Assisted Living in Virginia (2026): Cost & Who Pays

If you're pricing assisted living for a parent in Virginia, the figure to plan around is roughly $6,944 a month in 2026, a bit above the national median.1 That works out to about $83,328 a year, the state's approximate median in the CareScout 2025 Cost of Care Survey. Most families pay for it privately, but there's a state program that can help eligible residents with room and board.

This guide explains what assisted living means in Virginia, what you'll actually pay, why standard Medicaid does not cover the rent here, where the Auxiliary Grant fits, and how to check out a place before anyone signs.

In This Guide

• Key Takeaways
• What Assisted Living in Virginia Is
• What It Costs
• Help Paying: the Auxiliary Grant, and Why It Isn't Medicaid
• How to Vet an Assisted Living Facility in Virginia
• Frequently Asked Questions

What Assisted Living in Virginia Is

When families here say "assisted living," they're usually describing a specific license: an Assisted Living Facility, regulated and inspected through the Virginia Department of Social Services Division of Licensing Programs.2 An ALF is a congregate residential setting that provides or coordinates personal and health care services, 24-hour supervision, and day-to-day help for four or more adults who are aged, infirm, or have disabilities. It's housing plus supervision plus assistance, in one place.

One detail trips up a lot of families, so it's worth pinning down early. Nursing homes in Virginia are licensed by a different agency, the Department of Health. Assisted living facilities are licensed by the Department of Social Services.2 That split matters when you go looking for a license or an inspection record, because you have to know which agency holds it. When you tour a place that markets itself as assisted living, ask whether it holds a current DSS Assisted Living Facility license. That license is what tells you the state is inspecting it.

The distinction also matters for the question every family eventually asks, which is who pays. An ALF and a nursing home are not the same setting, and they don't have the same payment rules. We'll come back to that.

What It Costs

Virginia runs a bit above the middle of the country on assisted living price. In the CareScout (Genworth) 2025 Cost of Care Survey, released March 2, 2026, the median cost of assisted living in the state was about $83,328 a year, roughly $6,944 a month, above the 2025 national median of $74,400 a year ($6,200 a month).1 These are industry-survey medians, not government rates, so treat them as a budgeting starting point rather than a quote.

Where you look inside Virginia moves the number a lot. Northern Virginia, near D.C., generally runs above the state median; rural parts of the state generally run below it. For context, here's how the settings compare in the same survey:1

A note on that home-care line: in the 2025 survey, CareScout merged its former "homemaker" and "home health aide" categories into a single non-medical caregiver category, so the $80,080 figure covers in-home help broadly rather than a clinical home health aide.1

One thing changed sharply this survey year. Virginia's nursing-home costs jumped year-over-year (a semi-private room up about 18 percent, a private room up about 19 percent) and now sit above the national medians, after running below them in the prior survey.1 That's a reminder not to assume a general ranking holds for the specific care your family needs, and to re-check current figures before you budget.

One caution when you compare quotes. The price a facility advertises is usually a base rate that covers the room, meals, and a basic level of help. Care often gets billed in tiers on top of that, so a resident who needs more hands-on help, or memory care, pays more, sometimes a lot more. Ask every place for a written breakdown: what's in the base rate, what's an add-on, how care needs get assessed, and how often the rate rises. Two facilities with the same headline price can land far apart once the care fees are added.

Help Paying: the Auxiliary Grant, and Why It Isn't Medicaid

Here's the honest version first, because this is where families most often get caught short. A standard assisted living stay in Virginia is largely private-pay, and standard Virginia Medicaid does not pay an ALF's room and board.2 If you've been assuming Medicaid will cover the rent at an assisted living facility the way people imagine it covering a nursing home, that assumption is the one to let go of now, before it shapes a budget.

What does exist is a different program with a similar-sounding purpose: the Virginia Auxiliary Grant. The Auxiliary Grant is a state income supplement that helps people who receive SSI or who are aged, blind, or disabled pay for room and board at a licensed ALF or an approved adult foster care home, up to a maximum monthly rate set by the Virginia General Assembly.2 For a low-income resident, it can be the piece that makes a licensed ALF affordable at all.

The part to hold onto: the Auxiliary Grant is not Medicaid. It's a separate program with its own application, and qualifying for one doesn't automatically mean qualifying for the other.2 A resident might have the Auxiliary Grant helping with room and board, Medicaid covering medical care, or both, or neither, depending on their situation. So if money is tight, the move is to apply for the Auxiliary Grant specifically, not to assume Medicaid eligibility carries over to the rent.

Where does Medicaid come in, then? Virginia Medicaid, run by the Virginia Department of Medical Assistance Services (DMAS), covers nursing-facility care as an entitlement for those who qualify, which is a different and higher level of care than an ALF.3 Anyone seeking Medicaid long-term care in a nursing facility, the CCC Plus waiver under Cardinal Care, or the Program of All-Inclusive Care for the Elderly (PACE) first has to complete an LTSS screening to confirm they meet the nursing-facility level of care.3 Financially, the long-term-care income limit is 300% of the SSI federal benefit rate (about $2,982 a month for an individual in 2026, with a path to qualify when the private cost of care exceeds income), the resource limit is $2,000 for an individual with spousal-impoverishment protections, and Virginia applies a five-year look-back to asset transfers.3 That's the nursing-home track. It is not a route to having Medicaid pay an assisted living facility's rent.

If your parent's income or assets are near the line, it's worth understanding how Medicaid asset rules and spend-down work before anyone applies, because how money is handled in the years beforehand can change whether and when someone qualifies. Our guides to Medicaid planning strategies and the Medicaid personal needs allowance cover the questions that come up most.

How to Vet an Assisted Living Facility in Virginia

Records tell you the history; a visit tells you the present. Do both, and do the records first.

Bring the agreement home and read it without a salesperson in the room. If the refund, care, or discharge terms are unclear, have a family member or an elder law attorney look it over before anyone signs. The goal isn't a perfect place. It's one whose limits you understand going in.

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.