Where to check your Virginia Medicaid status

You can check your Virginia Medicaid status through the VDSS (Virginia Department of Social Services) online portal, by phone, or in person at your local department of social services office. The online portal is the fastest option if you have your case number or Social Security number handy.

To use the online portal, go to www.dss.virginia.gov and look for the section labeled "Check Your Case Status" or "My Account." You will need to log in with your username and password. If you do not have an account, you can create one using your Social Security number and other identifying information. The portal shows your current coverage status, what programs you are enrolled in, and any pending decisions on your case.

If you prefer to call, contact the Virginia Medicaid Customer Service line at 1-866-873-6227. Have your case number or Social Security number ready. Wait times vary by time of day, but calling early in the morning typically means shorter holds. The line is open Monday through Friday, 8 a.m. to 5 p.m. Eastern time.

Key Takeaways

  • The VDSS online portal at www.dss.virginia.gov is the fastest way to check your status and shows your current coverage, enrolled programs, and pending decisions.
  • You can call Virginia Medicaid Customer Service at 1-866-873-6227 Monday through Friday, 8 a.m. to 5 p.m., if you do not have internet access or prefer to speak with someone.
  • Your local department of social services office can also look up your status in person, and staff can answer questions about your specific case.
  • You will need either your case number or Social Security number to check your status through any method.
  • If your status shows a pending decision, the portal or customer service line can tell you what documents VDSS is waiting for from you.

What information you need to check your status

Before you log in or call, gather one of these pieces of information: your Medicaid case number (printed on your Medicaid card or in any letter from VDSS), your Social Security number, or your date of birth and last name. Having your case number is fastest because the system will pull up your file immediately.

If you have lost your case number, you can still use your Social Security number or your name and date of birth. The system will search for your account and display your status. If you have moved recently or changed your name, make sure the information you provide matches what VDSS has on file, or the search may not find your case.

Understanding what your status means

When you check your status, you will see one of several possible outcomes. "Active" means you are currently enrolled in Medicaid and your coverage is in effect. "Pending" means VDSS is reviewing your case and has not yet made a decision; the portal will usually show what documents they are waiting for. "Denied" means your request was not approved, and you should see a reason on the screen or in a letter that arrived by mail.

"Closed" means your Medicaid coverage has ended. This can happen if your income increased above the limit, you did not renew your coverage, you moved out of Virginia, or you no longer meet other program rules. If your case is closed and you think it was a mistake, you can request a hearing or reopen your case by contacting your local office.

"Suspended" is less common and usually means VDSS needs more information from you before they can continue your coverage. Check the details on the portal or call customer service to find out what is needed and how to send it in.

What to do if your status shows "pending"

A pending status means your case is still being reviewed. The portal will list the documents or information VDSS needs from you. Common requests include proof of income (recent pay stubs or tax returns), proof of citizenship or legal residency, proof of Virginia residency (utility bill or lease), or verification of household members.

Send the requested documents as soon as possible through the method VDSS specifies—usually by mail, fax, or through your online account. Keep copies for your records and note the date you sent them. If you do not send the documents by the deadline shown on the portal or in your letter, your case may be closed without a decision.

If you are unsure what documents to send or how to send them, call customer service at 1-866-873-6227 and ask them to explain. They can also tell you how long the review usually takes, though this varies depending on how busy the office is and how complete your application is.

How to find your local department of social services office

If you want to check your status in person or need help with your case, you can visit your local VDSS office. To find the office nearest you, go to www.dss.virginia.gov, click "Find Your Local Office," and enter your city or zip code. The website will show you the address, phone number, and hours of operation.

Many offices now require you to make an appointment before you visit, especially since the COVID-19 pandemic. Call ahead or check the office's page on the VDSS website to see if you need an appointment. Bring your case number or Social Security number, and bring any documents related to your case if you are there to discuss a specific issue.

What to do if you cannot find your case or status

If the online portal does not find your case, or if you get an error message, try these steps: first, double-check that you are using the correct information (case number, Social Security number, or name and date of birth exactly as VDSS has it on file). Spelling errors or mismatched information will cause the search to fail.

If you recently applied for Medicaid, your case may not yet be in the system. New applications typically take 30 to 45 days to process, so if you applied fewer than 30 days ago, check back later. If you applied more than 45 days ago and still cannot find your case, call customer service to ask whether your application was received and where it stands.

If you have moved to Virginia from another state, your old Medicaid case from your previous state will not show up in the Virginia system. You will need to apply for Virginia Medicaid separately. Contact your local VDSS office or call 1-866-873-6227 to start a new application.

How to request a hearing if you disagree with your status

If your case was denied or closed and you believe the decision was wrong, you have the right to request a hearing. You must request it within 30 days of the date on the letter VDSS sent you. To request a hearing, call 1-866-873-6227 or contact your local VDSS office in writing.

At the hearing, you can present documents and explain why you believe the decision was incorrect. You can bring someone to help you, such as a family member, friend, or legal advocate. The hearing is conducted by an independent hearing officer who will review your case and make a new decision. This process usually takes several weeks.

Frequently Asked Questions

How often should I check my Medicaid status?

Check your status at least once a year, especially if your income, household size, or living situation has changed. If VDSS sends you a renewal notice, check your status right away to make sure you understand what documents they need. Some people check monthly to stay on top of any changes.

What if the portal says I need to renew but I already sent in my renewal?

VDSS may not have processed your renewal yet. Call customer service at 1-866-873-6227 and tell them you sent in your renewal. They can check whether they received it and when they expect to process it. If they did not receive it, ask what documents they need and how to send them again.

Can I check someone else's Medicaid status?

No, you can only check the status of your own case through the online portal or by phone. If you are a parent or guardian checking on a child's coverage, you will need to log in with your own account or call and provide your relationship to the person. VDSS staff can discuss a child's case with a parent or legal guardian.

What does it mean if my status changed from active to closed without warning?

VDSS may have closed your case because your income increased, you did not respond to a renewal notice, or they could not verify your information. Check your mail for a letter explaining the closure. If you did not receive a letter or disagree with the closure, call customer service right away to find out why and whether you can reopen your case.

Is there a way to get alerts when my status changes?

The online portal does not currently send automatic alerts, but you can check your status regularly by logging in. Some people set a monthly reminder on their phone to check. If you prefer phone contact, call customer service and ask whether they can add a note to your file requesting that they call you if your status changes.