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Don’t lose benefits
UnitedHealthcare Community Plan of Virginia FAMIS
With UnitedHealthcare Community Plan (FAMIS), your child gets extras that other plans don’t offer. View the list of benefits below to see all that our plan covers. It’s for children and young adults up to age 19 whose families meet income requirements.
This plan is available in the following counties:
Accomack, Albemarle, Alexandria City, Alleghany, Amelia, Amherst, Appomattox, Arlington, Augusta, Bath, Bedford, Bedford City, Bland, Botetourt, Bristol, Bristol City, Brunswick, Buchanan, Buckingham, Buena Vista City, Campbell, Caroline, Carroll, Charles City, Charlotte, Charlottesville City, Chesapeake City, Chesterfield, Clarke, Colonial Heights City, Covington City, Craig, Culpeper, Cumberland, Danville City, Dickenson, Dinwiddie, Emporia City, Essex, Fairfax, Fairfax City, Falls Church City, Fauquier, Floyd, Fluvanna, Franklin, Franklin City, Frederick, Fredericksburg City, Galax City, Giles, Gloucester, Goochland, Grayson, Greene, Greensville, Halifax, Hampton City, Hanover, Harrisonburg City, Henrico, Henry, Highland, Hopewell City, Isle of Wight, James City, King George, King William, King and Queen, Lancaster, Lee, Lexington City, Loudoun, Louisa, Lunenburg, Lynchburg City, Madison, Manassas City, Manassas Park City, Martinsville City, Mathews, Mecklenburg, Middlesex, Montgomery, Nelson, New Kent, Newport News City, Norfolk City, Northampton, Northumberland, Norton City, Nottoway, Orange, Page, Patrick, Petersburg City, Pittsylvania, Poquoson City, Portsmouth City, Powhatan, Prince Edward, Prince George, Prince William, Pulaski, Radford City, Rappahannock, Richmond, Richmond City, Roanoke, Roanoke City, Rockbridge, Rockingham, Russell, Salem, Scott, Shenandoah, Smyth, Southampton, Spotsylvania, Stafford, Staunton City, Suffolk City, Surry, Sussex, Tazewell, Virginia Beach City, Warren, Washington, Waynesboro City, Westmoreland, Williamsburg City, Winchester City, Wise, Wythe, and York.
- UnitedHealthcare Community Plan of Virginia FAMIS
When you apply for Medical Assistance, you are screened for all possible programs based on your age, income, and other information. To be eligible for a Medical Assistance Program, you must meet the financial and non-financial eligibility conditions for that program. Please visit the Virginia Department of Social Services’ (VDSS) Medicaid Assistant Program page for eligibility details and/or VDSS Medicaid Forms and Applications page for application and other Medicaid form details.
FAMIS is Virginia’s health insurance program for children of eligible families including those who meet one of the following categories:
- Children under age 21
- Foster Care and Adoption Assistance Child under age 26
- Pregnant women including two months post delivery
- Parent Care-Takers
Medicaid eligible persons who do not meet certain exclusion criteria must participate in the program. Enrollment is not a guarantee of continuing eligibility for services and benefits under the Virginia Medical Assistance Services Program.
Find providers and coverage for this plan.
Search for doctors, hospitals, behavioral health and other specialists.
Find medications covered by this plan.
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Benefits & Features
Assistance for Asthmatics
Receive mattress covers and pillowcases that help eliminate dust mites for people with asthma.
Boys and Girls Club
Free registration fee at a participating Boys and Girls Club of America.
- For all school-aged members between the ages of 5 and 18
- Present your United ID card at the time of registration
Call Member Services for participating clubs.
We cover up to $500 in chiropractic services per year. A small copayment may apply.
Choice of Doctor
You can choose your child’s primary care provider (PCP). Use the Doctor Lookup tool to see if your doctor is in our network.
Your PCP is your main doctor for:
- Preventive care.
- Treatment if you are sick or injured.
- Referrals to specialists for certain conditions.
For members who don’t have a doctor or whose doctor is not in our network, we can help find a new one close by.
Our members pay nothing for preventive care or annual checkups covered by our plan.
There is a small copayment for other types of care. The copayment amount is based on a member’s ability to pay.
Beginning July 1, 2021, coverage will include cleanings, x-rays, exams, fillings, dentures, root canals, gum-related treatment, oral surgery and more. Your dental services are provided by the State, not UnitedHealthcare.
If you have diabetes, we'll help make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best.
Our diabetes program also includes self-care training and classes focused on:
- Planning healthy meals.
