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FAMIS

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FAMIS is Virginia's health insurance program for children. It makes health care affordable for children of eligible families. FAMIS covers all the medical care growing children need to avoid getting sick, plus the medical care that will help them if they do get sick or get hurt.

Information about FAMIS is available in the following languages: English, Spanish, Traditional Chinese, Simplified Chinese, Vietnamese, Arabic, Farsi, Korean, Russian, Hindi, Amharic, French, Kurdish, Urdu and Somali.

Services Covered by FAMIS

  • Doctor visits
  • Dental care
  • Well Baby Checkups
  • Emergency care
  • Hospital visits
  • Vision care
  • Vaccinations
  • Mental health care
  • Prescription medicine
  • Well Child Checkups
  • Tests and X-rays
  •  

FAMIS Member Handbook (English)

FAMIS Member Handbook (Spanish)
 
FAMIS Covered Services
 

Cost to the Family

There are no enrollment costs or monthly premiums for FAMIS. For some services, the family will have to pay a co-payment. Most co-payments are just $2.00 or $5.00. Some services, like regular check-ups, are free. Click here for more information.

Who is eligible for FAMIS?

Your children may be eligible if they:

  • Live in Virginia
  • Are not eligible for FAMIS Plus (also known as Children's Medicaid)
  • Are under age 19
  • Are United States citizens or qualified aliens
  • Live in families meeting FAMIS income guidelines

Information for immigrants is available in the following languages: English, Spanish, Traditional Chinese, Simplified Chinese, Vietnamese, Arabic, Farsi, Korean, Russian and Hindi.

FAMIS is now available as an option for children of state employees. Click here for more information.

Income Guidelines

Qualifying for FAMIS also depends on household income and family size. For your family size, count the number of people included on your federal taxes. If you don’t file taxes, count how many children and stepchildren under age 19 live in your home. Add yourself if you are the mother, father or stepparent of the children. Then add your husband or wife. For example, if you have 4 children and/or stepchildren under age 19 living in your home, plus yourself and your husband, your family size is 6. We determine eligibility based on monthly income. The current monthly income limit for a family of 6 is $5,566.

FAMIS Income Limits* (Gross Income) - Effective January 25, 2016
Family Size Monthly Yearly
Each Additional Family Member $712 $8,528
1
$2,030 $24,354
2
$2,737 $32,841
3
$3,444 $41,328
4
$4,152 $49,815
5
$4,859 $58,302
6
$5,566 $66,789
7
$6,276 $75,297
8
$6,986 $83,825

* Includes 5% standard disregard

To find out if your children may be eligible for FAMIS, answer the questions on the Eligibility Screening Tool on the Eligibility page.

How Do I Apply?

To find out if your children may qualify for FAMIS, answer the questions on the Screening Tool on the Am I Eligible? page. If, after using the Screening Tool, you think you may qualify for Medicaid, FAMIS, or Plan First, call Cover Virginia at 1-855-242-8282 or follow the instructions on the Apply page. For more information about how to appeal a decision, visit the Appeals page.

Renewal and Change-of-Address

FAMIS and FAMIS Plus must be renewed at least every 12 months. It is very important that you report any change in your address to the agency that is managing the case. If we do not have a correct address, we will not be able to notify you when it is time to renew coverage and the child will be cancelled from the program.

 
 
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