Comparing Medicaid plans in Virginia starts with a practical question: which option supports the care you actually use? Virginia’s Cardinal Care program offers five managed care options, but choosing one requires more than recognizing a plan’s name.
This guide explains how the plans differ, what to check before enrolling, and how to apply or request a change. You will also learn about a separate benefit that could help lower household communication costs.
1. What Medicaid Plans Are Available in Virginia in 2026?
Virginia’s Cardinal Care Managed Care program offers five health plans in 2026: Aetna, Anthem HealthKeepers Plus, Humana Healthy Horizons, Sentara, and UnitedHealthcare.
Most eligible Medicaid members can choose among these plans. However, certain groups follow different arrangements. For example, eligible foster care members receive specialized coverage through Anthem’s statewide Foster Care Specialty Plan.
| Plan name | Provider directory | Where to review current extra benefits |
| Aetna Better Health of Virginia | Aetna’s Virginia “Find a provider” tool | Virginia member benefits and current handbook |
| Anthem HealthKeepers Plus | Anthem’s Virginia Medicaid provider search | HealthKeepers Plus benefits and member materials |
| Humana Healthy Horizons in Virginia | Humana’s Virginia Medicaid provider finder | Virginia member benefits and current handbook |
| Sentara Community Plan | Sentara’s Medicaid provider search | Sentara Medicaid benefits and member materials |
| UnitedHealthcare Community Plan | UnitedHealthcare’s Virginia provider search | Virginia Community Plan benefits and handbook |
When comparing Medicaid plans in Virginia, use the enrollment broker’s compare plans and find a provider tools to begin your research. For any extra benefit, check its 2026 effective dates, eligibility conditions, limits, and whether advance approval is required. An advertised extra is useful only if you qualify to receive it.
2. What Are the Different Types of Medicaid in Virginia?
Understanding Medicaid plans in Virginia becomes easier when you separate how care is delivered from which coverage category you qualify for. A health plan manages services; your eligibility category determines the coverage rules that apply.
Managed Care and Fee-for-Service Medicaid
Under managed care, an MCO coordinates covered services through its provider network. With fee-for-service, Virginia Medicaid pays participating providers directly for covered care.
Cardinal Care includes both arrangements. Some members initially receive fee-for-service coverage before their managed care enrollment begins, while others have different enrollment arrangements based on their circumstances.
Coverage Programs and Eligibility Groups
Virginia provides coverage pathways for eligible children, pregnant individuals, adults, older adults, and people with disabilities. Income requirements and other conditions depend on the category.
FAMIS is Virginia’s Children’s Health Insurance Program (CHIP). Although it has separate eligibility rules, FAMIS members can also choose participating health plans through Cardinal Care.
Long-term services and supports may require additional assessments and eligibility requirements. They are not separate competing health insurance plans.
3. What Is the Best Medicaid Plan for Virginia?
The most suitable plan is the one that supports your actual care needs. There is no single choice that works best for everyone when comparing Medicaid plans in Virginia.
Use this checklist in order:
- Confirm your doctors and specialists: Search the directory, then call each provider’s office to verify participation in the specific Medicaid plan and whether they can continue seeing you.
- Check prescriptions and pharmacies: Confirm medication coverage, participating pharmacies, and any prior authorization, quantity limits, or other requirements.
- Protect ongoing treatment: Ask about scheduled procedures, therapy, medical equipment, care coordination, language assistance, and relevant member support.
- Review usable extras: Compare additional benefits only after confirming that you meet their conditions.
Some benefits are administered separately from your main health plan. For example, Virginia’s Cardinal Care Smiles dental program is managed by DentaQuest, so check the appropriate provider directory for those services.
The official Consumer Decision Support Tool adds performance information. Its 2025 – 2026 edition uses calendar-year 2024 data for 2025 reporting rates, with information current as of August 2025.
Humana’s ratings are unavailable because it was a new Virginia plan in 2025; missing ratings do not establish poor performance.
Narrow your options, then confirm your most important care arrangements before selecting a plan.
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4. How to Apply for Medicaid and Choose Your Virginia Health Plan?
