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Care You Can Count On at Home
Eden Home Health Care helps individuals and families explore dependable in-home support based on their needs, schedule, eligibility, and service availability. Complete the secure form and our team will contact you to discuss the next steps.
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✓Personal care and companion support
✓Family-centered care planning
✓Insurance and eligibility guidance
✓Flexible scheduling based on availability
✓Respectful and dependable caregivers
✓Clear communication throughout the intake process
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Virginia Medicaid and Cardinal Care education: managed care, fee-for-service, LTSS, personal care, respite, authorization, appeals, health plans, and transportation concepts — without inventing Eden network or NEMT status.
Virginia families, Medicaid members, caregivers, and professionals asking how coverage, plans, and authorization work.
What is not automatically guaranteed
The existence of a Virginia Medicaid plan does not mean Eden is contracted or in-network with that plan. Contact Eden to verify current network participation for a specific member, service, and location. Nothing here guarantees eligibility, hours, a ride, or payment.
Step-by-step process
1
Confirm Medicaid or FAMIS enrollment
Cardinal Care includes managed-care and fee-for-service members. Enrollment is not the same as authorized personal care.
2
Identify the payer path
Managed-care members usually work with an MCO. Fee-for-service members follow DMAS processes.
3
Assessment if required
LTSS personal care and respite often need an assessment and plan of care. A nurse does not automatically visit every request.
4
Service authorization
The payer approves the service type, units, and period. Eden does not approve hours.
5
Scheduling after a decision
Only authorized services can be scheduled, and only when staffing is available.
Limitations
The existence of a Virginia Medicaid plan does not mean Eden is contracted or in-network with that plan. Contact Eden to verify current network participation for a specific member, service, and location. Nothing here guarantees eligibility, hours, a ride, or payment. Eden educational resources are not a substitute for official Medicaid, waiver, or health-plan determinations. Rules vary by program, assessment, authorization, and plan. Confirm current details with DMAS, your MCO, and Eden intake.
Important definitions
Short definitions used on this page. Program manuals may phrase lists slightly differently.
Cardinal Care: Virginia's Medicaid and FAMIS program brand. All Medicaid managed-care and fee-for-service members are part of Cardinal Care.
Cardinal Care Managed Care (CCMC): Virginia's current Medicaid managed-care program, effective July 1, 2025. It combined the historic CCC Plus managed-care and Medallion 4.0 programs. Do not confuse CCMC with the CCC Plus Waiver.
MCO: Managed Care Organization — the health plan that coordinates covered services for many Cardinal Care members.
LTSS: Long-Term Services and Supports — including personal care, respite, adult day health, and related community services when authorized.
FFS: Fee-for-service — Medicaid coverage administered by DMAS rather than an MCO. Some members remain in FFS; most are in managed care.
Service authorization / prior authorization: The payer's approval of a specific service, amount, and period. Authorization is not the same as Medicaid eligibility or waiver enrollment.
Appeal: A request to review a coverage decision such as a denial, reduction, or termination. Deadlines come from the official notice.
Plain-English summary
Virginia Medicaid and Cardinal Care education: managed care, fee-for-service, LTSS, personal care, respite, authorization, appeals, health plans, and transportation concepts — without inventing Eden network or NEMT status.
Virginia Medicaid overview
Virginia Medicaid and FAMIS are branded Cardinal Care. Members may receive services through Cardinal Care Managed Care or fee-for-service. Having a Medicaid card does not start home care, approve hours, or prove a specific provider is in-network.
Cardinal Care
Cardinal Care connects members to covered services as needs change. All managed-care and fee-for-service Medicaid and FAMIS members are part of Cardinal Care. Program enhancements that began July 1, 2025 did not, by themselves, reduce existing covered benefits for eligible members.
Cardinal Care Managed Care
As of July 1, 2025, DMAS lists five statewide managed-care plans: Aetna Better Health of Virginia; Anthem HealthKeepers Plus; Humana Healthy Horizons of Virginia; Sentara Health Plans; UnitedHealthcare of the Mid-Atlantic, Inc. (UnitedHealthcare Community Plan). Anthem HealthKeepers Plus also administers the statewide Foster Care Specialty Plan. Members compare plans through the official enrollment broker at virginiamanagedcare.com or the Virginia Cardinal Care app.
Fee-for-service
Some members remain in fee-for-service (FFS), where DMAS — not an MCO — administers many coverage decisions. Authorization, transportation, and appeals follow DMAS processes rather than a health-plan handbook.
Long-Term Services and Supports / LTSS
LTSS can include personal care, respite, adult day health, and related community supports when the member is eligible and the service is authorized. LTSS is not automatic with Medicaid enrollment.
