Virginia Medicaid Income Limits 2026: Eligibility & Assets

Virginia Medicaid income limits for long-term care run to $2,982 a month in 2026, but being over that line doesn't shut the door the way most guides imply. There's no Miller Trust to set up here, because Virginia lets you spend the excess down instead.

This guide walks through the 2026 income and asset rules for Virginia Medicaid long-term care for aged, blind, and disabled residents, the program the state runs as Cardinal Care. It covers the asset limit, how the spend-down works without a Qualified Income Trust, what a nursing-home resident keeps, what a spouse at home is protected from, the five-year look-back, and how to apply.

The asset limit: $2,000, and what doesn't count

For a single applicant seeking Medicaid-funded long-term care, Virginia caps countable assets at $2,000. When both spouses apply, the limit is $4,000, counted as $2,000 each. This is the standard federal figure, unchanged in decades, and it's where Virginia is far stricter than states that have raised their limits into the tens of thousands.

"Countable" is the load-bearing word. Virginia, like every state, exempts a long list of assets from the count:

• Your home, as long as equity stays under the $752,000 limit and you, a spouse, or a dependent relative live there or you intend to return.
• One vehicle, regardless of value.
• Household goods and personal effects.
• A prepaid burial arrangement.

So the $2,000 applies to things like bank accounts, a second car, and investments, not the roof over your head or the car in the driveway. The gap between the strict cash limit and these generous exemptions is exactly why Medicaid planning exists, and why the look-back rules below matter so much. For the broader toolkit, see our guide to Medicaid planning strategies.

How the income test actually works: spend-down, not a Miller Trust

Here is where most write-ups about Virginia go wrong. They quote the $2,982/month income standard for long-term care, which is correct, set at 300% of the 2026 SSI federal benefit rate of $994, and then describe Virginia as if it were a hard income-cap state. It isn't.

Virginia is a medically needy state. That means an applicant whose income sits above $2,982 is not simply disqualified. Instead, the excess becomes a spend-down: once you've incurred enough medical and care costs in a budget period to absorb the income above Virginia's medically needy threshold (which runs roughly $410 to $615 a month for an individual, depending on the region), Medicaid covers the rest.

The practical consequence is large. In a strict income-cap state, an applicant even one dollar over the limit is shut out unless they route the excess through a Qualified Income Trust, also called a Miller Trust. Virginia has no such requirement. Because the state offers a medically needy spend-down pathway, a high-income applicant never has to set up a trust to qualify; the excess income simply goes toward the cost of care.

Long-term care: what a nursing-home resident keeps

When Virginia Medicaid pays for nursing-facility care, the resident contributes nearly all of their monthly income toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for small personal expenses like clothing, a haircut, or a phone. In Virginia the PNA is $40/month.

The resident's remaining income goes to the facility, after deductions for a community spouse (below) and certain health-insurance premiums. The $2,000 asset limit applies to nursing-home applicants the same way it applies to anyone else. And because Virginia uses spend-down rather than a hard income cap, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care. For the national picture on how the PNA is calculated, see our explainer on the Medicaid personal needs allowance.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Virginia applies the federal figures for 2026:

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in assets, far above the $2,000 applicant limit, and is protected to a monthly income floor in the federal MMMNA range while the other spouse receives Medicaid-funded care.

The five-year look-back

Virginia reviews asset transfers made in the 60 months before a long-term-care application. Giving away money or property for less than fair market value during that window, gifting a grandchild a down payment, signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though you're otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets.

After death: estate recovery

Like every state, Virginia runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state pursues repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. An undue-hardship waiver also exists. For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Virginia

Virginia Medicaid, branded Cardinal Care, is run by the Virginia Department of Medical Assistance Services (DMAS), and applications are processed by your local Department of Social Services. You have three ways to apply:

1. Online through CommonHelp, the state benefits portal at commonhelp.virginia.gov, which handles Medicaid alongside other assistance programs.
2. By phone through the Cover Virginia call center at 1-855-242-8282.
3. In person at your local Department of Social Services office.

Long-term-care applicants also go through a level-of-care screening to confirm they need nursing-facility-level services. Apply even if you think you're over the income limit. Because Virginia uses a medically needy spend-down rather than a hard cap, many people who assume they earn too much for long-term-care Medicaid are not disqualified at all.

Learn More

• Medicaid Planning Strategies
• How Medicaid Estate Recovery Works
• The Medicaid Personal Needs Allowance, Explained

Find personalized help working through Virginia Medicaid eligibility and spend-down for your family 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.