Applying for Medicaid in Virginia does not have to be complicated. Virginia expanded Medicaid in January 2019, which means more residents than ever can qualify for free or low-cost health coverage through the state's Cardinal Care program. Whether you are an adult, a parent, pregnant, or applying on behalf of a child, this guide walks you through every step of the Virginia Medicaid application process in 2026.
Not sure if you qualify before you start? Use our free eligibility screener to find out in minutes. You can also visit the Virginia Benefits Overview for a complete look at all assistance programs available in the state.
Who Can Apply for Virginia Medicaid?
Virginia Medicaid (also known as Cardinal Care) covers several groups of residents. Thanks to Medicaid expansion, adults between 19 and 64 can now qualify based on income alone, with no asset test required. Eligible groups include:
- Adults ages 19 to 64 with household income at or below 138% of the Federal Poverty Level (FPL)
- Children under 19 through Medicaid (up to 148% FPL) or FAMIS (up to 205% FPL)
- Pregnant individuals through Medicaid (up to 148% FPL) or FAMIS MOMS (up to 205% FPL)
- Seniors age 65 and older and individuals who are aged, blind, or disabled (income and asset limits vary)
- Former foster care youth up to age 26, regardless of income
Newborns born to a parent enrolled in Medicaid or FAMIS MOMS are automatically eligible for coverage through their first birthday.
Virginia Medicaid Income Limits for 2026
Your eligibility depends on your household size and monthly income. The following tables show the income thresholds for different coverage groups.
Adult Medicaid (Ages 19 to 64)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 | $1,732 | $20,783 |
| 2 | $2,347 | $28,166 |
| 3 | $2,963 | $35,548 |
| 4 | $3,578 | $42,931 |
| 5 | $4,193 | $50,314 |
| 6 | $4,808 | $57,696 |
These limits are based on 138% of the 2026 Federal Poverty Level and include a 5% income disregard. There is no asset limit for expansion adults.
Children's Coverage (Medicaid and FAMIS)
| Family Size | Medicaid Monthly | Medicaid Yearly | FAMIS Monthly | FAMIS Yearly |
|---|---|---|---|---|
| 1 | $1,969 | $23,621 | $2,727 | $32,718 |
| 2 | $2,669 | $32,028 | $3,697 | $44,362 |
| 3 | $3,370 | $40,434 | $4,668 | $56,006 |
| 4 | $4,070 | $48,840 | $5,638 | $67,650 |
| 5 | $4,771 | $57,247 | $6,608 | $79,294 |
| 6 | $5,472 | $65,653 | $7,579 | $90,938 |
FAMIS (Family Access to Medical Insurance Security) is Virginia's Children's Health Insurance Program. It has no premiums, co-pays, or deductibles and provides 12 months of continuous coverage from the enrollment date.
Pregnancy Coverage
Pregnant individuals can qualify for Medicaid at up to 148% FPL, or for FAMIS MOMS at up to 205% FPL. Coverage continues for 12 months after the end of pregnancy. Income limits match the children's coverage table above.
How to Apply: 4 Ways to Submit Your Application
Virginia offers multiple ways to apply for Medicaid. Choose the method that works best for you.
Option 1: Apply Online Through CommonHelp
The fastest way to apply is through Virginia's online benefits portal.
- Go to commonhelp.virginia.gov
- Create an account with your name, email address, and a password
- Select "Apply for Benefits" and choose health coverage
- Enter your household information, income details, and other requested data
- Upload or attach any supporting documents
- Review your application and submit it electronically
CommonHelp is available 24 hours a day, 7 days a week. You can also use it to track your application status and report changes after enrollment.
Option 2: Apply by Phone Through Cover Virginia
Call the Cover Virginia helpline to apply with assistance from a trained representative.
- Phone: 1-855-242-8282
- TTY: 1-888-221-1590
- Hours: Monday through Friday, 8:00 AM to 7:00 PM; Saturday, 9:00 AM to 12:00 PM
A representative will walk you through the application over the phone and can answer questions about eligibility or required documents.
Option 3: Apply in Person at Your Local DSS Office
You can visit your local Department of Social Services (DSS) office to apply in person. A caseworker can help you fill out the application and submit required documents on the spot.
To find your nearest office, visit the Virginia DSS office locator or call 1-855-635-4370.
Option 4: Submit a Paper Application by Mail or Fax
If you prefer a paper application, you can download one from the Cover Virginia website or request one by calling 1-855-242-8282. Complete the form and mail or fax it to your local DSS office.
Documents You Will Need
Gathering your documents before you start will help your application move faster. Have the following ready:
- Proof of identity: Driver's license, state ID, passport, or birth certificate
- Proof of citizenship or immigration status: Birth certificate, U.S. passport, or immigration documents
- Social Security numbers for all household members applying
- Proof of income: Pay stubs (last 30 days), tax returns, W-2 forms, self-employment records, Social Security award letters, or unemployment statements
- Proof of Virginia residency: Utility bill, lease agreement, or mail showing your Virginia address
- Proof of pregnancy (if applying for pregnancy coverage): A statement from your doctor or clinic
You do not need to have every document ready to submit your application. Virginia allows you to apply first and provide documentation afterward, but submitting documents upfront can speed up processing.