Personal care
Personal care (sometimes personal assistance) helps with authorized ADLs and, when the program allows, certain IADLs. Coverage requires eligibility plus service authorization. See the Personal Care guide for ADLs, bathing, dressing, and related tasks.
Respite
Respite is temporary relief for an unpaid primary caregiver. It is a different service from the member's personal care and has its own authorization rules.
Family caregivers
A parent or spouse is not automatically a paid caregiver. Virginia LRI rules apply only in defined relationships and only when extraordinary ADL-focused care is authorized.
Agency-directed and consumer-directed services
Agency-directed: a licensed agency is the employer. Consumer-directed: the member or representative is the employer of record, often with a services facilitator. Eden's typical public role is agency-directed care.
Assessments and plan of care
Depending on the program, an assessment documents needs. A plan of care lists authorized supports. Caregivers should not perform tasks the plan does not authorize.
Service authorization and prior authorization
Authorization is the payer's approval of a service, amount, and period. Prior authorization, when required, happens before the service is billed. Timelines are program-specific; this page does not invent a statewide approval clock.
How service hours are determined
Requested, assessed, authorized, scheduled, and EVV-verified hours can all differ. Who approves care: the MCO for most managed-care members, or DMAS in fee-for-service. Eden does not decide Medicaid hours.
Eden does not set your hours
Families sometimes hear a universal hour number. Unless a current official source states a figure for that exact program, treat hour amounts as unauthorized guesses.
Reassessment and renewal
Needs and eligibility can be reviewed later. Missing a Medicaid renewal or redetermination can interrupt services even if the person's needs did not change. Use official DMAS or plan instructions for deadlines.
Denials, appeals, and grievances
A denial, reduction, or termination notice should explain appeal rights. An appeal challenges a coverage decision. A grievance is a complaint about quality or customer service. Members may later have a path to a state fair hearing. This is education, not legal advice.
Care coordination and changing plans
Plan care coordinators help members use covered benefits. Changing health plans is generally allowed during open enrollment or other official change periods published by DMAS / the enrollment broker. Continuity-of-care rules, if any, are time-limited.
Member ID information
The name on the card, member ID, and plan phone number are the starting point for member services. Do not post member IDs in chat or email this website.
Finding providers
Use the official enrollment broker provider search and the plan directory. A plan existing on the DMAS roster does not mean Eden participates with that plan for a specific service.
Understanding Medicaid transportation
Virginia Medicaid may offer non-emergency medical transportation (NEMT) through managed-care or fee-for-service pathways. A plan or transportation broker — not Eden — typically arranges Medicaid-paid rides. Reservation, eligibility, and approval rules belong to DMAS or the member's plan. Eden does not advertise itself as a Medicaid transportation provider or NEMT provider on this page, and does not guarantee ride approval, trip assignment, coverage, reimbursement, or availability.
Two different transportation ideas
Eden Transportation assistance (when offered as an Eden service) is not the same as Medicaid-paid NEMT. Confirm which path applies before assuming a ride is covered.
Common Medicaid terminology
MCO, LTSS, FFS, CCMC, service authorization, plan of care, EVV, appeal, grievance, LRI, agency-directed, and consumer-directed are defined in the glossary. Cardinal Care is the program brand; Cardinal Care Managed Care is the current managed-care program; the CCC Plus Waiver is a separate waiver name.
Eden participation / network status
The existence of a Virginia Medicaid plan does not mean Eden is contracted or in-network with that plan. Contact Eden to verify current network participation for a specific member, service, and location. Coverage and network participation depend on the member's plan and current provider-network status. Contact Eden for verification.
Historical Molina note
HISTORICAL ONLY. Molina is not on the current DMAS Cardinal Care Managed Care roster. DMAS moved remaining Molina members to Humana Healthy Horizons of Virginia effective July 1, 2025.
Not a current plan
Do not treat Molina as a current Virginia Medicaid MCO.
Important limitations
Eden educational resources are not a substitute for official Medicaid, waiver, or health-plan determinations. Rules vary by program, assessment, authorization, and plan. Confirm current details with DMAS, your MCO, and Eden intake.
Eligibility and applicability
Program rules, assessments, and payer authorization decide what can start. Medicaid enrollment, waiver enrollment, service eligibility, service authorization, and authorized hours are not the same status.
Assessment and documentation
Depending on the program and service, an assessment and supporting documentation may be required. A nurse does not automatically visit first for every request.
Authorization and approval
When authorization is required, the payer or MCO reviews the requested service and hours. Outcomes can include approval, partial approval, a request for more information, or denial. Eden does not approve the benefit.
Hours and limits
Requested, assessed, authorized, scheduled, and EVV-verified hours can all differ. This site does not invent a universal hour number.
How services can interact
Personal care, respite, companion, adult day, and transportation follow separate rules. A plan may authorize one, more than one, or none.
