When you apply for coverage and sign the application you agree (under penalty of perjury) that you have provided true answers to all the questions on the form to the best of your knowledge. You may be subject to penalties under federal law if you provide false and/or untrue information.Enrollment in Managed Care
Once you or a family member is enrolled in managed care, a premium is paid each month to the managed care organization (MCO) for the person’s coverage. If the individual, child or pregnant woman is not eligible for FAMIS, FAMIS Plus, FAMIS MOMS, or Medicaid because you did not report truthful information or failed to report required changes in your family size or income, you may have to repay the monthly premiums paid to the MCO. You may have to repay these premiums even if no medical services were received during those months.Reporting Changes
You must tell the local Department of Social Services if anything changes and is different than what was stated on the application. You can visit www.commonhelp.virginia.gov to report any changes. A change in your information could affect the eligibility for member(s) of your household.Discrimination
Under federal law, discrimination isn’t permitted on the basis of race, color, national origin, sex, age, sexual orientation, gender identity, or disability. You can file a complaint of discrimination by visiting www.hhs.gov/ocr/office/file.Incarceration
You must confirm that no one applying for health insurance on the application is incarcerated (detained or jailed). You must state the name of any person incarcerated.Why we need this information
We need this information to check your eligibility for help paying for health coverage if you choose to apply. We’ll check your answers using information in our electronic databases and databases from the Internal Revenue Service (IRS), Social Security, the Department of Homeland Security, and/or a consumer reporting agency. If the information doesn’t match, we may ask you to send us proof.Renewal of coverage in future years
To make it easier to determine your eligibility for help paying for health coverage in future years, you can choose to allow the Medicaid or FAMIS programs or the Marketplace to use income data, including information from tax returns. You will receive notification of the outcome of your renewal. You have the right to opt out at any time.
If you agree, we will renew your eligibility automatically for the next 5 years (the maximum number of years allowed), or for a shorter number of years: 4 years 3 years 2 years or 1 year. If you do not agree, we will not use information from tax returns to renew your coverage.Other Health Insurance
If anyone on the application is eligible for Medicaid, you give the Medicaid agency rights to pursue and get any money from other health insurance, legal settlements, or other third parties. You also give to the Medicaid agency rights to pursue and get medical support from a spouse or parent.Absent Parent Support
If any child on the application has a parent living outside of the home, you will be asked to cooperate with the agency that collects medical support from an absent parent. If you think that cooperating to collect medical support will harm you or your children, you can tell Medicaid and you may not have to cooperate.Voter Registration
As a citizen of the Commonwealth of Virginia, we are required to provide you with the opportunity to register to vote when applying for benefits. If you are not already registered and you want to register to vote, you can complete a voter registration form at www.sbe.virginia.gov.