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How Cardinal Care plans say members can access benefits, get help finding providers and use dental/vision services
Summary
Representatives from Aetna, Anthem, Humana, Sentara and UnitedHealthcare described enhanced benefits, care coordination and how members can find providers, report grievances and access carved‑out dental and vision programs.
Representatives from the five managed care organizations participating in Cardinal Care briefed members on value‑added benefits, care management, behavioral health resources and how to find in‑network providers during a DMAS member session.
Plan offerings and value‑adds: each MCO described enhanced benefits beyond core Medicaid services, including transportation, food or grocery cards, GED support, devices or data plans, maternity and postpartum programs, and dedicated programs for justice‑involved members and those with complex behavioral‑health needs. Aetna described maternity care managers assigned through 12 months postpartum; Anthem highlighted care teams and peer support specialists; Sentara emphasized school liaison and diabetes/asthma supports; Humana highlighted a prevention and PERS (personal emergency response system) offering; UnitedHealthcare described OnePath Fitness, diaper rewards and housing application assistance.
Finding providers and network adequacy: members repeatedly asked how to find in‑network providers. Plans advised members to use the Virginia Cardinal Care app, the managed care website or the plan’s provider finder tools and member services lines. Several members raised concerns about provider shortages on Virginia’s Eastern Shore. Plan representatives said they continuously monitor networks and are actively recruiting providers in underserved areas; they also noted telehealth and doctor‑chat services as supplemental options.
Dental and vision services: speakers clarified that dental services under Cardinal Care are administered through the statewide Cardinal Care Smiles dental program; sentiment in the session was that dental access waits can be long and that more dentist contracting is needed. UnitedHealthcare named March Vision Care as its vision vendor; other plans referenced VSP or EyeMed for vision coverage and said members should check the back of their ID card, plan handbooks or plan web pages for vendor‑specific guidance.
Behavioral health and care coordination: plans emphasized care management and behavioral health supports. Sentara described programs for adolescents and transition‑age youth and a Virginia youth‑to‑adult resource; Aetna highlighted MDLIVE virtual behavioral health and programs for justice‑involved members; Anthem noted preferred behavioral health providers and digital mental health toolkits. Plans said member services teams and assigned care managers can help expedite access, make referrals and request out‑of‑network authorizations when necessary.
How to get help: DMAS and plan speakers directed members to the Virginia Cardinal Care app, virginiamanagedcare.com, plan member services lines, and the MAXIMUS enrollment broker for enrollment and provider network questions. DMAS reiterated that local departments of social services manage eligibility and renewals but cannot resolve MCO network or coverage questions; those are handled by the health plans.
Ending: plan representatives encouraged members to contact member services or care managers for difficult provider searches, to file grievances or appeals through plan processes, and to consult plan handbooks and the DMAS Cardinal Care web pages for authoritative contacts and details.