- Managing stress.
- Living a healthy lifestyle.
If you have chronic or high-risk illnesses, our disease management services are designed to support you.
We have special programs for:
- Congestive heart failure
- Chronic obstructive pulmonary disease (COPD).
- Coronary artery disease.
Durable Medical Equipment
Some members may need extra support to live safely at home.
Our plan covers medical equipment ordered by your child's doctor or case manager. This can include supplies like:
Free classes to help improve your child’s health or address a condition.
Our plan also offers classes on nutrition, parenting and more. You and your child can even get a free ride, if needed, to and from the class.
Healthy First Steps®
Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up.
We will help you:
- Choose a pregnancy provider and a pediatrician (child’s doctor).
- Schedule visits and exams and arrange rides to your visits.
- Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
- Get supplies, including breast pumps for nursing moms.
- Connect with community resources such as Women, Infants and Children (WIC) services.
An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.
You can earn great gifts for your child by doing things like:
- Completing well-child exams.
- Getting lab tests.
- Recording your family’s health activities.
Trouble hearing can affect your child's everyday life in many ways. Our plan includes services and support to help protect your child's hearing.
- Exams, therapy and tests.
- Hearing aids and batteries.
Some members have a small copay.
Our plan covers:
- Nursing care.
- Room and board.
- Supplies and equipment.
- Treatment and therapies.
- Diagnostic tests and exams.
And after leaving the hospital, a member is not alone. We make sure the follow-up care is available to continue healing at home.
After surgery or a serious illness, your child may need extra care and services to recover. This may include an in-home medical visit to check on how well your child is healing. With approval, our plan covers:
- Medical equipment like hospital beds, walkers or wheelchairs.
- Disposable medical supplies
- An in-home medical visit.
- Help with personal care or housekeeping.
Your child's doctor and you need to understand each other. Speaking English as a second language can make this difficult. We can arrange for a medical interpreter to be at your child's appointments.
We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.
Kidney Disease Care
Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do.
Our plan includes:
- Health education and support.
- Organ transplant if needed.
Lab and X-rays
Knowing what’s wrong and finding it early can make all the difference for your child. Our plan covers:
- Labs and testing.
- X-rays, scans and other imaging.
We’ll help you get the information needed for your child’s health.
You can get information in another language. Just ask. Then anything we write to you will only be in that language. This is provided at no cost to you.
Our plan includes prescription drugs and refills, including family planning drugs, supplies and devices.
We also cover over-the-counter medicines with a written order from your doctor.
And we make getting your medicine easy. You can fill your prescriptions at local pharmacies.
We're looking out for you. Member advocates can help solve problems, provide training and education, and work on issues that concern members. Our member advocates can be reached at 1-844-445-8316 and are available M-F 8 a.m. - 8 p.m. ET.
- Provide information about your plan.
- Teach you to get the care you need.
- Help with doctor issues or complaints.
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call at 1-844-752-9434, M-F 8 a.m. - 8 p.m ET. We’ll answer your questions simply and completely.
We can also help you find:
- Home care providers.
- Dentists and vision providers.
Mental health is as important as physical health. That’s why we have coverage for both.
- Behavioral therapy.
- Substance use treatment.
Now your child can get any kind of blood test needed at home.
Our mobile lab brings the lab to your home. In addition to convenience, the mobile lab offers:
- Accurate test results.
- Comfortable setting for members.
There are no copayments for:
- Preventative care.
There is a small copayment for other medical services including prescription drugs, or vision care. Please call Member Services for more information.
While your child's health care is low-cost or free, the care quality is high. Your child gets:
- Visits to doctors in our network.
- Treatments at hospitals and clinics.
- Prescription drugs and over-the-counter medicines.
Medical questions and situations can come at inconvenient times. When you have questions about your child's care, you can call a nurse 24 hours a day, 7 days a week at 1-800-842-3014.
Our nurses will:
- Listen to the symptoms.
- Help with care questions.
- Advise you about getting care for your child at a doctor visit or an urgent care center.
- Help you know when to take your child to the emergency room
Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:
- Provide medical care.
- Answer any questions and concerns.
Knowing what's wrong and finding it early can make all the difference for your child.
Our plan covers:
- Labs and testing.
- X-rays, scans and other imaging.
We'll help you get the information needed to help improve your child's health or be at his or her best.
Sometimes you need extra help to manage your child’s recovery after an illness or injury. If needed, we provide someone to help with:
Physical, Speech or Occupational Therapy
Physical, occupational and speech therapy can help your child recover from a serious injury or illness, or simply reach his or her full potential. Depending upon your plan, you may have a copay for therapy visits.
