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 $6,945 a month in 2026, a bit above the national median.1 That works out to about $83,340 a year, the state's approximate median in the CareScout 2025 Cost of Care Survey. There's also a state program, separate from Medicaid, that can help eligible residents with the cost.

This guide explains what assisted living means in Virginia, what you'll actually pay, where the Auxiliary Grant fits and how it differs from Medicaid, 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, licensed by 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.

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 $83,340 a year, roughly $6,945 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.

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.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. The main public help with the cost of a Virginia ALF is not Medicaid. It's the Auxiliary Grant, a state- and locally-funded program that is separate from Medicaid.2 If you've been assuming Medicaid will simply pick up the rent at an assisted living facility, check that assumption with your local department of social services before it shapes a budget.

The Virginia Auxiliary Grant is a cash payment for aged, blind, or disabled people who receive SSI, or who would qualify for SSI except for excess income, and who live in an ALF licensed by VDSS, an adult foster care home approved by a local board of social services, or supportive housing. Grant rates are set by state regulation, not by the facility, and a recipient keeps a personal needs allowance in an amount set in the state budget. To get the grant in an ALF, your parent must be assessed by a case manager or other qualified assessor on admission, annually after that, and whenever their condition changes enough to warrant a different level of care.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, applied for through your local department of social services, 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 long-term care in a nursing facility or a community-based setting for those who qualify, which is a different set of rules from 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 that determines the level of care they need and whether Medicaid will cover it.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; someone over it can still qualify by spending excess income down on their cost of care), 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 Medicaid long-term care track, and it is separate from the Auxiliary Grant.

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.