What Happens After You Apply
Once your application is submitted, here is what to expect:
- Confirmation: You will receive a confirmation number or notice that your application was received
- Review period: Virginia has up to 45 days to process a standard Medicaid application (90 days for disability-based applications)
- Request for information: The state may contact you if additional documents or clarification is needed. Respond promptly to avoid delays
- Approval or denial: You will receive a written notice with the decision. If approved, the notice will include your coverage start date and information about selecting a health plan
- Health plan selection: Once enrolled, you may need to choose a managed care plan. If you do not select one, a plan will be assigned to you
You can check the status of your application at any time by logging into CommonHelp or calling Cover Virginia at 1-855-242-8282.
What Virginia Medicaid Covers
Virginia Medicaid provides comprehensive health coverage, including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance use disorder services
- Preventive care and screenings
- Lab tests and X-rays
- Emergency room visits
- Transportation to medical appointments
- Limited dental and vision services for adults
- Comprehensive dental and vision coverage for children
Children enrolled in FAMIS receive the same comprehensive benefits with no out-of-pocket costs.
Tips to Get Your Application Approved Faster
- Apply online through CommonHelp for the quickest processing
- Submit all documents with your initial application rather than waiting for a request
- Double-check your information for accuracy, especially income figures and Social Security numbers
- Report all household members even if they are not applying for coverage, since household size affects income limits
- Respond quickly to any requests for additional information
- Keep copies of everything you submit
What to Do If You Are Denied
If your application is denied, you have the right to appeal. Your denial notice will explain the reason and include instructions for filing an appeal. In Virginia, you typically have 30 days from the date of the notice to request an appeal hearing.
Common reasons for denial include:
- Income exceeds the limit for your household size
- Missing or incomplete documentation
- Failure to respond to requests for information
- Not meeting residency or citizenship requirements
If your income is too high for Medicaid, you may still qualify for subsidized health insurance through Virginia's Insurance Marketplace or other assistance programs. Use our free screener to check what you may be eligible for.
Other Benefits You May Qualify For
Many Virginians who qualify for Medicaid are also eligible for other programs, including:
- SNAP (food assistance): Up to $298 per month for individuals, with income limits of 200% FPL in Virginia
- LIHEAP (utility assistance): Help paying heating and cooling bills for households at or below 150% FPL
- WIC: Nutrition support for pregnant and postpartum individuals and children under 5
- Lifeline: Discounts on phone and internet service for Medicaid participants
Check all the programs you may qualify for with our free eligibility screener.
Frequently Asked Questions
How long does it take to get approved for Medicaid in Virginia?
Virginia has up to 45 days to process a standard Medicaid application. Applications based on disability may take up to 90 days. Applying online and submitting all documents upfront can help speed up the process.
Can I apply for Virginia Medicaid if I am not a U.S. citizen?
Lawfully present immigrants may qualify for Medicaid or FAMIS depending on their immigration status, income, and how long they have been in the U.S. Some immigrants must wait five years before becoming eligible for full Medicaid. Pregnant individuals and children may have shorter or no waiting periods. Emergency Medicaid is available regardless of immigration status.
Is there a cost for Virginia Medicaid?
Medicaid for expansion adults, children, and pregnant individuals in Virginia has no monthly premiums. Most services have no co-pays. FAMIS also has no premiums, co-pays, or deductibles.
Can I apply for Medicaid at any time, or is there an enrollment period?
Medicaid does not have an open enrollment period. You can apply at any time during the year. This is different from marketplace health insurance, which generally requires you to enroll during the annual open enrollment window unless you have a qualifying life event.
What is the difference between Medicaid and FAMIS in Virginia?
Medicaid covers adults, children, pregnant individuals, and seniors based on income and other criteria. FAMIS is specifically for children under 19 whose family income is too high for Medicaid but at or below 205% FPL. FAMIS provides the same comprehensive coverage with no out-of-pocket costs.
What if I already have health insurance? Can I still apply?
Yes, you can apply for Medicaid even if you currently have other health insurance. If you are approved, Medicaid can work alongside your existing coverage or replace it. In some cases, Virginia offers a Health Insurance Premium Payment (HIPP) program that helps pay premiums for employer-sponsored insurance if it is more cost-effective.
Get Started Today
Applying for Medicaid in Virginia is free, and you can start the process in just a few minutes online. Visit CommonHelp to apply directly, or use our free eligibility screener to see what programs you may qualify for before you apply.
For questions or help with your application, contact Cover Virginia at 1-855-242-8282 (Monday through Friday, 8:00 AM to 7:00 PM; Saturday, 9:00 AM to 12:00 PM) or call Virginia 211 by dialing 2-1-1 for local assistance.
