If you live in Virginia and need affordable health coverage, Medicaid could be the answer. Virginia offers several Medicaid programs for adults, children, pregnant individuals, and people with disabilities. With income guidelines updated as of January 13, 2026, now is a great time to check whether you or your family qualifies. This guide breaks down the latest Virginia Medicaid eligibility rules, income limits, covered programs, and how to apply. You can also use our free benefits screener to instantly check your eligibility for Medicaid and 10 other assistance programs.
For a broader look at all available programs in the state, visit our Virginia Benefits Overview.
Who Qualifies for Virginia Medicaid in 2026?
Virginia Medicaid covers several groups of residents, each with its own eligibility criteria. The main categories include:
- Adults ages 19 to 64 through Medicaid Expansion (income up to 138% of the Federal Poverty Level)
- Children under 19 through Medicaid for Children and FAMIS (income limits vary by program)
- Pregnant individuals with coverage extending 12 months postpartum
- Adults 65 and older and individuals with disabilities through the Aged, Blind, or Disabled (ABD) program
- Former foster care youth ages 18 to 26 who had Medicaid on their 18th birthday (no income limit)
To qualify, you must be a Virginia resident and a U.S. citizen or lawfully residing immigrant.
2026 Income Limits for Virginia Medicaid: Adults
Virginia expanded Medicaid in 2019, covering adults ages 19 to 64 with household income at or below 138% of the Federal Poverty Level (FPL). The table below includes the standard 5% FPL disregard already built in.
| Household Size | Monthly Income Limit | Yearly Income Limit |
|---|---|---|
| 1 | $1,836 | $22,025 |
| 2 | $2,489 | $29,864 |
| 3 | $3,142 | $37,702 |
| 4 | $3,795 | $45,540 |
| 5 | $4,449 | $53,379 |
| 6 | $5,102 | $61,217 |
| 7 | $5,755 | $69,056 |
| 8 | $6,408 | $76,894 |
| Each additional | +$654 | +$7,839 |
Source: CoverVA, effective January 13, 2026.
These figures are based on Modified Adjusted Gross Income (MAGI). Most types of income count, including wages, self-employment income, Social Security benefits, and unemployment compensation.
2026 Income Limits for Children: Medicaid and FAMIS
Virginia provides two programs for children under 19. Medicaid for Children covers families with lower incomes, while FAMIS (Family Access to Medical Insurance Security) covers children in families that earn too much for Medicaid but still need help. Both programs have no premiums or copays.
| 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 |
| 7 | $6,172 | $74,060 | $8,549 | $102,582 |
| 8 | $6,873 | $82,466 | $9,519 | $114,226 |
| Each additional | +$701 | +$8,407 | +$971 | +$11,644 |
Source: CoverVA, effective January 13, 2026. Includes 5% FPL disregard.
Children enrolled in Medicaid or FAMIS receive 12 months of continuous coverage from the date of enrollment. Coverage will only end early if the child turns 19, permanently moves out of Virginia, or coverage is ended by a parent or guardian.
Coverage for Pregnant Individuals
Pregnant individuals in Virginia can qualify for Medicaid with income up to 148% FPL. Coverage includes full health care benefits during pregnancy and for 12 months after the baby is born. Virginia was one of the first states to extend postpartum Medicaid coverage to a full 12 months.
If your income is above the Medicaid limit but below 205% FPL, you may qualify for FAMIS MOMS, a CHIP-based program that provides pregnancy-related coverage.
When applying, a pregnant woman counts as two people for household size purposes, which raises the income threshold automatically.
Coverage for Aged, Blind, or Disabled Individuals
Adults age 65 and older, or those who are blind or have a qualifying disability, may be eligible for Medicaid through the ABD program. The income limit for ABD Medicaid is approximately $967 per month for an individual (based on SSI standards). Asset limits also apply: generally $2,000 for an individual.
For those who need nursing home care or long-term care services, income limits are higher (up to $2,982 per month in 2026), but strict asset limits of $2,000 still apply. Virginia also has a Medically Needy spend-down option for individuals whose income exceeds the standard limit but who have high medical expenses.
Work and Community Engagement Requirements (Coming 2027)
Starting in January 2027, Virginia will introduce work and community engagement requirements for adults enrolled in Medicaid Expansion. These requirements will apply only to Expansion adults ages 19 to 64. They will not affect children, pregnant individuals, postpartum individuals, or adults with a disability or over age 64.