Family caregiver implications
A parent or spouse is not automatically a paid caregiver. Virginia LRI rules apply only in defined relationships and only when the current official policy and authorization allow it.
Agency-directed vs consumer-directed
Agency-directed: a licensed agency is the employer. Consumer-directed: the member or representative is the employer of record, with services-facilitator support where the waiver allows. Eden's typical public role is agency-directed care.
Insurance and MCO implications
Managed-care members usually follow their plan's authorization and appeal process. Fee-for-service members follow DMAS processes. A plan existing on the official roster does not mean Eden is in-network.
Current Cardinal Care health plans
Independently verified from the official DMAS Cardinal Care members page as of September 2, 2026. This is educational plan information, not a ranking and not a claim that Eden is in-network with every plan.
The existence of a Virginia Medicaid plan does not mean Eden is contracted or in-network with that plan. Contact Eden to verify current network participation for a specific member, service, and location.
Cardinal Care Managed Care members enrolled with this plan. Confirm the legal plan name printed on the member ID card.
Member support overview
Use the member ID card and the plan's official Virginia site for current member services numbers. Do not rely on a third-party blog for phone numbers.
Care coordination
Plan care coordinators help members use covered benefits. They do not replace service-authorization rules or Eden's scheduling process.
Personal care / respite pathway
Personal care and respite, when covered, usually need the plan's LTSS authorization and an authorized plan of care. Hours are a payer decision.
Authorization pathway
Personal care, respite, and other LTSS usually require the plan's service authorization process when the member is in managed care. Eden can help assemble documentation; the plan makes the coverage decision.
Transportation pathway
Medicaid-paid non-emergency transportation, if covered, is arranged through the plan's transportation program or broker — not by treating Eden as an NEMT provider.
Official member resources
Use the plan's official Virginia member site and the DMAS enrollment broker for current handbooks and phone numbers. Plan site
Official provider resources
Provider manuals and directories are published by the plan. Do not rely on a marketing blog. DMAS roster
What Eden can help with
Help a family match the card name to a public plan, gather intake facts, and verify with Eden whether participation can be confirmed for that member and service.
What Eden cannot decide
Eden does not enroll members in plans, rank plans, approve hours, or guarantee in-network status because a plan exists on the DMAS roster.
Last verified
September 2, 2026
Anthem HealthKeepers Plus(Anthem)
Who the plan serves
Cardinal Care Managed Care members enrolled with this plan. Confirm the legal plan name printed on the member ID card.
Member support overview
Foster care, former foster care, and adoption-assistance members may have a specialty-plan enrollment path. Confirm the plan name printed on the member ID card.
Care coordination
Plan care coordinators help members use covered benefits. They do not replace service-authorization rules or Eden's scheduling process.
Personal care / respite pathway
Personal care and respite, when covered, usually need the plan's LTSS authorization and an authorized plan of care. Hours are a payer decision.
Authorization pathway
Authorization, care coordination, and LTSS workflows are plan-administered. Ask Anthem member services or an Eden coordinator to confirm the current process for the specific service.
Transportation pathway
Medicaid-paid non-emergency transportation, if covered, is arranged through the plan's transportation program or broker — not by treating Eden as an NEMT provider.
Official member resources
Use the plan's official Virginia member site and the DMAS enrollment broker for current handbooks and phone numbers. Plan site
Official provider resources
Provider manuals and directories are published by the plan. Do not rely on a marketing blog. DMAS roster
What Eden can help with
Help a family match the card name to a public plan, gather intake facts, and verify with Eden whether participation can be confirmed for that member and service.
What Eden cannot decide
Eden does not enroll members in plans, rank plans, approve hours, or guarantee in-network status because a plan exists on the DMAS roster.
Last verified
September 2, 2026
Humana Healthy Horizons of Virginia(Humana)
Who the plan serves
Cardinal Care Managed Care members enrolled with this plan. Confirm the legal plan name printed on the member ID card.
Member support overview
If a family still has a Molina card, they should confirm current enrollment. Molina is not on the current DMAS CCMC roster.
Care coordination
Plan care coordinators help members use covered benefits. They do not replace service-authorization rules or Eden's scheduling process.
Personal care / respite pathway
Personal care and respite, when covered, usually need the plan's LTSS authorization and an authorized plan of care. Hours are a payer decision.
Authorization pathway
Continuity-of-care rules may apply after a plan change, but they are time-limited and plan-specific. Confirm remaining authorizations with Humana and DMAS — do not assume prior Molina approvals continue indefinitely.
Transportation pathway
Medicaid-paid non-emergency transportation, if covered, is arranged through the plan's transportation program or broker — not by treating Eden as an NEMT provider.
