LTSS Services
Virginia LTSS Services Overview
🏡 Long Term Services and Supports (LTSS)

If you're on a home and community-based waiver or living in a nursing facility, all Medicaid health plans in Virginia cover LTSS to help you live safely in your home or a setting of your choice.

  • Adult day health care
  • Assistive technology
  • Environmental modifications
  • Nursing facility or long-stay hospital care
  • Personal care and respite care
  • Personal emergency response system
  • Private duty nursing
  • Support for members transitioning from nursing facilities
  • Other medically necessary services
🧠 DD Waiver Members

If you're enrolled in a DD waiver, you'll also be enrolled in a Medicaid Health Plan for your non-waiver services. DMAS or a DMAS contractor will continue to pay for your DD waiver services.

🦷 Other Services Covered by DMAS
  • Dental care through Smiles for Children
  • School health services arranged by your child’s school
🎁 Added Benefits from Health Plans
  • Free phone services
  • Wellness programs
  • Transportation, vision, hearing, and more

👉 Compare and switch plans here

🧭 Tap-to-Access: Medicaid & CSB Directories

“Explore your waiver pathway, find your local CSB, or manage your Medicaid plan.”

📘 Virginia Medicaid & MCO Portals

📍 Find Your Local CSB by County

D-SNP Coverage Breakdown
🩺 Dual Eligible Special Needs Plan (D-SNP): Coordinated Medicare + Medicaid Support
🩺 What is a D-SNP?

A Dual Eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan for people who qualify for both Medicare and Medicaid. It helps coordinate your benefits under one health insurance company (MCO), often reducing costs and simplifying care.

  • ✅ No Medicare premiums or co-pays for doctor visits
  • ✅ Small co-pays for prescriptions
  • ✅ One MCO handles both Medicare and Medicaid

This alignment is called Exclusively Aligned Enrollment.

🛡️ What does Virginia Medicaid cover?
  • 🏠 CCC+ and DD Waivers (FIS, BI, CL)
  • 👩‍⚕️ Consumer-Directed Personal Care
  • 🧑‍🦽 Long-Term Services & Supports
  • 🚗 Transportation to appointments
  • 🍼 Full coverage for children and pregnant members

Waiver services are Medicaid-only and support daily living.

🔗 How do Medicare & Medicaid work together?
  • Medicare pays first for covered services
  • Medicaid may cover co-pays and deductibles
  • Waiver services are not covered by Medicare
  • D-SNP plans help coordinate both lanes under one MCO

This dual coordination helps reduce confusion and improve care.

🔄 Transitioning from Fee-for-Service to CCC+ Waiver: What Families Need to Know

“One path closes, another opens—with care, clarity, and choice.”

Step 1: Confirm Medicaid Eligibility

If your child is already on Medicaid, you're eligible to be screened for CCC+ Waiver services. No new financial application is needed.

Step 2: Request a Screening

Contact your local Department of Social Services or Health Department. A social worker and nurse will assess your child’s medical or nursing needs.

Step 3: Apply or Update Medicaid

Visit CommonHelp.virginia.gov or call 1-833-522-5582. TDD: 1-888-221-1590.

Step 4: Submit Appendix D

Ask DSS for the Appendix D form—it’s required to begin long-term services and supports under CCC+.

Step 5: Choose a CCC+ Health Plan

Once approved, you’ll select a CCC+ Health Plan and begin services like personal care, respite, and assistive technology. A care coordinator will guide your family.

📬 Contact & Support

CCC+ Waiver Questions: cccpluswaiver@dmas.virginia.gov

Consumer-Directed Services: cdsf@dmas.virginia.gov

Full CCC+ Overview: DMAS CCC+ Waiver Page

🧒 EPSDT vs CCC+ Waiver: Medicaid Pathways for Children Under 18

“Every child deserves care that grows with them—whether it’s early screenings or long-term support.”

What is EPSDT?

EPSDT stands for Early and Periodic Screening, Diagnosis, and Treatment. It’s a federal Medicaid benefit for children under 21 that guarantees access to medically necessary care—even if it’s not typically covered by Medicaid.

Includes well-child visits, therapies, dental, vision, mental health, and more.

Automatic: No separate application. Begins with Medicaid enrollment.

DMAS EPSDT Page

What is the CCC+ Waiver?

CCC+ Waiver provides long-term supports for children with medical or nursing needs. It helps families avoid institutional care by offering personal care, respite, assistive tech, and more.

Requires: LTSS screening + Appendix D form.

DMAS CCC+ Waiver Page

Can EPSDT and CCC+ Work Together?

Yes! A child enrolled in CCC+ still receives EPSDT benefits. CCC+ adds wraparound supports like personal care and respite, while EPSDT continues to cover therapies, screenings, and medically necessary treatments.

How to Enroll

EPSDT: Begins automatically with Medicaid enrollment. No extra steps.

CCC+ Waiver: Families request a screening from their local Department of Social Services or Health Department.

Once approved, they choose a CCC+ Health Plan and begin services.

Appendix D: Required for CCC+ enrollment. DSS staff can assist.

📬 Contact & Support

Cover Virginia Helpline: 1-855-242-8282 (TDD: 1-888-221-1590)

Consumer-Directed Services: cdsf@dmas.virginia.gov

Waiver Fact Sheet: Virginia Medicaid Waiver Programs PDF

🛠️ CCC+ Waiver Approved but Not Showing: What Families Can Do

“You’ve done everything right—now let’s help the system catch up.”

Step 1: Call Cover Virginia

Call 1-855-242-8282 (TDD: 1-888-221-1590)

Say: “I was approved for the CCC+ Waiver, but it’s not showing in Medicaid yet. Can you check the status?”

