Medicaid Income Limit Virginia Guide – Medicaid in Virginia, also known as Cardinal Care, provides essential health coverage to low-income individuals and families. If you live in Virginia and are wondering whether your income qualifies you for Medicaid, this guide breaks down the Medicaid income limit Virginia rules for 2026 in clear, up-to-date detail. All figures are effective January 13, 2026, and reflect official guidelines from the Virginia Department of Medical Assistance Services (DMAS) and CoverVA.
Income limits vary by program, household size, age, pregnancy status, and disability. Most categories use Modified Adjusted Gross Income (MAGI) rules with a 5% Federal Poverty Level (FPL) disregard, while others follow non-MAGI rules with asset tests.
What Is Medicaid in Virginia and Who Is It For?
Virginia Medicaid covers doctor visits, hospital care, prescription drugs, preventive services, dental, vision, and more—at little or no cost. Key groups include:
- Low-income adults ages 19–64 (Medicaid Expansion)
- Children under 19
- Pregnant and postpartum individuals
- Seniors and people who are blind or disabled (ABD)
- Those needing long-term care or home- and community-based services
Eligibility depends on income, household size, residency in Virginia, citizenship or qualifying immigration status, and other factors. There is no asset test for MAGI-based groups (most adults, children, and pregnant individuals), but ABD and long-term care categories do have resource limits.
2026 Virginia Medicaid Income Limits for Adults Ages 19–64 (Medicaid Expansion)
Most working-age adults qualify through Medicaid Expansion if their income is at or below 138% of the Federal Poverty Level (FPL). There is no asset test and no disability requirement.
2026 Monthly and Yearly Income Limits (includes 5% FPL disregard):
| Household Size | Yearly Income | Monthly Income |
|---|---|---|
| 1 | $22,025 | $1,836 |
| 2 | $29,864 | $2,489 |
| 3 | $37,702 | $3,142 |
| 4 | $45,540 | $3,795 |
| 5 | $53,379 | $4,449 |
| 6 | $61,217 | $5,102 |
| 7 | $69,056 | $5,755 |
| 8 | $76,894 | $6,408 |
| Each additional | +$7,839 | +$654 |
Special note: Former foster care youth ages 18–26 who had Medicaid on their 18th birthday qualify with no income limit. Work and community engagement requirements begin in January 2027 for this group only.
2026 Virginia Medicaid Income Limits for Children Under 19
Children qualify for full Medicaid (FAMIS Plus) or FAMIS (CHIP) depending on income. Both programs offer comprehensive coverage with no premiums or copays for most services.
2026 Income Limits (includes 5% FPL disregard):
| Family Size | Medicaid for Children (≈148% FPL) | FAMIS (≈205% FPL) | ||
|---|---|---|---|---|
| Yearly | Monthly | Yearly | Monthly | |
| 1 | $23,621 | $1,969 | $32,718 | $2,727 |
| 2 | $32,028 | $2,669 | $44,362 | $3,697 |
| 3 | $40,434 | $3,370 | $56,006 | $4,668 |
| 4 | $48,840 | $4,070 | $67,650 | $5,638 |
| 5 | $57,247 | $4,771 | $79,294 | $6,608 |
| 6 | $65,653 | $5,472 | $90,938 | $7,579 |
| 7 | $74,060 | $6,172 | $102,582 | $8,549 |
| 8 | $82,466 | $6,873 | $114,226 | $9,519 |
| Each additional | +$8,407 | +$701 | +$11,644 | +$971 |
Children receive 12 months of continuous coverage once approved.
2026 Virginia Medicaid Income Limits for Pregnant and Postpartum Women
Pregnant individuals can qualify for Medicaid for Pregnant Women or FAMIS MOMS/Prenatal Coverage. Coverage includes prenatal care, delivery, postpartum services for 12 months after birth, and dental benefits.
