Virginia Medicaid Income Limits 2026: MAGI, Long-Term Care, Assets

Virginia Medicaid income limits come in two versions, and most guides give you only one. For long-term care the 2026 standard is $2,982 a month, and being over that line does not shut the door the way most write-ups imply: there is no Miller Trust to set up here, because Virginia lets you spend the excess down instead.1 For everyone else, including adults under 65, children, and parents and caretaker relatives, a different test applies. It is set as a percent of the federal poverty level, and it carries no asset limit at all.2

This guide covers both. It starts with which limit applies to you and Virginia's 2026 MAGI figures by group, including what changes on your 65th birthday, then works through the long-term-care rules for aged, blind, and disabled residents in detail: 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 Commonwealth runs both tracks through its Department of Medical Assistance Services.1

In This Guide

• Virginia Medicaid Income Limits in 2026: The Numbers That Matter
• Which Virginia Medicaid Income Limit Applies to You
• Turning 65: When the MAGI Pathway Closes
• The Virginia Medicaid Asset Limit and What Does Not Count
• How the Virginia Medicaid Income Limit Works: Spend-Down, Not a Miller Trust
• What a Nursing-Home Resident Keeps
• Protecting the Spouse Who Stays Home
• The Five-Year Look-Back
• After Death: Estate Recovery
• How to Apply in Virginia
• Frequently Asked Questions
• Learn More

Which Virginia Medicaid Income Limit Applies to You

Virginia runs two different Medicaid income tests. They produce different numbers for the same household, and which one applies depends on who is asking, not on how much they earn.

The $2,982/month figure above is the SSI-related aged, blind, and disabled (ABD) standard. It governs nursing-facility and waiver coverage, and it is the number that carries the $2,000 asset limit.1,3 Most of this guide is about that test, because it is the one families face when a parent needs long-term care.

The other test is MAGI, short for modified adjusted gross income. It governs the groups that make up most Medicaid enrollment: adults under 65 who are not disabled or pregnant, children, pregnant women, and parents and other caretaker relatives. MAGI limits are set as a percent of the federal poverty level (FPL), and federal law bars Virginia from applying any asset or resource test to these groups.2

That last point is the sharpest contrast on this page. The $2,000 asset limit that dominates long-term-care planning does not exist on the MAGI side. Someone applying through a MAGI group who is worried about their savings is worried about the wrong test.2

Virginia's 2026 MAGI Income Limits by Group

Virginia has adopted the ACA Medicaid expansion, so it covers the expansion adult group, which it calls MAGI Adults.4,8

Why the same group shows two numbers. Virginia states a base standard for each group and then adds the standard five-percentage-point FPL disregard on top of it. That is why the federal eligibility table lists Virginia's adult group at 133% while Virginia's own charts state 138%. The two figures are not in conflict, and neither is wrong: the federal table shows the base standard, Virginia's chart shows the standard after the disregard, and the five-point gap between them is the disregard itself. Virginia's charts apply it to the MAGI Adults, children, and pregnant-women standards.4

Children are one band, not three. Virginia does not split children into age bands for the income standard. Infants, young children, and teenagers all use a single Child Under Age 19 standard of 143% FPL, even though the federal table lists three separate columns at that same level. Children over the Medicaid limit are served by FAMIS, Virginia's separate CHIP program, at 200% FPL. The federal floor for children is 133% FPL, so Virginia covers children somewhat above the minimum it is required to meet.4,9

Pregnant women qualify at 143% FPL, and FAMIS MOMS and FAMIS Prenatal extend pregnancy coverage up to 200% FPL.4

The Parent and Caretaker-Relative Pathway

A grandparent raising a grandchild is the case that brings eldercare readers to this group, so it is worth being precise about it.