Have your Medicaid ID ready.

Step 2: Call Your Health Plan

Call the number on your Medicaid card and ask for the care coordinator.

Say: “We were told the CCC+ Waiver was approved, but it’s not showing in your system yet. Can you check if DMAS has sent the update?”

Step 3: Email the Waiver Team

Email cccpluswaiver@dmas.virginia.gov

Include your Medicaid ID, the date of the screening, and the name of your DSS worker.

Subject line: “CCC+ Waiver Approved – Not Showing in Medicaid or MCO”

Step 4: Follow Up with DSS

Call your local DSS office and ask: “Has my waiver been uploaded to the Medicaid system?”

If needed, ask them to resend the Appendix D or escalate the case.

📬 Need Help?

Cover Virginia: 1-855-242-8282

Waiver Support: cccpluswaiver@dmas.virginia.gov

Consumer-Directed Services: cdsf@dmas.virginia.gov

🫂 Group Homes in Virginia: Support, Choice, and Clarity
🏡 What Are Group Homes?

Group homes are shared living environments designed for individuals who benefit from daily support, structured routines, and team-based care. They offer safety, stability, and community while honoring each resident’s dignity and preferences.

Some homes specialize in behavioral health, others in developmental support or trauma-informed care. Most are staffed 24/7 and accept residents based on their Tier level and care needs.

🔍 How to Choose a Group Home
  • What to look for: Staff credentials, home environment, Tier acceptance
  • Questions to ask: What’s the daily routine? How is care personalized?
  • Virtual walkthroughs: Ask for a video tour or photo gallery

📊 Understanding Tier 1–4

  • Tier 1: Mild support needs
  • Tier 2: Moderate support needs
  • Tier 3: Moderate + some behavioral challenges
  • Tier 4: High medical or behavioral support needs

These tiers help match individuals to homes that meet their support level.

🌟 Virginia Residential & Therapeutic Services – N. Chesterfield

2 openings available at Jasmine Mayton’s group home in North Chesterfield. Trauma-informed, Tier 1–4 inclusive, and family-centered. Welcomes individuals seeking structured support and community-based care.

🌱 Independent Living Starts Here: Leaving Nursing Homes with Support and Choice
🏠 Money Follows the Person (MFP)

Helps individuals transition from nursing homes into private homes or family settings. Supports include housing setup, care coordination, and Medicaid-funded services that center your independence.

🔗 Learn more from DMAS
🌟 Centers for Independent Living (CILs)

Peer-led organizations offering transition support, skills training, and advocacy for individuals seeking independent, community-based living.

🔗 Find your local CIL
👵 Area Agencies on Aging (AAA)

Regional support for older adults and individuals with disabilities. Services include housing coordination, care planning, and connections to independent living resources.

🔗 Locate your AAA
🏡 Housing Choice Vouchers (HUD)

Rental assistance for individuals transitioning out of nursing homes into private residences. Vouchers help cover housing costs in community-based settings.

🔗 Explore HUD’s Voucher Program
🔍 Easy Access Virginia

A statewide portal for disability services, housing, and independent living supports. Designed to help individuals and families navigate resources with clarity and ease.

🔗 Visit Easy Access Virginia
🏡 Sponsored Residential Services in Virginia
🏠 What Are Sponsored Residential Services?

Sponsored Residential Services offer a home-like setting for individuals who need daily support. Instead of living in a facility, patients live with a trained provider in their private home—receiving care, structure, and emotional connection in a family-style environment.

These homes are part of Virginia’s Medicaid Waiver system and are available to individuals with developmental disabilities, behavioral health needs, or medical conditions that require consistent support.

🔗 Explore Sponsored Homes on My Life, My Community
🔍 How to Choose a Sponsored Home
  • Ask about: Provider training, daily routines, Tier acceptance
  • Visit the home: Look for warmth, safety, and personalized touches
  • Request a walkthrough: Photos, videos, or virtual tours can help
  • Talk to the provider: Ask how they support autonomy and emotional needs

📊 Tier Overview

  • Tier 1: Mild support needs
  • Tier 2: Moderate support needs
  • Tier 3: Moderate + behavioral support
  • Tier 4: Intensive medical or behavioral support

Sponsored homes often specialize in one or more tiers. Matching is key to comfort and success.

🚐 Transportation Services: Getting There with Dignity

“Every appointment, every outing—made possible with care.”

  1. Who: Medicaid-enrolled individuals receiving waiver services
  2. What: Coordination of non-emergency medical transportation (NEMT)
  3. When: Weekdays 8:00 AM–6:00 PM, with urgent support available
  4. Where: All active corridors—urban, rural, and transitional zones
  5. How: Verified eligibility, scheduled rides, bilingual follow-through, and warm documentation

🤝 Working Together for DD & CCC+ Waiver Success

“Families thrive when systems align. Here's how we walk together.”

  1. CSBs (Community Services Boards): Gatekeepers for DD waiver eligibility, crisis support, and regional coordination. They initiate waiver screenings and authorize services.
  2. MCOs (Managed Care Organizations): Medicaid health plans that fund and approve CCC+ waiver services. They manage transportation, authorizations, and care coordination.
  3. Service Facilitators: Credentialed advocates who guide families through enrollment, documentation, and ongoing support. We ensure services are person-centered and compliant.
  • ✅ CSBs screen and refer families to waiver pathways
  • ✅ MCOs authorize services and coordinate Medicaid benefits
  • ✅ Service Facilitators ensure families receive timely, dignified support
  • ✅ All three collaborate to uphold choice, safety, and emotional resonance

📍 Find Your Local CSB by County

Tap below to locate your CSB and begin DD waiver screening: