Cardinal Care Managed Care (2024)

Virginia Medicaid

Overview

On October 1, 2023, Virginia Medicaid combined the two managed care programs of Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) into Cardinal Care Managed Care.

Cardinal Care Managed Care continues to offer members the same programs and services and does not reduce or change any existing coverage.Cardinal Care Managed Care also continues to partner with the same health plans to ensure we meet your health needs as they evolve.


Who Participates in Cardinal Care Managed Care?

Cardinal Care Managed Care serves the following Medicaid members:

  • Infants, children, or youth
  • Pregnant individuals
  • Medicaid expansion adults ages 19-64
  • Older adults
  • Children or adults with disabilities
  • Those who receive Medicare benefits and full Medicaid benefits (dual eligible members)
  • Those who receive Medicaid long-term services and supports (LTSS)

Frequently Asked Questions

FAQs from Cardinal Care Managed Care Members.

What is Cardinal Care?

Cardinal Care is a single system of health coverage for all Virginia Medicaid members. Cardinal Care connects members to the care they need when they need it and reduces transitions between programs as their health care needs change. All managed care and fee-for-service Medicaid members are part of the Cardinal Care program.

Cardinal Care Managed Care is the new name of Virginia's managed care program. On October 1, 2023, Virginia Medicaid combined its two existing managed care programs – Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) – into one program, eliminating the need for members to switch programs if their health care needs change. Care coordination is available to all members, as needed.

Does Cardinal Care affect my health plan?

Cardinal Care continues to offer members the same programs and services and does not reduce or change any existing coverage. Members can continue to receive the same benefits, see the same doctors and providers, and have access to the same health care services. Members may stay with their same health plan and continue to have the option to change their health plan once a year during open enrollment. Members in managed care do not need to take any action to enroll in Cardinal Care Managed Care.

If I receive a new Cardinal Care card, does that mean that my Medicaid coverage has automatically renewed?

No; you must continue to respond to all renewal and eligibility notices you receive from your local Department of Social Services (DSS) and the Department of Medical Assistance Services (DMAS). For more information, visit the Cover Virginia website.

What is a health plan?

A health plan is a network (group) of doctors, hospitals, clinics and other health care providers. They work together to meet your health care needs.

Can I change my health plan?

Yes. You can change your health plan in the first 90 days after you become a Cardinal Care Managed Care member. After 90 days, you can only change your plan during open enrollment. Open enrollment is based on your region and only once a year. At other times, you can change plans if you get approval from the Department of Medical Assistance Services.

What is a primary care provider (PCP)?

A PCP is a doctor, clinic or other provider you choose to manage your health care. Your PCP will get to know you and your health care needs. Your PCP will help you when you are sick or need a check-up and refer you to specialists when you need them.

What is care coordination / care management?

Learn more about the differences between care coordination and care management, how to get a care manager, and how your care manager can help you on the Care Management webpage.

Contact Information

Managed Care Helpline

Tel: 1-800-643-2273

Enrollment

Please visit
VirginiaManagedCare.com to choose a health plan or find more information.

Enroll

Member Handbook View the Cardinal Care Managed Care Model Member Handbook. Model Member Handbook
Cardinal Care Managed Care (2024)
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