PRDC can help you determine if you are eligible and work with your county Department of Social Services to help get you and yours signed up. Once enrolled it is important you update your eligibility every six months as required in order to keep your benefits active.
Children enrolled in Virginia’s Smiles For Children program, the dental component of FAMIS, receive comprehensive dental care at no cost to their families. This can even include braces if they are medically necessary! Children are income eligible if they live in households at or below 205% of the Federal Poverty level. See the graph below for more information.
Children enrolled in Virginia’s Smiles For Children program, the dental component of FAMIS, receive comprehensive dental care at no cost to their families. This can even include braces if they are medically necessary!
Dental services for children enrolled in FAMIS or FAMIS Plus are provided through the Smiles For Children program. The Smiles For Children program encourages good dental health and recommends regular checkups with your child’s dentist.
There are no costs or co-payments for dental care services in the Smiles For Children program.
You should only use dental providers, like Piedmont Regional Dental Clinic, enrolled in the Smiles For Children network.
To access services, use your child’s Commonwealth of Virginia (blue and white) plastic ID card or MCO member card each time you visit the dentist.
The Smiles For Children program is managed by DentaQuest. All FAMIS and FAMIS Plus enrollees get a Smiles For Children member handbook. The member handbook explains your child’s dental benefits in more detail. A listing of all the Smiles For Children dental providers is also mailed to each enrolled family.
For questions or to find a dentist in your area, call Smiles For Children at 1-888-912-3456.
For information on how to apply, click here.
For Adult Pregnant Women:
Pregnant women are also eligible for comprehensive dental benefits on Medicaid! You are income eligible if your household income is at or below 148% of the federal poverty level (a pregnant woman counts as two people when applying for Medicaid, more if twins or triplets are diagnosed). See the chart below for more eligibility information. To receive these benefits you must enroll in Medicaid Pregnant Women’s program through your county DSS. Once your baby is born, you will need to enroll your newborn for coverage as well.
Dental services for pregnant women enrolled in Medicaid and FAMIS MOMS include:
X-rays and examinations
Gum related treatment
Crowns, bridges, partials and dentures Tooth extractions and other oral surgeries, and
Other appropriate general services
Orthodontic treatment is not included in the coverage.
Click here Adult Pregnant Women FAQs to learn more about Medicaid benefits for pregnant women or watch our video:
New Medicaid Coverage for Adults
Adults are eligible for Medicaid coverage if their household income is at or below 138% of the federal poverty level. See the chart below for more details. Benefits include dental coverage for extractions limited exams and x-rays. It is very important to choose/change your Managed Care Organization MCO) carefully because they offer very valuable, and varying, dental benefits in addition to what Medicaid offers.. You can change your MCO up to one time per year. Click here to see full FAQ’s and the differences in dental benefits for the different MCO’s.
Dual Enrolled Medicare/Medicaid CCC+
CCC+ members have the same income eligibility requirements and coverage as chidlren in the FAMIS program. But they have benefits offered by Managed Care Organizations very similiarly to adult coverage. Click here for more information on dental benefits offered by Managed Care Organizations in the CCC+ program.
Click on the chart or here
to see whether you qualify. Another good way is to use this free eligibility screening tool: http://coverva.org/screener_1r.cfm