2026 Income Limits (includes 5% FPL disregard):
| Family Size | Medicaid for Pregnant Women (≈148% FPL) | FAMIS MOMS / FAMIS Prenatal (≈205% FPL) | ||
|---|---|---|---|---|
| Yearly | Monthly | Yearly | Monthly | |
| 1 | $23,621 | $1,969 | $32,718 | $2,727 |
| 2 | $32,028 | $2,669 | $44,362 | $3,697 |
| … (same as children table above) | … | … | … | … |
Note: A pregnant woman’s household size is counted as at least two people.
2026 Virginia Medicaid Income Limits for Aged, Blind, or Disabled (ABD) Individuals
Seniors (65+) and people who are blind or disabled use non-MAGI rules. These categories have both income and resource limits.
- Standard ABD: $1,084/month (1 person) or $1,463/month (2 people)
- Medicaid Works (working disabled/blind ages 16–64): $1,856/month (1 person) or $2,509/month (2 people)
Income includes a $20 unearned income disregard. Excess income may be “spent down” on medical bills to qualify. Resource limits apply (typically $2,000–$3,000 depending on category).
2026 Long-Term Care (Nursing Home & HCBS Waivers) Medicaid Income Limits in Virginia
For institutional care or home- and community-based services waivers, the income limit is 300% of the Federal SSI benefit rate.
- Single applicant: $2,982 per month
- Married couple (both applying): $5,964 per month combined
- Asset limit: $2,000 (single) or $4,000 (couple); spousal protections apply for the non-applicant spouse
Applicants must also meet a nursing-home level of care.
How Virginia Medicaid Counts Income (MAGI vs. Non-MAGI)?
- MAGI groups (Expansion adults, children, pregnant): Count taxable income from tax return (wages, Social Security, etc.) with deductions. 5% FPL disregard is built into the charts above.
- Non-MAGI groups (ABD, long-term care): Count gross income with specific disregards (e.g., $20 unearned). Assets/resources are also evaluated.
Household size generally follows your federal tax filing unit.
Asset/Resource Limits for Virginia Medicaid
- MAGI categories (most adults, kids, pregnant): No asset test
- ABD and long-term care: Yes—typically $2,000–$3,000 for individuals (higher for couples)
Certain assets like your home, one vehicle, and burial funds are usually excluded.
Additional Eligibility Factors Beyond Income
You must:
- Be a Virginia resident
- Be a U.S. citizen or qualifying immigrant
- Meet age, pregnancy, or disability criteria for certain programs
Disability is determined by the Social Security Administration or DMAS.
How to Apply for Medicaid in Virginia? Step-by-Step
- Gather proof of income, residency, citizenship, and household members.
- Apply online at CoverVA (coverva.dmas.virginia.gov) or CommonHelp.
- Or call 1-855-242-8282 or visit your local Department of Social Services.
- You can also apply by mail or in person.
Processing usually takes 45 days (90 days for disability). Apply even if you think you might be over the limit—presumptive eligibility exists for pregnant women and children in some cases.
What If Your Income Is Too High for Virginia Medicaid?
You may still qualify for:
- Premium tax credits on the Virginia Insurance Marketplace (VIM) if income is 100–400% FPL
- FAMIS for children up to 205% FPL
- Medicare Savings Programs (for those with Medicare)
Frequently Asked Questions About Medicaid Income Limit Virginia
Is there a work requirement?
Only for Medicaid Expansion adults starting January 2027.
Do I have to reapply every year?
Yes—annual renewal is required, but children get 12 months continuous coverage.
What if my income changes?
Report changes promptly; they may affect eligibility or premiums (rare).
Can I get retroactive coverage?
Yes—up to 3 months prior to application for pregnant women and others in some cases.
Final Tips and How to Stay Updated
Income limits are updated annually based on federal poverty guidelines. Always check the official CoverVA website (coverva.dmas.virginia.gov) or call the helpline for your specific situation, as a full eligibility determination considers more than just the charts above.
If you live in Virginia and need help applying or understanding your options, visit CoverVA today or contact your local Department of Social Services. Getting covered can protect your health and finances—don’t wait if you think you qualify.
This guide is for informational purposes only and is based on the most current official Virginia Medicaid guidelines as of April 2026. Rules can change; verify with DMAS or CoverVA for your personal circumstances.