Medicaid plans › Virginia
Virginia Medicaid Managed-Care Plans for Providers
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
Virginia Medicaid (Cardinal Care) is run by the Virginia Department of Medical Assistance Services. 1,810,041 people were enrolled in its 5 managed-care plans in 2024. To see their patients, a provider enrolls with Virginia Medicaid (Cardinal Care) through the Provider Services Solution (PRSS) portal, then applies to each plan separately.
| Plan | Members (2024) | Share | Parent |
|---|---|---|---|
| Sentara Health Plans | 624,067 | 34.5% | In-state |
| Anthem Healthkeepers | 543,748 | 30% | Elevance Health |
| Aetna Better Health of Virginia | 271,844 | 15% | CVS Health |
| UnitedHealthcare | 233,958 | 12.9% | UnitedHealth Group |
| Molina Healthcare of Virginia | 136,424 | 7.5% | Molina Healthcare |
How Joining Works in Virginia
First the state: Virginia Medicaid (Cardinal Care) enrollment through the Provider Services Solution (PRSS) portal, which gives you the Medicaid ID every plan asks for. Then the plans: each takes its own participation request and credentials you from your CAQH ProView (DataSpring) profile. 4 parent companies run plans here, and plans owned by the same company still contract state by state.
How to Join Each Virginia Plan
Anthem Healthkeepers (Elevance Health): Elevance Health plans take participation requests through the plan's provider site for that state, most of them now inside Availity Essentials, and credential from your CAQH ProView (DataSpring) profile. Each state is its own contract.
Aetna Better Health of Virginia (CVS Health): Aetna Better Health plans each have a state-specific "Join our network" request on aetnabetterhealth.com. They are separate from Aetna's commercial network, so an Aetna commercial contract does not carry over.
UnitedHealthcare (UnitedHealth Group): UnitedHealthcare Community Plans use UnitedHealthcare's provider onboarding: a participation request on the UnitedHealthcare provider site, credentialing from your CAQH ProView (DataSpring) profile, then a state-specific Community Plan agreement.
Molina Healthcare of Virginia (Molina Healthcare): Molina credentials each state separately. The contract request goes through the state's Molina provider site and requires an active state Medicaid enrollment; credentialing uses your CAQH ProView (DataSpring) profile.
Sentara Health Plans: This plan is run in-state rather than by a national carrier, so participation requests go to the plan's own provider relations or contracting team, listed on its provider website.
Also in Virginia: Medicare, Virginia Medicaid (Cardinal Care) and commercial credentialing.
Questions
Which Virginia Medicaid plan is the largest?
Sentara Health Plans, with 624,067 members in 2024, 34.5% of the 1,810,041 people enrolled in Virginia's Medicaid managed-care plans.
Do I have to join every Virginia Medicaid plan?
No. Each plan is a separate contract. Practices usually start with the two or three largest plans in their county, then add others as patients ask for them. All of them require Virginia Medicaid (Cardinal Care) enrollment first.
Membership from KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Plans change when the state rebids its contracts; we confirm the current list on every file.