Applying for coverage and selecting Medicaid plans in Virginia are separate steps. Follow the sequence below so you know both whether you qualify and which coverage is active.
Apply and Review Your Decision
Follow Cover Virginia’s application guidance to apply through CommonHelp, by telephone, or using a paper application. Respond to requests for supporting information so your application can be reviewed.
Read your eligibility decision and any separate plan assignment information carefully. Medicaid approval determines eligibility; it does not necessarily mean your preferred managed care plan is already active.
Select a Plan and Confirm Active Coverage
Virginia’s enrollment broker can help compare plans, check providers, and make a selection. Contact the Managed Care Helpline at 1-800-643-2273 for assistance.
Initial coverage may be fee-for-service. Before an appointment or prescription refill, confirm your plan’s effective date and the provider network applicable on that date. Ask your provider to verify the coverage they should bill.
5. Can You Change Medicaid Plans in Virginia?
Yes. Virginia Medicaid members generally have 90 days from the date on their plan assignment letter to choose a different managed care plan.
Check your notice for the exact deadline or call the Managed Care Helpline at 1-800-643-2273.
After that period, annual open enrollment provides another opportunity to change Medicaid plans in Virginia. Dates vary by region, so there is no single statewide enrollment window.
Requests outside the normal change periods require approval from the Virginia Department of Medical Assistance Services, or DMAS.
Before switching, confirm the new effective date and discuss ongoing treatment with both plans.
Check upcoming appointments, medication refills, equipment, and existing authorizations to understand what arrangements are needed.
6. Keeping in Touch with Your Health Plan Could Cost Less
Choosing a Medicaid plan in Virginia takes careful comparison, and it is worth giving your phone plan the same attention. Member services and appointment desks reach you by phone, so a mobile plan that fits your budget pays off every time one of them calls.
Lifeline is a federal benefit that helps with exactly that cost. It offers up to $9.25 per month toward qualifying broadband or bundled service, and up to $34.25 on qualifying Tribal lands.
Think of eligibility as a question about your household: does your income, or your participation in a qualifying program, meet the rules?
Medicaid is one such program, but it does not sign you up for Lifeline, so you still apply and complete verification. Each household receives one benefit, and it cannot be transferred.
An Eligible Telecommunications Carrier (ETC) is the provider that delivers the service, so it is the one you compare and choose.
Cintex Wireless is an ETC that also offers free or discounted phones, which adds a device to the comparison.
It has announced a merger with AirTalk Wireless, another ETC, so more phones will be available to look at through one online application.
Here is a walk-through for applying:
- Enter your ZIP code on the AirTalk Wireless website to see current service and offers in your area.
- Look through the available plans and phones, including the option to bring a compatible phone you already own, and settle on the one that suits you.
- Provide your personal and household details, and upload any documents requested.
- Submit and wait for the result. After approval, you will receive your SIM, eSIM, or device with activation instructions.
IMPORTANT: The government does not subsidize devices. Lifeline programs cover basic service costs only. Free or discounted devices, upgrade plans, or top-ups are exclusive benefits provided by AirTalk Wireless and Cintex Wireless as part of the promotional offers. Terms and conditions apply. Limited-time promotion—offers vary by state, stock availability, and eligibility.
7. FAQs
Do All Virginia Medicaid Plans Cover the Same Services?
Virginia’s Cardinal Care plans follow state Medicaid coverage requirements, but provider networks, care coordination, and extra benefits may differ. Compare participating doctors, medications, and plan-specific services before enrolling.
Can Family Members Choose Different Medicaid Plans in Virginia?
Yes. Family members enrolled in Virginia Medicaid can choose different Cardinal Care managed care plans when eligible. Each person can select a plan based on their healthcare needs, available providers, and enrollment requirements.
Does Virginia Medicaid Cover Dental Care?
Yes. Virginia Medicaid covers dental services for eligible adults and children through Cardinal Care Smiles, administered by DentaQuest. Covered treatments depend on eligibility and applicable requirements. Check its dental directory before scheduling an appointment.
Conclusion
Choosing among Medicaid plans in Virginia starts with confirming doctors, prescriptions, and ongoing care. Compare the five options, review your enrollment notice, and verify effective dates before making a decision.
