A semi-private nursing home room in Virginia runs about $123,005 a year. Almost no family can pay that out of pocket for long. So the real question is which funding source applies to you, and in what order. This guide lays out how to pay for senior care in Virginia in 2026.

Most families combine several sources. Private savings buy time while you line up Virginia Medicaid, VA benefits, or insurance.

In This Guide

How People Pay for Senior Care in Virginia

There are five main ways to pay. Each one covers something different. Most families use a mix.

Payer What It Does What It Doesn't Do
Out of pocket Your own income and savings, spent on the care you choose Runs down savings at the Virginia costs shown below
Medicare Up to 100 days of skilled nursing facility care per benefit period, generally after a qualifying hospital stay No long-term (custodial) care, in any setting: at home, in the community, in assisted living, or in a nursing home
Medicaid (Cardinal Care) Covers long-term care in a nursing facility or at home for aged, blind, and disabled residents who qualify Income and asset limits apply
VA Aid and Attendance A higher maximum VA pension rate for a veteran who needs another person's help with daily activities Only for those who meet VA's service, income, net worth, and care-need rules
Long-term care insurance Pays toward long-term care at home, in the community, or in a facility, once the policy's benefit trigger and waiting period are met Only if a policy is in force; people in poor health or already receiving care may not qualify for a new one

What Senior Care Costs in Virginia

Know what you're paying for before you work out how to pay. The figures below are Virginia statewide medians from the CareScout (Genworth) 2025 Cost of Care Survey, released March 2, 2026. These are industry-survey medians, not government figures. Virginia costs now run above the national medians for most care settings, after sharp year-over-year jumps in nursing-home rates.

Care Type Median Cost What It Is
In-home care (non-medical caregiver) $80,080/year ($6,673/month) Non-medical help with daily activities, meals, and errands
Adult day health care $20,995/year ($1,750/month) Daytime supervision and activities
Assisted living $83,340/year ($6,945/month) Room, board, and personal care
Nursing home (semi-private) $123,005/year ($10,250/month) Skilled, around-the-clock care
Nursing home (private room) $140,160/year ($11,680/month) Private room, skilled care

These are statewide medians, so the price at a specific facility can differ. A two-year nursing home stay at the statewide median already passes $246,000. That is why families combine the funding sources below. For a fuller breakdown, see our cost of senior care in Virginia guide.

Paying Out of Pocket

Many families start here. They draw on Social Security, pensions, retirement savings, and home equity. For a while it may be the only option, especially before Medicaid comes through.

A few private-pay tools Virginia families use:

  • Home equity. Sell the home, rent it out, or borrow against it. A federally insured reverse mortgage (a HECM) turns equity into cash for a borrower 62 or older who lives in the home, but the loan balance grows each month and must eventually be repaid, usually by selling the home. The home you live in is also excluded from Virginia Medicaid's asset count, so weigh any move against a future Medicaid plan first.
  • Life insurance. A policy that already carries an accelerated death benefit can pay out part of the death benefit early, typically up to about half, and whatever is paid comes off what beneficiaries later receive; the feature usually has to be on the policy before the insured becomes terminally ill. A policy can also sometimes be sold in a life settlement. Either move can affect Medicaid eligibility.
  • Retirement and investment accounts. These can pay for care directly, but withdrawals from a traditional IRA are taxed as ordinary income, and a distribution before age 59½ normally raises the tax by 10% of the taxable portion unless one of the statute's exceptions applies. Plan the order you draw on them alongside any future Medicaid application.

The hard truth: paying out of pocket at Virginia prices drains savings fast. Treat private pay as a bridge. Our guides to paying for in-home care and paying for assisted living cover the options in more depth.

What Medicare Does and Doesn't Cover

This is where families get caught off guard. Medicare does not pay for long-term care. It will not cover custodial care, the ongoing help with activities of daily living, when that is the only care a person needs.

