- Note: If you are over 65, blind, disabled, or have a special medical need, scroll down on this page to find additional documents we may need you to complete. You can also get a one page supplement to the application if there are more than two people in your household.
When you apply, you will need this information:
- Full legal name
- Date of birth
- Social Security numbers (or document numbers for any legal immigrants who need insurance)
- Note: You may be asked to prove citizenship or immigration status after you apply. Read a list of acceptable [PDF] verification documents.
- Note: If self-employed, read [PDF] Self-employment Expenses Information.
Application Assisters
If you need help with your application, find an Application Assister.
How to send information we ask for
We will send you a letter if we need more information. You can send your information to Virginia Medicaid in one of these ways:
- Online: commonhelp.virginia.gov
- Email: verify_docs@coverva.org
You can scan and upload, attach electronic copies, or take a photo of your information and attach it to the email. To keep your information secure, this email address only receives information. You will not get a reply.
- Mail: Use the address on the letter we send asking for information.
- Fax: 1-888-221-9402
For questions, call Cover Virginia at 833-5CALLVA.
Applying for more than two people
You may need to print more pages if you are applying for Medicaid, FAMIS or Plan First for more than two people in your household. Use the Additional Person Single Page Supplement. You cannot use this application by itself. You must also complete the Application for Health Coverage & Help Paying Costs. Then submit the Additional Person Single Page Supplement with your application.
Applying for Medicaid for adults over age 19 with disabilities, or who are 65 or older, or for anyone who needs long-term care
You must complete the ABD-LTC Application – Appendix D and the Application for Health Coverage & Help Paying Costs.
Applying for the medically needy
Complete Medically Needy Spenddown – Appendix E if you applied for health care coverage for someone who is medically needy, but has income greater than the Medicaid limit and wants to be evaluated for a spenddown based on income, resources, and medical expenses. Spenddown works like an insurance policy deductible. The amount of the “deductible” is called the “spenddown liability.” Once medical bills are equal to or greater than the spenddown liability, the application will be re-evaluated for Medicaid eligibility.
Applying for persons with special needs
Complete Nursing or Community Based Care – Appendix F if you applied for health care coverage for someone who needs help with everyday things like bathing, dressing, walking or using the bathroom to live safely in the home. Also complete Appendix F if a doctor or nurse has told the person applying that they have a physical disability, chronic (long-term) disease, mental or emotional illness, or addiction disorder.
To learn more about how to appeal a decision, go to the Cover Virginia Appeals webpage.
