Virginia Medicaid Plan for Adults - Plan First

Plan First

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Zip Code23464
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Program Details

What is Plan First?

Plan First is Virginia's limited benefit family planning insurance program that pays for birth control and family planning services for women and men who do not qualify for a full-benefit Medicaid program. Plan First is a limited coverage program and not considered full coverage Medicaid.

Who is it for?

Medicaid,Adults

Who is Eligible?

Men and women may be eligible if they: Are not eligible for full benefits through Medicaid or FAMIS; Are US citizens or legally-residing immigrants; Live in Virginia; Meet the monthly income limits. Please visit www.planfirst.org for current income limits.
If you are under the age of 19 or pregnant, you may be eligible for full benefits through Medicaid or FAMIS. You can have other private insurance and still be eligible for Plan First. Visit www.planfirst.org for more inofrmation.

What is Covered?

Plan First covers:

  • Yearly physical exams for family planning (birth control) purposes, including PAP test (if appropriate), Sexually Transmitted Infection (STI) testing;
  • Family planning education & counseling;
  • Birth control methods provided by a doctor or obtained with a prescription such as contraceptive implants, ring, patch, IUDs, birth control pills, diaphragms, Depo Provera, and condoms;
  • Sterilization (tubal ligations, Essure and vasectomies), if that is your choice; and
  • Non-Emergency transportation to family planning services.*IUDs, implants and Depo Provera must be provided by the doctor.

What is not Covered?

Plan First does not pay for:

  • Exams for women/men who no longer need or want pregnancy prevention services
  • Treatment for medical problems, including STIs or other reproductive health problems
  • Repeat Pap tests due to a problem or Pap tests for women who do not need birth control
  • Pharmacy, except for family planning purposes as noted above
  • Vaccinations
  • Hysterectomies
  • Mammograms
  • Infertility treatments
  • Abortions
  • Emergency transportation -- ground or air ambulance

How much is it?

If you become sick or need help for preventive care or other medical conditions not related to family planning, you will have to pay for the costs of seeing a doctor and/or getting treatment. Low cost or no cost providers may include: Community Health Centers that provide medical care for a fee based on your income, Free Clinics and/or local Health Departments.

How to Apply?

  • Apply online at www.coverva.org
  • Call Cover Virginia toll free at 1-(855)242-8282 to apply on the phone; or
  • Visit your local Department of Social Services in the city or county in which you live.
You will be evaluated for full Medicaid or FAMIS benefits. If you are not eligible for full benefits, you will then be evaluated for Plan First. If you are not in need of birth control, or no longer wish to participate in Plan First, contact your eligibility worker at your local Department of Social Services.

Will I have to pay co-payments?

Plan First does not charge a co-payment for covered family planningservices.

Income and Resource Requirements

Qualifying for Plan First 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.

What if I have other medical insurance or other health coverage?

You can still be eligible for Plan First if you already have health insurance. The other insurance will be billedbefore Plan First, but Plan First will pay for covered services if the other insurance does not.

Physicians that accept medicaid assignment

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TRENT, CYNTHIA
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RIPOLL, IGNACIO
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LADERBERG, STEVEN
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CHUCKER, INGRID
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WALMART PHARMACY 10-6226
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CVS PHARMACY #05802
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ROSENBLUM, LEVIN, BARNEY & HASTY, LTD
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KEN J TOMPKINS MD PC
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OAKWOOD NURSING & REHABILITATION CENTER
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YATES, KELLEY
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FARM FRESH PHARMACY
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ARRINGTON, ELIZABETH
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JACQUELINE B SMITH DDS PLLC
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JAMES T SAUNDERS MD PC
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VIRGINIA BEACH DERMATOLOGY ASSOCIATES PLLC
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HARRIS TEETER PHARMACY #350
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PROM, SAUNORA
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DUDDING, LEIGH
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JAMES, SALLY
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SMITH, JACQUELINE
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ELBESHBESHY, TAREK
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FARM FRESH PHARMACY
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ROBERTS, BEVERLY
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RITE AID PHARMACY 11273
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RITE AID PHARMACY 11275
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CYNTHIA TRENT, CPNP, AE-C
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  • Phone Number
    (757) 523-4589
  • Office Locations
    1212 LAKE JAMES DR
    VIRGINIA BEACH, VA 23464
1212 LAKE JAMES DR VIRGINIA BEACH VA, 23464

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