Official member resources
Use the plan's official Virginia member site and the DMAS enrollment broker for current handbooks and phone numbers. Plan site
Official provider resources
Provider manuals and directories are published by the plan. Do not rely on a marketing blog. DMAS roster
What Eden can help with
Help a family match the card name to a public plan, gather intake facts, and verify with Eden whether participation can be confirmed for that member and service.
What Eden cannot decide
Eden does not enroll members in plans, rank plans, approve hours, or guarantee in-network status because a plan exists on the DMAS roster.
Last verified
September 2, 2026
Sentara Health Plans(Sentara)
Who the plan serves
Cardinal Care Managed Care members enrolled with this plan. Confirm the legal plan name printed on the member ID card.
Member support overview
Provider directories and member handbooks are published by the plan. Contact Sentara or Eden to verify whether a specific provider is in network for a specific service.
Care coordination
Plan care coordinators help members use covered benefits. They do not replace service-authorization rules or Eden's scheduling process.
Personal care / respite pathway
Personal care and respite, when covered, usually need the plan's LTSS authorization and an authorized plan of care. Hours are a payer decision.
Authorization pathway
LTSS authorizations, if required, are decided by the plan using the member's assessment and plan of care. Eden cannot approve hours.
Transportation pathway
Medicaid-paid non-emergency transportation, if covered, is arranged through the plan's transportation program or broker — not by treating Eden as an NEMT provider.
Official member resources
Use the plan's official Virginia member site and the DMAS enrollment broker for current handbooks and phone numbers. Plan site
Official provider resources
Provider manuals and directories are published by the plan. Do not rely on a marketing blog. DMAS roster
What Eden can help with
Help a family match the card name to a public plan, gather intake facts, and verify with Eden whether participation can be confirmed for that member and service.
What Eden cannot decide
Eden does not enroll members in plans, rank plans, approve hours, or guarantee in-network status because a plan exists on the DMAS roster.
Last verified
September 2, 2026
UnitedHealthcare of the Mid-Atlantic, Inc. (UnitedHealthcare Community Plan)(UnitedHealthcare)
Who the plan serves
Cardinal Care Managed Care members enrolled with this plan. Confirm the legal plan name printed on the member ID card.
Member support overview
Confirm the legal plan name and member services number on the ID card. Community Plan branding does not by itself prove Eden is in network.
Care coordination
Plan care coordinators help members use covered benefits. They do not replace service-authorization rules or Eden's scheduling process.
Personal care / respite pathway
Personal care and respite, when covered, usually need the plan's LTSS authorization and an authorized plan of care. Hours are a payer decision.
Authorization pathway
Prior authorization and LTSS service authorization, when required, follow UnitedHealthcare's published processes. Timelines are not universal across all Virginia plans.
Transportation pathway
Medicaid-paid non-emergency transportation, if covered, is arranged through the plan's transportation program or broker — not by treating Eden as an NEMT provider.
Official member resources
Use the plan's official Virginia member site and the DMAS enrollment broker for current handbooks and phone numbers. Plan site
Official provider resources
Provider manuals and directories are published by the plan. Do not rely on a marketing blog. DMAS roster
What Eden can help with
Help a family match the card name to a public plan, gather intake facts, and verify with Eden whether participation can be confirmed for that member and service.
What Eden cannot decide
Eden does not enroll members in plans, rank plans, approve hours, or guarantee in-network status because a plan exists on the DMAS roster.
Explain public program concepts, gather intake facts, help verify benefits, and submit documentation the payer requests when Eden is the provider.
What Eden cannot decide
Eden cannot approve Medicaid eligibility, waiver enrollment, MCO enrollment, service authorization, or a specific number of hours. Those decisions belong to DMAS, the health plan, or another payer.
Common questions
What is Cardinal Care?
Cardinal Care is Virginia's Medicaid and FAMIS program brand. Managed-care and fee-for-service members are part of Cardinal Care. It is not, by itself, approval for personal care hours.
What is an MCO?
A managed care organization — the health plan that coordinates covered services for many Cardinal Care members. The current DMAS roster lists Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Health Plans, and UnitedHealthcare Community Plan.
Is Eden in-network with all Virginia Medicaid plans?
No public page claims that. The existence of a Virginia Medicaid plan does not mean Eden is contracted or in-network with that plan. Contact Eden to verify current network participation for a specific member, service, and location.
Does Eden decide my Medicaid hours?
No. The payer — typically the MCO or DMAS — authorizes hours. Eden can help with documentation and next steps.
How does Medicaid transportation work?
Medicaid-paid non-emergency transportation is arranged through the member's plan or a DMAS transportation pathway, not by treating Eden as an NEMT provider. Eligibility, reservations, and approvals are official determinations. Eden does not guarantee rides.
Eden educational resources are not a substitute for official Medicaid, waiver, or health-plan determinations. Rules vary by program, assessment, authorization, and plan. Confirm current details with DMAS, your MCO, and Eden intake.
