Virginia Medicaid covers hundreds of thousands of residents across multiple eligibility categories, each with its own income rules. Whether you are a working adult, parent, pregnant, elderly, or living with a disability, the income limit that applies to you depends on which Medicaid program you fall under. This guide breaks down the 2026 income limits by group, shows the dollar amounts by household size, and walks you through how to apply.
Virginia expanded Medicaid in 2019, which opened coverage to most adults ages 19 to 64 who had previously been excluded. Virginia also adopted the updated 2026 Federal Poverty Level (FPL) figures on January 13, 2026, earlier than most states, so the numbers below reflect the current thresholds in effect now.
What Is Virginia Medicaid?
Virginia Medicaid is the state's publicly funded health insurance program, administered by the Department of Medical Assistance Services (DMAS). It covers doctor visits, hospital care, prescriptions, mental health services, dental care for children, and long-term care, depending on the program. Virginia calls its Medicaid portal CoverVA.
Virginia also runs FAMIS (Family Access to Medical Insurance Security), the state's Children's Health Insurance Program (CHIP), which covers children and some pregnant people at slightly higher income levels than Medicaid.
2026 Income Limits by Eligibility Group
Adults Ages 19 to 64 (Medicaid Expansion)
Virginia expanded Medicaid under the Affordable Care Act, so most adults between 19 and 64 who are not on Medicare qualify if their income falls at or below 138% FPL. This is the largest coverage group in the state.
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|
| 1 | $1,732 | $20,784 |
| 2 | $2,344 | $28,128 |
| 3 | $2,956 | $35,472 |
| 4 | $3,568 | $42,816 |
| 5 | $4,180 | $50,160 |
| 6 | $4,792 | $57,504 |
These figures are based on 138% FPL using the 2026 federal poverty guidelines. There is no asset test for expansion Medicaid. Adults on Medicare are not eligible for expansion coverage but may qualify for other Medicaid programs.
Children (Medicaid for Children)
Children under 19 qualify for full Medicaid coverage at up to 148% FPL. Children from families with higher incomes may qualify for FAMIS (see below).
| Household Size | Monthly Income Limit (148% FPL) | Annual Income Limit |
|---|
| 1 | $1,858 | $22,296 |
| 2 | $2,516 | $30,192 |
| 3 | $3,175 | $38,100 |
| 4 | $3,834 | $46,008 |
| 5 | $4,493 | $53,916 |
| 6 | $5,151 | $61,812 |
FAMIS (Children's Health Insurance Program)
Children whose family income is between 148% and 205% FPL qualify for FAMIS rather than Medicaid. FAMIS provides comprehensive coverage similar to Medicaid but may have small cost-sharing requirements.
| Household Size | Monthly Income Limit (205% FPL) | Annual Income Limit |
|---|
| 1 | $2,574 | $30,888 |
| 2 | $3,483 | $41,796 |
| 3 | $4,393 | $52,716 |
| 4 | $5,302 | $63,624 |
| 5 | $6,212 | $74,544 |
| 6 | $7,121 | $85,452 |
Pregnant Women
Pregnancy Medicaid covers prenatal care, labor and delivery, and postpartum care for 12 months after birth. Income limit is 148% FPL, the same threshold as Medicaid for children. FAMIS MOMS extends coverage up to 205% FPL for pregnant people who exceed the Medicaid limit.
Coverage for both Medicaid and FAMIS MOMS continues for a full 12 months postpartum regardless of income changes during that period.
Aged, Blind, and Disabled (ABD) Medicaid
Adults who are 65 or older, blind, or have a qualifying disability may qualify for ABD Medicaid. This program has lower income limits and includes an asset test.
| Household Composition | Monthly Income Limit |
|---|
| Individual | $1,064 |
| Married couple (both applying) | $1,442.66 |
| Married couple (one applying) | $1,442.66 |
Asset limits for ABD Medicaid: $2,000 for an individual, $3,000 for a couple. Certain assets are exempt, including a primary home, one vehicle, personal belongings, and burial funds up to $1,500.
Nursing Home and Long-Term Care Medicaid
Nursing Home Medicaid covers the cost of skilled nursing facility care for people who medically need that level of care. Income and asset rules are stricter.
| Applicant Status | Monthly Income Limit |
|---|
| Single applicant | $2,982 |
| Married, both applying | $5,964 |
| Married, one applying | $2,982 (applicant only) |
Asset limit: $2,000 for a single applicant. For married couples where one spouse applies and one remains in the community, the community spouse may keep up to $162,660 in assets (or 50% of joint assets, whichever is greater, with a minimum of $32,532). The community spouse is also guaranteed a minimum monthly income of approximately $2,644.
Medically Needy Program
Virginia has a Medically Needy program for people whose income exceeds regular Medicaid limits but who face high medical costs. This program uses a spend-down process, where excess income is applied toward medical bills until the person meets the eligibility threshold.
| Group | Individual (Monthly) | Couple (Monthly) |
|---|
| Group I | $410.05 | $522.01 |
| Group II | $473.14 | $582.55 |
| Group III | $615.08 | $741.53 |
These limits are effective July 1, 2025 through June 30, 2026.
What Counts as Income?
