Access to comprehensive healthcare is crucial for expectant and new mothers, and Virginia’s Cardinal Care program ensures eligible residents receive coverage throughout pregnancy and for 12 months postpartum.
This extended coverage applies to pregnant individuals enrolled in full-benefit Medicaid and Family Access to Medical Insurance Security (FAMIS) MOMS* members. The 12-month postpartum continuous coverage is not limited to pregnancy coverage groups.
Benefits of this continuous coverage include comprehensive care such as family planning, dental, community doulas, lactation services, mental health and substance use treatment, medical transportation and more.
Medicaid and FAMIS MOMS members do not need to take any additional action besides reporting their pregnancy to Medicaid to activate extended postpartum coverage. All enrolled members are assessed for pregnancy-related risks; this information, along with the member’s medical records, claims data, and population health data, all inform which level of Managed Care Organization (MCO) care management the member will receive. Coverage ends at the end of 12 months postpartum, and the member’s eligibility for Medicaid coverage is reevaluated. The member might qualify for coverage in a different eligibility group, such as low-income parents with children.
All health plans under Virginia Medicaid offer the same comprehensive Medicaid services. However, each plan has a unique selection of extra benefits for eligible members. This helpful chart describes the enhanced benefits each health plan offers, ranging from a $25 monthly allowance for over-the-counter purchases to 24/7 virtual breastfeeding support and education.
For more information about extended postpartum coverage, visit the Cover VA websites below:
https://coverva.dmas.virginia.gov/learn/coverage-for-pregnant-individuals/
https://www.dmas.virginia.gov/for-members/benefits-and-services/maternal-and-child-health/
*FAMIS prenatal coverage participants who do not meet immigration criteria for other coverage will receive coverage through 60 days postpartum.