What Medicare does cover is limited and medical:

  • Skilled nursing facility care for up to 100 days per benefit period, after a qualifying inpatient hospital stay of at least three consecutive days. Days 1 through 20 cost $0 a day once the $1,736 Part A deductible is paid, and it has normally already been paid if the qualifying hospital stay fell in the same benefit period. Days 21 through 100 carry a coinsurance of $217 a day in 2026. After day 100, Medicare pays nothing.
  • Home health care when a doctor or allowed practitioner orders part-time or intermittent skilled nursing or therapy, the person is homebound, and a Medicare-certified agency provides it.
  • Hospice care for someone certified as terminally ill with a life expectancy of six months or less who chooses comfort care.

Two things about that three-day stay catch families out. Time under observation or in the emergency room before admission does not count toward it, even overnight. And coming up short is not always the end of it: the requirement can be waived when the doctor belongs to an Accountable Care Organization approved for a Skilled Nursing Facility 3-Day Rule Waiver, and a Medicare Advantage plan may waive it too; re-entering a skilled nursing facility within 30 days does not need a fresh qualifying stay; and when a hospital switches someone from inpatient to observation status, a fast appeal can be filed while they are still in the hospital. Appealing a past stay is a narrower door: new requests closed on January 2, 2026 unless the filer shows good cause for filing late.

What Medicare does not pay for is long-term care, also called custodial care: help with daily activities such as dressing, bathing, and using the bathroom, plus adult day health care, provided at home, in the community, in an assisted living facility, or in a nursing home. For ongoing care, Virginians turn to Medicaid, VA benefits, long-term care insurance, or private pay.

Virginia Medicaid (Cardinal Care) for Long-Term Care

Virginia Medicaid, branded Cardinal Care, covers long-term care for aged, blind, and disabled residents who qualify. The Virginia Department of Medical Assistance Services runs it, and your local Department of Social Services processes applications.

Cardinal Care covers long-term services and supports in a nursing facility or a community-based setting. Anyone seeking that care in a nursing facility, the CCC Plus waiver, or PACE must first complete an LTSS screening, which determines the level of care needed and whether Medicaid will cover it.

How Medicaid Pays for Care at Home

If you would rather keep a parent at home than move them into a facility, Virginia Medicaid can pay for care there through home and community-based services (HCBS) under the Commonwealth Coordinated Care Plus (CCC Plus) waiver, which runs through Medicaid managed care. CMS describes its services as including adult day health care, personal assistance, respite care, assistive technology, environmental modifications, a personal emergency response system, private duty nursing, and transition services, for people who meet a hospital or nursing facility level of care. Members can choose agency-directed care, consumer-directed care, or a mix of the two.

The financial rules are the same as for nursing-facility Medicaid: the monthly income standard of 300% of the $994 SSI payment standard, which works out to $2,982, and the $2,000 asset limit both apply to waiver applicants. To apply, contact your local Department of Social Services. Some waiver services carry limits, such as a soft weekly cap on personal care hours that allows exceptions, so confirm the current services, limits, and timing with them when you apply.

Who Qualifies in 2026

Virginia is a section 209(b) state and a medically needy state. An applicant whose income is over the standard can still qualify for nursing-facility care, the CCC Plus waiver, or PACE through a spend-down.

  • Assets: up to $2,000 in countable assets for a single applicant in 2026, and $3,000 for a couple with both applying. The home, one vehicle, and personal belongings are typically exempt.
  • Income: for nursing-facility care, the CCC Plus waiver, and PACE, Virginia sets the standard at 300% of the SSI payment standard. The 2026 SSI payment standard is $994 a month, so the limit works out to $2,982. An applicant over it can still qualify by spending down the excess on medical and care costs.
  • Spousal protection: when one spouse enters care and the other stays home, the couple limit above does not apply. Virginia instead protects a share of the couple's countable assets for the at-home spouse, called the spousal protected resource amount (PRA). The federal minimum and maximum community-spouse resource standards for 2026 are $32,532 and $162,660, but $162,660 is not a ceiling on what a Virginia community spouse may keep. DMAS sets the PRA as the greatest of four alternatives, and two of those carry no dollar figure at all: an amount designated by a DMAS hearing officer, and an amount a circuit court orders as spousal support after the Medicaid administrative appeals process is exhausted. So a Virginia PRA can lawfully exceed $162,660. Once the PRA is deducted, the spouse entering care must be at $2,000 or less in countable resources.