For most Medicaid programs, Virginia uses Modified Adjusted Gross Income (MAGI) methodology. This includes:
- Wages and salaries
- Self-employment income
- Social Security benefits (for most programs)
- Unemployment compensation
- Alimony received
- Rental income
Items that generally do not count as income include child support received, gifts, inheritances, and most federal benefits like SSI payments.
For ABD and nursing home programs, Social Security income and pension payments count toward the monthly income limit.
How to Apply for Virginia Medicaid in 2026
Virginia offers four ways to apply. The fastest method for most people is the online portal.
Step 1: Gather your documents
Before you start, collect:
- Social Security numbers for all household members applying
- Proof of income (pay stubs, tax returns, benefit award letters)
- Proof of identity (driver's license, passport, or state ID)
- Immigration documents if applicable
- Information about any current health insurance coverage
Step 2: Choose your application method
- Online: Apply at commonhelp.virginia.gov. This portal handles Medicaid, SNAP, and other benefit applications in one place. You can check status and upload documents here after applying.
- By phone: Call the Cover Virginia Call Center at 1-855-242-8282, Monday through Friday 8 a.m. to 7 p.m. and Saturday 9 a.m. to noon. TTY users call 1-888-221-1590.
- In person: Visit your local Department of Social Services office. Find locations at dss.virginia.gov/localagency.
- By mail: Download and mail a paper application to your local DSS office.
Step 3: Submit your application
Complete all required sections. Missing information will delay processing. For households with multiple members, include information for everyone who needs coverage, even if only one person is applying.
Step 4: Respond to any follow-up requests
DMAS or your local DSS may contact you for additional documents or clarification. Respond promptly to avoid delays.
Step 5: Receive your determination
Virginia has up to 45 days to process most Medicaid applications. For pregnant applicants and newborns, decisions are typically faster. If approved, coverage can begin retroactively to the first day of the month you applied, or up to three months before your application date in some cases.
Retroactive Coverage
Virginia Medicaid can cover medical bills up to three months before the application date if you were eligible during that period and received qualifying services. This is called retroactive coverage and can be valuable if you had medical expenses before you applied. Ask your caseworker about this option when you submit your application.
Renewals
Virginia Medicaid coverage must be renewed annually. DMAS will send a renewal notice before your coverage period ends. You can renew online through commonhelp.virginia.gov, by phone, or by mail. Many renewals are completed automatically using data from other state and federal sources, but you may need to update your income or household information.
If your income increases above the Medicaid limit, you may qualify for a subsidized health plan through the ACA Marketplace during a Special Enrollment Period.
Check Your Eligibility
Not sure whether your household qualifies? The income tables above give you a starting point, but actual eligibility depends on household composition, income type, residency, and other factors. Use the free eligibility screener at benefitsusa.org/screener to check Medicaid and other programs at once. It takes about two minutes and covers Virginia-specific rules.
You can also explore all Virginia assistance programs on the Virginia benefits page.
Frequently Asked Questions
What is the income limit for Medicaid in Virginia for 2026?
It depends on your eligibility group. Adults ages 19 to 64 qualify at up to 138% FPL, which is approximately $1,732 per month for a single person. Children qualify at up to 148% FPL under Medicaid and up to 205% FPL under FAMIS. Pregnant individuals qualify at up to 148% FPL, or 205% FPL under FAMIS MOMS.
Does Virginia check assets for Medicaid?
Most Virginia Medicaid programs do not have an asset test, including expansion Medicaid for adults and Medicaid for children. Asset limits do apply for ABD Medicaid ($2,000 for individuals) and nursing home Medicaid ($2,000 for individuals, with protections for the community spouse).
How long does it take to get approved for Medicaid in Virginia?
Virginia has up to 45 days to process most Medicaid applications. Pregnant applicants and newborns are typically processed faster. You can check application status online at commonhelp.virginia.gov.
Can I get Medicaid in Virginia if I work?
Yes. Working does not disqualify you from Medicaid. As long as your household income falls below the limit for your eligibility group, you may qualify regardless of employment status.
What does Virginia Medicaid cover?
Virginia Medicaid generally covers doctor visits, inpatient and outpatient hospital care, emergency services, prescription drugs, mental health and substance use treatment, preventive care, family planning, and for children, dental and vision care. Long-term care services are covered under nursing home and home-based waiver programs.
What if my income is over the limit?
If your income is slightly over the Medicaid limit, you may qualify for the Medically Needy spend-down program or for subsidized health plans through the federal Marketplace. Subsidies are available for households with incomes between 100% and 400% FPL. Use the screener at benefitsusa.org/screener to find out which program fits your situation.
Is FAMIS the same as Medicaid?
FAMIS is Virginia's CHIP program, separate from Medicaid but similar in coverage. It covers children and some pregnant people with incomes above the Medicaid limit but below 205% FPL. Children on FAMIS have access to most of the same services as those on Medicaid.
Can immigrants get Virginia Medicaid?
Lawfully present immigrants, including green card holders, refugees, and DACA recipients in some cases, may qualify for Virginia Medicaid depending on their immigration status and length of residency. Undocumented immigrants generally do not qualify for full Medicaid but may receive emergency Medicaid for acute medical conditions.
Where do I apply for Virginia Medicaid?
Apply online at commonhelp.virginia.gov, by phone at 1-855-242-8282, in person at your local Department of Social Services, or by mail using a paper application downloaded from coverva.dmas.virginia.gov.
