Virginia program
A fund for treatment with no coverage (Uninsured Medical Catastrophe Fund)
This state fund can pay for an approved treatment course when no other coverage can pay.
What it is
This state fund can pay for an approved treatment course when no other coverage can pay.
The treatment must have no private or government coverage available. The state must approve it before services begin. Available funding limits whether the fund can help.
Eligibility rules
- Gross income must be at or below 300% of poverty. Coverage for the needed treatment through private insurance or a government program closes this route.
- The fund does not approve a plan when the illness is expected to be terminal even with treatment.
What you get
- Payment for an approved treatment course lasting up to 12 months, while funding lasts.
What the rules cover
- The fund is small and can run out; qualifying does not guarantee money.
If you decide to apply
- Ask the hospital social worker whether the fund is accepting applications.
- Bring the proposed treatment plan, dates, income and proof that no other coverage is available for it.
The state Department of Medical Assistance Services · Official page ↗
If you decide to apply
- Ask the social worker to find out whether the fund is open and taking applications, and to get any approval in writing before treatment starts; do not let this check delay urgent care.
Good to know
The fund does not pay for treatment received before approval. Eligibility does not guarantee money is available.
Other details
- The hospital social worker can discuss assistance from the hospital if this fund cannot cover the proposed treatment.
Official sources
“Is the catastrophe fund open, and could it cover a treatment that no other coverage will pay for? Could you help weigh it against hospital assistance?”
Why I’m asking: I need to know whether any funding exists for an uncovered treatment.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask before treatment starts and give the treatment plan.
Your social worker
The hospital social worker usually knows whether the fund is taking applications.
The care team
Records and letters when the application asks for them.
- Who decides
- The state Department of Medical Assistance Services
- Ask your social worker
- “Is the state uninsured medical catastrophe fund taking applications this year, and would our treatment plan fit its 12-month rule?”
How to apply
First step: Ask the hospital social worker whether the fund is taking applications, and get the application before treatment begins.
- Ask first whether the fund has money this year.
- The fund requires approval before covered services begin. Your social worker can check this while urgent clinical care continues.
Official application / program page ↗
Where it starts: Ask the hospital social worker or the state agency about the fund before treatment starts.
What to gather
- The proposed treatment plan with dates
- Proof there is no coverage for it
- This month's income
How long: Your social worker can ask DMAS whether money is available, new applications are accepted and a decision timetable applies. DMAS must confirm written approval requirements for the proposed treatment before anyone relies on payment. This funding check should not delay urgent clinical care.
What a yes looks like
An approved treatment plan with the fund paying providers for it.
What a no looks like, and the next move
No funding this year, or coverage found elsewhere. Then the hospital assistance route is the one to push.
Watch out
- Nothing is paid for treatment given before approval; ask first.
- The page existing does not mean the fund is funded this month.
- Any coverage for that treatment, including Medicaid, closes the door.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Payment for a treatment course of up to 12 months for a family at or under 300% of the poverty line with no coverage for it, while funding lasts.
- $300 — Income ceiling
- $12 — Longest treatment course a plan can cover
Covers: Payment for an approved course of treatment
What it costs the family: None to apply.
The eligibility facts, as published
- Income
- gross income equal to or less than 300% of the poverty guidelines
- Coverage
- uninsured for the needed treatment and not eligible for it through private insurance or a government programme
- Treatment
- an approved plan of no more than 12 months; not approved where the illness is expected to be terminal even with treatment
- Timing
- nothing is paid for services given before the application is approved
- Funding
- Limited to available funding; DMAS confirms current funding and intake.
The trap: It never pays for anything given before the application is approved, so ask before treatment starts, not after the bill.
Where I read this
- Virginia Administrative Code 12VAC30-150 — Uninsured Medical Catastrophe Fund — Virginia Law Library, read September 10, 2026
- DMAS — Uninsured Medical Catastrophe Fund — Virginia Department of Medical Assistance Services, read September 10, 2026