Medicaid Expansion Set For Virginia

This year, the Virginia legislature voted to expand Medicaid coverage, and we spoke with Sarah Rexrode, Director of Highland County Social Services, to find out more about impacts and opportunities.

“Medicaid expansion is expected to cover some 400,000 Virginians – in Highland, we have an estimated 157 persons who will be eligible for Medicaid expansion. So, it is designed to cover those adults between the ages of 19 and 64, who are not Medicare eligible. So with this type of coverage, it follows the same rules that the current MAGI, or families and children Medicaid follows, and there is no asset test with that. So the eligibility requirements really are based on your residency in Virginia, not already in or eligible for Medicare, and you have to meet income requirements, which, of course, vary by household size. Those with income from up to 138% of the Federal poverty limit will qualify. So, a household of one can make about $16, 754 annually – a household of four can make $34,638 annually.

“There are currently 31 aid categories in Medicaid. Medicaid expansion is expected to add six more categories. It will cover caretaker adults, childless adults, incarcerated adults and presumptive eligible adults. Medicaid expansion in Virginia is supposed to cover those with chronic medical disease, mental illness, and substance use disorder, which are populations that are currently left out, unless they meet the age requirements.

“A work requirement will be included in Medicaid expansion, which is expected to be implemented in the next year. So, Medicaid expansion is going to happen in January, and the work requirement will come about a year later. As of right now, we know that work requirement is going to be called Training Education Employment and Opportunity Program, with the goal for able bodied working age adults enrolled in Medicaid to increase their health and well-being through community engagement, leading to self-sufficiency. There will be exemptions to that work requirement, and policy is being formed around those exemptions. We’ll be able to provide more about that once the work requirement is established.

“So a lot of people are wondering what services are going to be included in the new coverage. It is anticipated to cover doctor, hospital and emergency services, including: primary and specialty care; prescription drugs; laboratory and x-ray services; maternity and newborn care; home health services; behavioral health services, including addiction and recovery treatment; rehabilitative services,  including physical, occupational and speech therapies; family planning services; medical equipment and supplies; as well as preventative and wellness services, including annual wellness exams, immunizations, smoking cessation and nutritional counseling.”

“If you think you may qualify, you can go onto, and complete a screening tool, and it will tell you whether or not you may be eligible. The application period for the expanded Medicaid is supposed to be sometime in November – we’ve not been given a definite date of when that period will start, but it will start in November, with services to begin January 1st. There are some current Medicaid enrollees who will be automatically enrolled: those with gap insurance; plan-first insurance; and then current SNAP participants will also be invited into the program after completion of a shorter Medicaid application.”

Story By

Scott Smith

Scott Smith is the General Manager for Allegheny Mountain Radio and Station Coordinator and News Reporter for WVLS. Scott’s family has deep roots in Highland County. While he did not grow up here, he spent as much time as possible on the family farm, and eventually moved to Highland to continue the tradition, which he still pursues with his cousin. Unfortunately, farming doesn’t pay all the bills, so he has previously taken other jobs to support his farming hobby, including pressman/writer for The Recorder, and Ag Projects Coordinator for The Highland Center. He lives in Hightown with wife Michelle and son Ethan. In his spare time, he wishes he had more spare time, especially to ride his prized Harley-Davidson motorcycle.

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