- Occupational therapy.
- Physical therapy.
- Speech therapy.
- In-home therapy.
A pregnancy is a journey with the help of friends, family and a pregnancy doctor, or OB-GYN.
All of your recommended prenatal clinical visits and tests are covered.
At these visits, the clinic will:
- Make sure both mom and baby are healthy.
- Explain what to expect at each stage of your pregnancy.
- Answer your questions.
Most people know the bad health effects of smoking. And they know they need to quit. We support our members while they quit, with coaches and supplies. The only thing they won’t get from us is a lecture. Call Member services for information on our phone-based program to help you quit tobacco.
After a serious illness, surgery or injury your child may need extra nursing and therapy. If needed, our plan covers short stays in a rehabilitation center where your child can heal. Included are:
- Nursing home services.
- 24-hour nursing care.
- Help with activities of daily living.
- Physical, occupational and speech therapy.
Shots and Vaccines
Routine shots help protect your child from illness.
So, our plan covers:
- Recommended shots and vaccines.
- Influenza shots.
Your Community Department of Social Services (DSS) offers additional information and resources for:
- Energy and Food assistance
- Child care or Child support
- Protective Services
- Other resources
Visit the main Virginia website to see all what is offered, how to apply, and how to find your local agency. Visit www.dss.virginia.gov or call the main state number at 804-726-7000 for more information.
We encourage kids to take part in healthy activities like team or individual sports. We cover a sports physical each year for all school-aged members.
Text4baby can help new and expecting mothers keep themselves and their babies healthy.
You’ll get text messages throughout your pregnancy and your baby’s first year. Each text contains health and safety tips for topics like:
- Prenatal care.
- Labor and delivery.
- Safe sleep.
- Car seat safety.
So you and your baby can make a great start on life.
We pay for rides to and from:
- Medical visits and the pharmacy
- Food resources, including WIC and food banks
- Department of Social Services
- Weight Watchers
Unlimited Doctor Visits
There may be times when your child's health requires repeated doctor visits. Our plan does not limit the number the number of times your child can see a primary care provider. This way your child gets care when it's needed. And your doctor can see how your child's health is progressing.
Your child may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:
- Urgent care centers.
- Medical aid units.
- Other walk-in clinics.
Covers eye exams and glasses or contacts.
Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:
- Screening for obesity.
- Support for healthy diet and exercise choices.
- Weight Watchers Vouchers
Well visits with your doctor are important for good health. These visits can catch health problems early, so they can be treated. Preventive services include:
- Annual checkups for children.
- Well-baby care.
- Routine shots and tests.
There are no copayments for preventive care.
Getting Started With Your Coverage
Getting Started Guide
Toll Free Numbers
Your Care Coordinator: 1-866-622-7982, TTY 711
UnitedHealthcare Community Plan Member Services: 1-866-622-7982, TTY 711
UnitedHealthcare Community Plan 24/7 Medical/Behavioral Health Advice Line: 1-866-622-7982, TTY 711
UnitedHealthcare Community Plan 24/7 Behavioral Health Crisis Line: 1-866-622-7982, TTY 711
UnitedHealthcare Community Plan Adult Dental: 1-866-622-7982, TTY 711
UnitedHealthcare Community Plan Nurse Hotline: 1-888-547-3674
Smiles for Children through DentaQuest, DMAS Dental Benefits Administrator
- For questions or to find a dentist in your area, call Smiles for Children at. 1-888-912-3456. Information is also available on the DMAS website at or the DentaQuest website.
UnitedHealthcare Community Plan Transportation: 1-866-622-7982, TTY 711
DMAS Transportation Contractor for transportation to and from DD Waiver Services: 1-866-386-8331. TTY 1-866-288-3133. Or dial 711 to reach a relay operator Magellan of Virginia; DMAS Behavioral Health Services Administrator.
- TDD 1-800-424-4048
- Or dial 711 to reach a relay operator:
What to Do in an Emergency
Call 911 or go to the nearest hospital/emergency facility if you think you need emergency care. You can call 911 for help in getting to the hospital emergency room.
If you receive emergency services, call your doctor to schedule a follow up visit as soon as possible. Please call us and let us know of the emergency care you received.
An emergency is a condition in which you think you have a serious medical condition, or not getting medical care right away will be a threat to your life, limb or sight.
Appeals and Complaints Process
Appeals and Complaints Process
UnitedHealthcare Community Plan of Virginia FAMIS