Accepted insurance plans
Cardinal Care (Straight Medicaid)
Cardinal Care is the department of Medical Assistance Services (DMAS), Virginia’s Medicaid program. Cardinal Care covers all of Medicaid's managed care and fee-for-service members.
Aenta Better Health - Managed Care Organization (MCO)
Aetna Better Health of Virginia is a statewide Medicaid program offering managed care services and programs to individuals and families who qualify for Medallion Medicaid, FAMIS (Family Access to Medical Insurance Security), CCC Plus (Commonwealth Coordinated Care Plus), and Medicare Advantage Dual Eligible Special Needs Plans (D‐SNP).
Sentara Community Plan - Managed Care Organization (MCO)
Sentara Community Plan (former Optima Health & Virginia Premiere Plan) is a Virginia Medicaid plan available to people of all ages with incomes below a certain level and people with disabilities. Medicaid health plans cover a wide range of health services, including doctor visits, dental coverage, mental health support, and more.
Coming soon
Medicare
Medicare (Part A - Hospital) and (Part B - Doctor Visits) referred to as original Medicare will cover skilled services, short term skilled nursing services after surgery, and short term stay in rehabilitation centers after a surgical procedure or injury.
Skilled Services:
- Skilled RN Nursing Services
- Physical Therapy
- Occupational Therapy
- Speech Therapy
However, Medicare DOES NOT cover long term care such as nursing facilities or home healthcare daily living activities. To receive long term care services individuals must enroll in a Medicare Advantage Care Plan that offers Home Healthcare.
Medicare Advantage Plans
Medicare Advantage like Medicare Advantage Special Needs Plan (SNP) or a Value-Based Insurance Design (V-BID) plan, which offer specialized care coordination, benefits for chronic conditions like dementia, and potentially lower costs for enrollees. The ideal plan varies by individual and location, so comparing specific SNPs and V-BID plans available in Virginia. These plans aim to keep healthcare costs low for people with chronic conditions, potentially offering better financial outcomes than Original Medicare with a supplemental plan.
- Specialized Care: SNPs are designed for beneficiaries with specific chronic health conditions, including dementia, providing focused care coordination.
- Expanded Benefits: V-BID plans, in particular, go beyond standard Medicare benefits to include services like meal delivery, transportation, and home environmental improvements, which can significantly benefit individuals with dementia.
Medicare Supplemental Plans
A Medicare Supplement plan, also known as Medigap, is private insurance that helps pay for out-of-pocket costs not covered by Original Medicare (Part A and Part B). You must be enrolled in Original Medicare to purchase a Medigap policy. These policies will cover or fill in the gaps of coverage. Medicare Supplement plans DO NOT COVER long term care or home healthcare.
Private Insurance Plans
Private insurance is coverage offered by private companies and paid for through monthly premiums, as opposed to government-run programs like Medicare or Medicaid. In the United States, private health insurance is the most common type of coverage, with the majority of plans being provided through employers.
Healthy Horizons Plan - Managed Care Organization (MCO)
Healthy Horizons Plan is proud to partner with the Virginia Department of Medical Assistance Services to provide Medicaid coverage to eligible Virginia residents. We are committed to promoting health equity and improving health for all Virginians. Members have access to high-quality medical, behavioral health, pharmacy coverage and other benefits.
Virginia Medicaid - Managed Care Organization (MCO)
UnitedHealthcare Community Plan is a Virginia Medicaid plan that offers health coverage at a no-cost or low-cost to adults, people with disabilities, pregnant women, and children.
Virginia Medicaid - Managed Care Organization (MCO)
Anthem HealthKeepers Plus is a Virginia Medicaid plan that offers health coverage at a no-cost or low-cost to adults, people with disabilities, pregnant women, and children and youth in foster care, former foster care and those children receiving adoption assistance through the Foster Care Specialty Plan.