Registration Information

Your child may qualify to receive MCCP medical care if you:

• Live in Fairfax County or the Cities of Fairfax or Falls Church.
• Meet income guidelines.
• Do not have affordable health insurance through an employer or the Marketplace.
• Do not qualify for Medicaid (FAMIS Plus) and FAMIS.
• Cannot pay for doctor visits or medicine for your children.

Citizenship not required.

Have questions or need more information? Call 703-324-7315, TTY 711.

• Medical Care (Primary Care, Laboratory Services, Well Child Care, Pharmacy, Physical Exams, Immunizations, Eye Exams, Radiology, Physical Therapy, Mental Health, Specialty Services)
• Routine Dental Care (X-rays, Dental Cleanings, Fluoride Treatment, Fillings)
• Case Management (Transportation Arrangements, Counseling, Information and Referral, Advocacy, Coordination, Linkups to other needed service)

Co-payments are required for services. The partnership includes health care providers throughout Fairfax County.

Have questions or need more information? Call 703-324-7315, TTY 711.

Application Packet

• Child’s ID: birth certificate, passport, immunizations records or any other identifying document.
• The applicant caretaker must be a parent or legal guardian to apply for the children.
• Proof of address in Fairfax County: car registration, rental lease/mortgage, current mail or utility bill.
• Income verification: One full month of pay stubs (last month or this month), letter from employer, or signed tax return if self-employed.
• Unearned income verification: Unemployment, disability benefits, alimony or child support.
• Must be ineligible for Federal programs and have no access to affordable health insurance through parents’ employer or the Market Place.
• Verification of Income and Health Insurance Form to verify health insurance eligibility and affordability from employer.
• Use the checklist (English*, Spanish*) to help you collect the information needed to enroll your children in the MCCP.

Forms

• Application*
• Authorization to Release Medical Information Form (English*, Spanish*) completed and signed. Note: One form for each child is needed.
• Verification of Income and Health Insurance Form* The Health Insurance Section-Part II must be completed by the employer. Part I can be completed by the employer if you do not have current pay stubs.

*Fairfax County is committed to nondiscrimination on the basis of disability in all county programs, services and activities. To request reasonable accommodations or to receive this information in an alternate format, call 703-324-7315 or TTY 711.

Submit the Application Packet and Forms

Copies of the documents can be sent by email to DFSMCCP@fairfaxcounty.gov or mailed to:

• MCCP Program
  12011 Government Center Parkway, Suite 232
  Fairfax, Virginia 22035
  ATTN: MCCP Program

or mailed to any of these centers:

• Neighborhood Health at South County Building
  8350 Richmond Highway, #301, Alexandria 22309
  ATTN: MCCP Program
• Neighborhood Health at Merrifield Center
  8221 Willow Oaks Corporate Drive, #450, Fairfax 22031
  ATTN: MCCP Program
• HealthWorks at Reston Center
  11484 Washington Plaza West, 3rd Floor, Reston, VA 20190
  ATTN: MCCP Program

After Submitting the Application Packet and Forms

A case worker will call you to review the application with you. If you do not return all necessary information, your application will be denied 45 days following the date your application is received. Please call your case worker if you need assistance with collecting the required information.

Have questions or need more information? Call 703-324-7315, TTY 711.

MCCP children are enrolled in a medical home with access to regular check-ups, physicals, sick child visits, pharmacy, x-rays and lab work. Enrolled children also receive limited services for specialty care and dental care. Hospitalization and emergency room visits are not covered by the program. MCCP is not health insurance.

MCCP is a program of the Fairfax County Department of Family Services, administered by the Health Access Assistance Team (HAAT) under the Self-Sufficiency division, and is a collaboration between Fairfax County Government and the medical and business communities.