Virginia also applies a 60-month look-back. Assets given away or sold for less than fair value in the five years before applying can trigger a penalty period, though some transfers, such as those to a spouse, are exempt., For the full picture, see our guides to Virginia Medicaid income limits, how to apply for Virginia Medicaid, and Virginia Medicaid estate recovery.

Not sure whether your parent qualifies for Virginia Medicaid? Chat with Brevy's care navigator at brevy.com.

VA Aid and Attendance for Veterans

If your loved one is a veteran with wartime service, VA Aid and Attendance can be a real funding source. It works through the VA pension. The veteran must qualify for the pension, which takes active-duty service that includes at least one day during a wartime period, a discharge that was not dishonorable, being 65 or older or meeting another of VA's conditions such as a permanent and total disability, and income and net worth within VA's limits. Aid and Attendance then also requires a care need, such as needing another person's help with bathing, feeding, or dressing. It raises the maximum annual pension rate the veteran can receive. Housebound is a separate status with its own maximum rate. A surviving spouse on VA Survivors Pension has Aid and Attendance rates of their own.

These rates are ceilings rather than checks: VA pays the difference between the maximum and the claimant's income for VA purposes, so a veteran with other income receives less. For the rate year that began December 1, 2025, VA publishes these maximum annual pension rates:

  • Single veteran: up to $29,093 a year.
  • Veteran with one dependent: up to $34,488 a year.
  • Surviving spouse with no dependent children: up to $18,697 a year.

VA sets these as yearly maximums. It pays the award monthly: the maximum rate minus countable income, divided by 12 and rounded down to the whole dollar.

Aid and Attendance is need-based. The actual payment is the maximum rate minus income for VA purposes, and unreimbursed medical expenses can lower that income, but only the part above 5% of the maximum rate counts ($872 a year for a veteran with no spouse or child). The 2026 net worth limit is $163,699, and VA's net worth calculation counts the claimant's and their dependents' assets and income for VA purposes, so comparing savings alone against that limit gives the wrong answer. What VA leaves out of assets is the home you live in, your car, and basic home items like appliances, so a paid-off home does not by itself push anyone over the limit. VA pension also has a 36-month look-back on asset transfers, and it does not reach any date before October 18, 2018. Not every gift draws a penalty: a transfer for less than fair market value counts only if keeping the asset would have pushed net worth over the limit, buying an annuity or putting money in a trust that lowers net worth can count as a transfer, and the penalty period can run up to five years. If a parent may qualify, check before moving any assets, because VA's look-back runs back 36 months from the date it receives the claim.

Long-Term Care Insurance

Did your family member buy a long-term care policy years ago? Dig it out now. Read the benefit triggers, the daily maximum, and the waiting period before you need them. Most policies pay once the insured needs help with two or more of six activities of daily living or has a cognitive impairment, as the insurer's own assessment determines, and only after the elimination (waiting) period chosen at purchase. They then pay toward care at home, in the community, or in a facility, up to a pre-set daily or monthly limit.

Check whether the policy was sold under a state Long-Term Care Partnership program. Partnerships are a state option, not a national program, and they can shelter assets from Medicaid: in partnerships set up after 2005, every dollar the policy pays out is a dollar of assets Medicaid disregards, both for eligibility and for estate recovery. Ask DMAS whether a policy qualifies for that protection in Virginia. New coverage is priced by age at purchase, and most individual policies require medical underwriting, so someone in poor health or already receiving care may not qualify. If a policy exists, treat it as central, and time a Medicaid application around when its benefits run out. Our guide to long-term care insurance explains how these policies work.

Other Ways to Pay for Senior Care in Virginia

A few smaller levers can stretch a budget. None replaces the main sources above. Get advice before acting on the ones with long-term consequences.

  • Auxiliary Grant. A state- and locally funded cash payment, separate from Medicaid, for certain aged, blind, or disabled people who receive SSI or would qualify for it except for excess income, and who live in a licensed assisted living facility, an approved adult foster care home, or supportive housing. Apply through your local Department of Social Services.
  • Annuities and trusts. Some families look at annuities or trusts as part of Medicaid planning. Transfers for less than fair value inside the 60-month look-back can trigger a penalty period, so these moves are easy to get wrong. Talk to an elder-law attorney first.
  • A written funding plan. Combining sources in the right order is the whole game. Our guide to building a senior care funding plan walks through how to sequence them.

