Medicaid appeals in Virginia: hearing deadline and keeping benefits
Virginia Medicaid (Cardinal Care) and FAMIS: you have 30 days to ask for a fair hearing.
You can ask to keep your coverage during the appeal if you file before the date coverage ends or within 10 days of the date on the notice.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Medicaid (Virginia Medicaid (Cardinal Care) and FAMIS) denials in Virginia
- Medicaid agency
Virginia Department of Medical Assistance Services (DMAS) and local departments of social services
- Who holds the hearing
DMAS Appeals Division
- Hearing deadline
30 days
The date you receive the written notice (presumed 5 days after mailing)
- If you are late
If you file after the deadline without a reason, DMAS sends you a letter asking for 'good cause', and a hearing officer decides whether to accept it. There is no good cause for late MCO appeals, which have a 120-day deadline that cannot be extended.
- Temporary rule
If you lost coverage for not completing a renewal or sending renewal verifications, you have 90 days after you lost coverage to return the renewal paperwork (this is a renewal step, not an appeal).
- How to ask for a hearing
- Online: DMAS Appeals Information Management System (AIMS) portal
- Email: Appeals@dmas.virginia.gov
- Fax: (804) 452-5454
- Phone: (804) 371-8488 (TTY 1-800-828-1120)
- Mail: Appeals Division, Department of Medical Assistance Services, 600 E. Broad Street, Richmond, VA 23219 (you can also bring it in person)
- Form: DMAS Client Appeal Request Form (or a letter)
- Mail address
Appeals Division, Department of Medical Assistance Services, 600 E. Broad Street, Richmond, VA 23219
- What to include
Your name, contact information, the date of the notice, and why you want to appeal.
- Keeping your benefits during the appeal
You can ask to keep your coverage during the appeal if you file before the date coverage ends or within 10 days of the date on the notice. You must ask for it; it is not automatic. If you lose, you may have to repay the cost of care received during that time.
Law: 42 CFR 431.230; 12VAC30-110-35, -100, -160
- Faster (expedited) hearing
You can ask for an expedited appeal if the normal 90-day timeline could jeopardize your life, health or ability to attain, maintain or regain maximum function. If DMAS grants it, the appeal is decided within 72 hours of receiving the request for service denials (including Medicaid managed care plan decisions), or within 7 business days for eligibility claims and some nursing facility claims.
Law: 12VAC30-110-35, -100, -160
Medicaid health plan (managed care) in Virginia
- Appeal to the plan first
If you are in a Medicaid managed care organization (MCO), you must first appeal to the MCO. If you disagree with the MCO's final decision, appeal to DMAS within 120 days of receiving it.
- Then a state hearing
120 days
The date you receive the MCO's final decision
- Late requests
The 120 days cannot be extended; there is no good cause for late MCO appeals.
Law: 12VAC30-110; 42 CFR 438.402
Write my appeal: free letters
Sources
The official sources for Virginia are listed on the Virginia page.