Parents and other caretaker relatives are a federally mandatory Medicaid group, but they are covered only at the state's old cash-welfare (AFDC) income standard, frozen at pre-1996 levels and converted to a MAGI equivalent. That federal floor is typically far below the poverty level, which is why in a state that did not adopt the ACA expansion a working parent can be over the Medicaid income limit at a very low income.10

Two things change that picture in Virginia. First, the frozen-AFDC number is a federal minimum, not a ceiling, and a state may set its own standard above it. Virginia calls this group Low-Income Families with Children (LIFC) and sets it in dollars rather than as a percent of FPL, tiered by locality group, so it does not reduce to a single statewide percentage the way the other groups do. The current LIFC amounts come from DMAS; ask your local social services department for the figure that applies to your locality and household size.4

Second, because Virginia adopted the expansion, a caretaker between 19 and 64 who is over the LIFC standard is not out of options. The MAGI Adults group covers them up to 138% FPL whether or not they are caring for a child.4,5

Whether a particular grandparent counts as a caretaker relative, and whose income gets counted, are questions for DMAS rather than for a table. MAGI household size follows federal tax-filing relationships, so the household is generally the tax household, and the answer can come out differently from the household rules used on the ABD side for the same family.11

Turning 65: When the MAGI Pathway Closes

Because Virginia adopted the expansion, this transition applies here in full force, and it is the part of Virginia Medicaid income limits that catches families off guard.

The expansion adult group is written for people under 65 years of age, not pregnant, and not entitled to or enrolled in Medicare, at an effective ceiling of 138% FPL, with no asset test.5,2 For one person in 2026 that ceiling works out to roughly $1,835/month: 138% of the $15,960/year federal poverty guideline for a household of one in the 48 contiguous states and the District of Columbia, which is the schedule Virginia uses. (Alaska and Hawaii run on separate, higher guidelines.)6,5

On the 65th birthday that pathway closes, and the same person is assessed on the SSI-related ABD track instead. Two things change at once:

• The income yardstick. It becomes the SSI federal benefit rate of $994/month for an individual rather than 138% FPL.3
• A resource test appears. The MAGI groups are barred from applying one. The ABD track is not, and it defaults to the SSI standard of $2,000 for an individual, which is the figure Virginia uses.3,2,1

The gap between those two yardsticks is where families get caught. A 64-year-old covered at $1,600/month sits comfortably under the $1,835 expansion ceiling but well over the $994 SSI rate, so with modest savings they can be over both tests at 65 without a dollar of income changing.6,5,3 The income standard drops and an asset test that never applied to them appears.

Age is not the only trigger. The expansion group also excludes anyone entitled to or enrolled in Medicare, so a person under 65 who reaches Medicare through disability leaves the 138% no-asset-test group the same way.5

Virginia's medically needy rules blunt the income half of this transition. As the next sections explain, income above the ABD standard does not disqualify an applicant in Virginia; the excess goes toward the cost of care instead. The resource test is the sharper change, because on the MAGI side no asset test applied at all.1,2

The Virginia Medicaid Asset Limit and What Does Not Count

For a single applicant seeking Virginia Medicaid-funded long-term care, the state caps countable assets at $2,000. When both spouses apply, the limit is $4,000, counted as $2,000 each.1 This is the standard federal SSI-related resource figure, unchanged in decades, and it is 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 federal long-term-care limit of $752,000 in 2026, and you, a spouse, or a dependent relative live there or you intend to return.12
• One vehicle, regardless of value.1
• 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.1 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 Virginia Medicaid Income Limit Works: Spend-Down, Not a Miller Trust

Here is where most write-ups about Virginia Medicaid income limits 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 the state as if it were a hard income-cap state.1,3 It is not.

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 have incurred enough medical and care costs in a budget period to absorb the income above Virginia's medically needy threshold, the program covers the rest. For an individual that threshold is regionalized into three locality groups, running $421.94/month (Group I), $485.58/month (Group II), and $631.26/month (Group III), effective July 1, 2026.1

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.1

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 for an individual and $60/month for a couple when both are institutionalized.1

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.1 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 2026:7,12

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.7,1

The Five-Year Look-Back

Virginia reviews asset transfers made in the 60 months before a long-term-care application.1,13 Giving away money or property for less than fair market value during that window, whether gifting a grandchild a down payment or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid will not pay for long-term-care services, even though you are 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.1,14 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 is run by the Virginia Department of Medical Assistance Services (DMAS), and applications are processed by your local social services department. You have three ways to apply.1

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 are 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.1

Learn More

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.