Medicaid

Benefits for INTotal Health Members

INTotal Health serves more than 60,000 Medicaid members in the state of Virginia and offers a wide range of standard and value-added benefits. In addition to the videos above, you can also click the link below to read about our Value-Added INTotal Health Benefits, services covered by DMAS/Fee-for-service (FFS) Medicaid, services excluded from the managed care program, and benefits and services not offered by INTotal Health or Medicaid. Click here.
 

Services Obtained Outside of INTotal Health's System or Service Area

INTotal Health has many in-network doctors who give care to our members. If you need help finding an in-network doctor or want to confirm that your doctor is in INTotal Health’s network, please call Member Services at 1.855.323.5588 or visit our Find a Doctor tool at http://intotalhealth.prismisp.com/​.
 
Please read:
All out-of-network providers require a pre-authorization before giving services.
 
What is Out-of-Network Coverage?
Out-of-network coverage is when you go to a doctor who is not with INTotal Health. If you go to an out-of-network doctor, they may ask you to sign a waiver document. By signing this document, you may be at risk for paying for that service, especially if pre-authorization was not given to the doctor. If a pre-authorization was not given and if you receive nonemergent services from an out-of-network doctor, you may have to pay for that service. If you have questions, please call Member Services at 1.855.323.5588.

Information about Copayments and Other Charges for Which You are Responsible​

The following list (click link below) shows the healthcare services and benefits that members can get through INTotal Health. Your Primary Care Provider (PCP) or specialist will give you the care you need or refer you to a specialist that can give you the care you need. In some cases, your PCP or specialist may need to get preauthorization from INTotal Health before you can receive these services. Your PCP can call 1.855.323.5588 to do this. No copayments are required for any Medicaid covered service. 

For a few special INTotal Health benefits, members have to be a certain age or have a certain kind of health problem. If you have a question or are not sure whether we cover a certain benefit, you can call Member Services for help at 1.855.323.5588. If your benefits change for any reason, we will tell you about the change before it happens. Below is a list of the services that are covered by INTotal Health. 

Click here for list of INTotal Health Covered Services

How INTotal Evaluates New Technology for Inclusion

We constantly look at new medical advances and treatments to see if they can improve your covered benefits. Working with providers like yours, we look at scientific literature and government reviews to help decide whether these new medical advances and treatments are safe and helpful. If they have equal or better outcomes than the current covered benefit treatment or therapy, we may include them in your covered benefits.