Details are still being finalized. For the latest information, visit the Virginia Department of Medical Assistance Services (DMAS) website.
What Does Virginia Medicaid Cover?
Virginia Medicaid (branded as Cardinal Care) covers a wide range of services, including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Emergency care and ambulance services
- Prescription medications
- Behavioral and mental health services
- Dental care (through Cardinal Care Smiles)
- Vision care
- Lab tests, X-rays, and imaging
- Preventive care, vaccinations, and screenings
- Well-baby and well-child checkups
- Maternity and newborn care
- Substance use disorder treatment
There are no monthly premiums, copays, or deductibles for most Medicaid enrollees in Virginia.
How to Apply for Virginia Medicaid: Step by Step
Applying for Virginia Medicaid is free and can be done in several ways. Follow these steps:
Step 1: Check Your Eligibility
Before applying, use our free screener tool to get an instant estimate of which programs you may qualify for based on your income, household size, and location.
Step 2: Gather Your Documents
You will need the following for yourself and everyone in your household:
- Full legal name and date of birth
- Social Security Number (not required for household members not applying for coverage)
- Immigration document numbers (if applicable)
- Employer and income information (pay stubs, W-2 forms, or tax statements)
- Information about any current health insurance, including Medicare or employer-sponsored coverage
Step 3: Submit Your Application
Choose the method that works best for you:
- Online: Apply at commonhelp.virginia.gov or through Virginia's Insurance Marketplace
- By phone: Call Cover Virginia at 1-855-242-8282 (TTY: 1-888-221-1590), Monday through Friday 8 a.m. to 7 p.m., Saturday 9 a.m. to 12 p.m.
- By mail: Send your completed application to Cardinal Care Correspondence Center, P.O. Box 1820, Richmond, VA 23218
- In person: Drop off a paper application at your local Department of Social Services office. Find your nearest office at dss.virginia.gov/localagency
Step 4: Respond to Any Requests
After submitting, Virginia will try to verify your eligibility using the information provided. If additional documents are needed, you will receive a letter explaining what to send. Respond promptly to avoid delays or denial.
Step 5: Choose a Health Plan
Once approved, you will be asked to select a managed care health plan. Virginia Medicaid members can choose from several health plans depending on their region.
Annual Renewal
Virginia Medicaid coverage must be renewed each year. The state will send you a renewal notice before your coverage period ends. If you do not complete your renewal, you will lose coverage. Keep your contact information up to date with Cover Virginia to make sure you receive renewal notices.
Frequently Asked Questions
How long does it take to get approved for Virginia Medicaid?
Most applications are processed within 45 days. For applicants who qualify based on a disability, processing may take up to 90 days.
Can I apply for Virginia Medicaid if I am undocumented?
Undocumented immigrants are generally not eligible for full Medicaid coverage. However, emergency Medicaid may cover emergency medical conditions regardless of immigration status. Lawfully residing immigrant children and pregnant individuals may qualify for coverage.
What is the difference between Medicaid and FAMIS?
Medicaid for Children covers kids in families with incomes up to about 148% FPL. FAMIS covers children in families with higher incomes, up to about 205% FPL. Both programs offer the same comprehensive benefits with no cost to families.
Can I have Medicaid and private insurance at the same time?
Yes. Medicaid can serve as secondary insurance and may help cover costs that your primary insurance does not pay.
What happens if my income changes during the year?
You should report income changes to Cover Virginia. If your income increases above the limit, you may lose Medicaid eligibility, but you could qualify for subsidized coverage through Virginia's Insurance Marketplace. Children have 12 months of continuous coverage regardless of income changes.
Does Virginia Medicaid cover dental and vision?
Yes. Virginia Medicaid covers dental care through Cardinal Care Smiles and includes vision services for both children and adults.
How do I renew my Virginia Medicaid coverage?
You will receive a renewal notice from Cover Virginia. You can complete your renewal online at commonhelp.virginia.gov, by phone at 1-855-242-8282, or by returning the paper renewal form by mail.
Check Your Eligibility Now
Not sure if you qualify for Virginia Medicaid or other benefit programs? Use our free benefits screener to find out in minutes. It checks eligibility for Medicaid, SNAP, EITC, WIC, and more based on your specific situation.
