A place to start
What if I Do Not Know My Medicaid Waiver or Health Plan?
You do not have to learn every Medicaid term before asking for help. A plan, a waiver and an authorization answer different questions.
Virginia guidance · Reviewed
Look for the name, not the member number.
A health-plan ID card or assignment letter may identify the plan. The Commonwealth of Virginia Medicaid card and the plan card are not the same thing. You do not need to type a member number or send a photograph of either card in the public eligibility checker.
If you cannot find the plan name, DMAS lists a Managed Care Helpline at 1-800-643-2273 and a Member Helpline at 804-786-6145. Use the official member page below to find the right contact for your coverage question.
A waiver may appear in different paperwork.
A waiver enrollment notice, service plan or existing coordinator may identify CCC Plus, Family and Individual Supports or Community Living. Your managed-care plan name alone may not identify the waiver.
If you already work with a Community Services Board support coordinator, ask which waiver you are enrolled in or whether you are on a waiting list. Being on a DD waiver waiting list is different from having an active waiver slot and approved services.
Three useful questions to ask.
- Which health plan or fee-for-service arrangement covers the person today?
- Is the person enrolled in a waiver, awaiting a waiver slot, or needing an assessment?
- Are personal-care services authorized now, and who coordinates that authorization?
You can still complete the first check.
Choose “I do not know” for the plan or waiver and provide the information you do know. Your location, relationship, broad care needs and preferred contact method are enough to begin a conversation.
If Medicaid coverage itself is uncertain, say so. A Care Navigator can help organize the next questions without promising approval. Keep member numbers, birth dates and clinical records out of public messages; the team can explain any later private information-sharing process.
Official sources
These Virginia and local government resources explain the rules and the public programs described here.
This guidance and our preliminary screening do not guarantee Medicaid eligibility, paid caregiver employment or service authorization. First Choice Home Care does not make the final Medicaid or authorization decision. Your program and care plan determine which services may be approved.
Let’s find your family’s next step.
Start with a few simple questions. It is okay to be unsure.