Learn More

FinancialVirginia Senior Property Tax ReliefVirginia senior property tax relief is set by each county and city, not the state. Learn what state law requires, who qualifies, and how to apply locally. FinancialVirginia Retirement Income TaxNo, Virginia does not tax Social Security or Tier 1 Railroad Retirement. Seniors 65+ get an Age Deduction up to $12,000; pensions and IRAs are taxed to 5.75%. FinancialHow to Pay for Senior CareHow to pay for senior care: what it costs nationally and how Medicaid, Medicare, VA benefits, and private pay each fit. Who qualifies, what's covered, in 2026. FinancialHow to Pay for Assisted LivingHow to pay for assisted living in 2026: what it costs and how private pay, Medicaid waivers, VA Aid and Attendance, and long-term care insurance each fit. FinancialHow to Pay for Nursing Home CareHow to pay for nursing home care in 2026: what it costs and how Medicaid, Medicare, VA benefits, long-term care insurance, and private pay each fit in. Care TypesCost of Senior Care in VirginiaWhat senior care costs in Virginia in 2026: assisted living about $6,945 a month, a nursing home about $123,005 a year. See every setting and how to pay. MedicaidVirginia Medicaid Income LimitsVirginia Medicaid income limits: $2,982/mo for long-term care with a spend-down route above it, plus 138% FPL for under-65 adults with no asset test. MedicaidHow to Apply for Virginia MedicaidHow to apply for Virginia Medicaid in 2026 through CommonHelp, Cover Virginia, or your local DSS. Documents, the 45-day decision cap, screening, and appeals. MedicaidVirginia Medicaid Estate RecoveryVirginia Medicaid estate recovery 2026: DMAS recovers from an expanded estate, including the home, after a Medicaid member age 55+ dies. Who's protected.

Frequently Asked Questions

Does Medicare pay for assisted living or a nursing home in Virginia?

No. Medicare does not pay for long-term (custodial) care, including adult day health care and long-term care in an assisted living facility or a nursing home. It only pays for limited skilled care: up to 100 days in a skilled nursing facility per benefit period after a qualifying three-day inpatient hospital stay, and days 1 through 20 cost $0 a day after the $1,736 Part A deductible. Days 21 through 100 carry a $217 daily coinsurance in 2026, and after day 100 Medicare pays nothing. It also covers home health care and hospice for people who meet those benefits' own conditions., For ongoing care, Virginians rely on Medicaid, VA benefits, long-term care insurance, or private pay.

How does Virginia Medicaid help pay for senior care?

Virginia Medicaid, branded Cardinal Care, covers long-term care for aged, blind, and disabled residents who qualify, in a nursing facility or at home through the CCC Plus waiver. A single applicant can have up to $2,000 in countable assets in 2026. Virginia is a medically needy state: people over the income standard can still qualify for nursing-facility care, the CCC Plus waiver, or PACE by spending the excess down on care costs.

How much does senior care cost in Virginia?

In CareScout's 2025 Cost of Care Survey, released in March 2026, a semi-private nursing home room in Virginia runs about $123,005 a year, a private room about $140,160, assisted living about $83,340, and in-home care from a non-medical caregiver about $80,080.

Can VA benefits pay for senior care in Virginia?

Yes. A veteran with wartime service who qualifies for VA pension and needs another person's help with daily activities may qualify for VA Aid and Attendance, which raises the maximum pension rate. A surviving spouse on VA Survivors Pension has Aid and Attendance rates of their own. For the rate year that began December 1, 2025, the maximum annual rate is $29,093 for a single veteran, $34,488 with one dependent, and $18,697 for a surviving spouse with no dependent children. Those maximums are ceilings rather than payments: VA pays the difference between the limit and the claimant's income for VA purposes, divided into monthly payments, so a veteran with other income receives less than the figures above.

Find personalized help paying for senior care in Virginia at brevy.com.

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.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.