibility.
  • Any unreasonable period of time taken to decide if you are eligible.
  • Any decision denying, ending or reducing Medicaid-covered services.

You have the responsibility to:

• Complete the application and renewal forms accurately and truthfully to the best of your knowledge. False and untrue information may be subject to penalties under federal law.
• Supply requested information or tell your eligibility worker about any problems you may have getting the needed information.
• Tell your eligibility worker of any other medical insurance that may cover some of your bills.
• Keep scheduled appointments.
• Show your medical provider your medical cards when you go for care.
• Immediately report changes in your circumstances such as:
  • Change in address, birth of a child, death of a family member, marriage, new employment, adding or dropping other health insurance, or any change in household.
  • Early termination or loss of pregnancy.
  • Changes in your finances, including earned and unearned income, Social Security, Supplemental Security Income (SSI), work, changes in employment, transfers of assets, or inherited funds or property.
  • Any medical insurance that may cover some of your bills.
  • Filing of a personal injury claim due to an accident.

Note: You can report changes at commonhelp.virginia.gov, by calling Cover Virginia at 1-855-242-8282 (TDD: 1-888-221-1590), or by visiting your local department of social services (DSS). A change in circumstances could affect household members’ eligibility.

Correct information

When you apply, we’ll check your answers using information in our electronic records and those of the Internal Revenue Service (IRS), Social Security, the Department of Homeland Security, and a consumer reporting agency. If the information doesn’t match, we may ask you to send us proof.

Other health insurance

If anyone on the application qualifies for Medicaid, you give the Department of Medical Assistance Services rights to pursue and get any money from other health insurance, legal settlements or other third parties. You also give the Medicaid agency rights to pursue and get medical support from a spouse or parent.

Absent parent support

If any child on the application has a parent living outside of the home, you will be asked to cooperate with the agency that collects medical support from an absent parent. If you think that cooperating to collect medical support will harm you or your children, you can tell Medicaid and you may not have to cooperate.

Voter registration

Citizens of the Commonwealth of Virginia can register to vote when they apply for benefits, renew coverage, or report a change. If you are not already registered and you want to register to vote, you can complete a voter registration form at vote.elections.virginia.gov/VoterInformation or call or visit your local DSS to request a paper registration form.