Virginia's Medicaid program pays for care at home and in the community through the Commonwealth Coordinated Care (CCC) Plus Waiver. The CCC Plus Waiver is Virginia's main home- and community-based services (HCBS) waiver for older adults and adults with disabilities who would otherwise need a nursing facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA If you are trying to keep a parent or spouse in their own home rather than move them into a nursing home, this is the Virginia Medicaid HCBS waiver you will most likely be working with.
The CCC Plus Waiver lets someone who meets a nursing-facility level of care receive personal care, respite, nursing, and other supports where they live.
In This Guide
- What Are Virginia Medicaid HCBS Waivers?
- The CCC Plus Waiver in Detail
- Who Qualifies for Virginia Medicaid HCBS Waivers?
- What the CCC Plus Waiver Covers
- Is There a Waiting List?
- How to Apply
What Are Virginia Medicaid HCBS Waivers?
Home- and community-based services, usually shortened to HCBS, are the long-term supports Medicaid pays for outside an institution, in your own home, a family member's home, or the community, rather than in a nursing facility. States deliver them under a federal Medicaid authority called a 1915(c) waiver, named for the section of the Social Security Act that allows a state to "waive" the usual rule that long-term care be provided in an institution.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
The idea is straightforward: many people who qualify for nursing-home care would rather stay home, and it often costs Medicaid no more, sometimes less, to support them there. A 1915(c) waiver is how a state makes that possible, defining who can enroll, what services they can receive, and the level of care they must meet.
Virginia runs its main HCBS waiver for older adults and adults with disabilities as the CCC Plus Waiver.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA It operates as a 1915(c) waiver with concurrent 1915(b) managed-care authority, which is why you may hear it discussed alongside Virginia's Medicaid managed-care plans. Virginia rebranded that managed-care program Cardinal Care in 2023, but the waiver itself is still the CCC Plus Waiver, so don't let the two names confuse you.
The CCC Plus Waiver in Detail
The Commonwealth Coordinated Care (CCC) Plus Waiver is administered by the Virginia Department of Medical Assistance Services (DMAS), the agency that runs Medicaid in the Commonwealth. It provides care in the home and community rather than in a nursing facility or other specialized-care medical facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
It serves three overlapping groups:
- Older adults.
- Adults with a physical disability.
- People who are chronically ill or severely impaired, having lost a vital body function, and who need substantial and ongoing skilled nursing care.
What ties these groups together is a single test: without the waiver's services, the person would require admission to a nursing facility, or a prolonged stay in a hospital or specialized-care nursing facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA That "but for the waiver, they'd need institutional care" standard is the heart of every 1915(c) waiver, and it is what the eligibility screening is built to confirm.
Who Qualifies for Virginia Medicaid HCBS Waivers?
Qualifying for the CCC Plus Waiver comes down to two separate tests, a functional one and a financial one. You have to clear both.
The functional test: nursing-facility level of care
First, an assessment has to show that you need the level of care a nursing facility provides.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA In Virginia this is confirmed through a Long-Term Services and Supports (LTSS) screening, which looks at how much help you need with everyday activities and medical needs and determines whether you meet a nursing-facility level of care. You request that screening through your local Department of Social Services, or a hospital discharge planner can arrange it if you are being discharged from a hospital.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
The financial test: Medicaid eligibility
Second, you have to be financially eligible for Medicaid. Virginia's institutional and HCBS income rules cap a waiver participant's total maintenance-needs allowance at 300% of the Supplemental Security Income (SSI) federal benefit rate.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA The SSI federal benefit rate is set by the federal government and updated each year; for 2026 it is $994 a month for an individual.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
Because the exact income and asset figures that flow from these rules can change and depend on your household, it is worth confirming them against the current numbers before you plan around them. Our Virginia Medicaid income and asset limits guide walks through where those thresholds land, and Virginia is a medically needy state, which means some applicants who are over the income limit can still qualify by spending down.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
What the CCC Plus Waiver Covers
The waiver pays for the supports that let someone with real care needs stay at home. Covered services include:Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
- Personal care and personal assistance with daily activities such as bathing, dressing, and mobility, delivered either through an agency or through a consumer-directed option in which you hire and manage your own aide.
- Respite care to give a family caregiver a break, again available agency-directed or consumer-directed.
- Adult day health care at a community center during the day.
- Private duty nursing for people who need ongoing skilled nursing at home.
- Services facilitation to help you manage consumer-directed care.
- Assistive technology and environmental modifications, such as a wheelchair ramp or bathroom grab bars.
- A personal emergency response system, the wearable button that summons help.
- Transition services to help someone move from a facility back into the community.
Two limits are worth knowing. Personal care carries a soft cap of 56 hours per week, with exceptions available when the individual's needs justify more, and respite is limited to 480 hours per state fiscal year, the year that runs July 1 through June 30.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA
Is There a Waiting List?
This is where the CCC Plus Waiver stands apart from Virginia's other Medicaid waivers. The CCC Plus Waiver serves all ages and does not have a waiting list.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA Once you complete the LTSS screening and are found eligible, you can enroll rather than wait for a slot to open.
That matters because Virginia's separate developmental disability (DD) waivers, which serve people with intellectual and developmental disabilities, do have a waiting list and are accessed through your local Community Services Board, not the Department of Social Services.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA The two systems are easy to mix up, so if the person you are helping has an intellectual or developmental disability, the DD waivers may be the right door and the process is different. For anyone qualifying on the basis of age, physical disability, or ongoing skilled-nursing needs, the CCC Plus Waiver is the pathway, and there is no line to stand in.
How to Apply
Applying involves two connected steps: getting the level-of-care screening and getting approved for Medicaid.
To start the level-of-care side, contact your local Department of Social Services and request an LTSS screening, or ask the hospital discharge planner to arrange one if you are leaving a hospital.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA The screening determines whether you meet the nursing-facility level of care the waiver requires.
For the Medicaid side, you complete a Medicaid application, which you can do online through CommonHelp, by phone through the Cover Virginia Call Center, or on paper.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA Federal rules give the state a decision deadline: a Medicaid eligibility determination generally may not take longer than 45 calendar days, or 90 days when eligibility is based on a disability.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf If your decision runs past that window without one of the narrow exceptions the rule allows, that is worth following up on.
Our how to apply for Virginia Medicaid guide covers the application itself in more detail, and it is fine to begin the Medicaid application and the LTSS screening around the same time.
Frequently Asked Questions
Does the CCC Plus Waiver cover adults under 65?
Yes. Although it is often described as a program for older adults, the CCC Plus Waiver serves people of all ages, including adults with a physical disability and people who are chronically ill or severely impaired and need substantial, ongoing skilled nursing care.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA What decides eligibility is meeting a nursing-facility level of care and Virginia Medicaid's financial rules, not reaching a particular age.
Can I choose and manage my own caregiver?
Often, yes. For personal care and respite, the CCC Plus Waiver offers a consumer-directed option alongside the traditional agency-directed model, which lets you hire, train, and supervise your own aide, with services facilitation available to help you manage the arrangement.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA Whether a particular family member can be paid depends on the program's current rules, so confirm the specifics with the Department of Medical Assistance Services (DMAS) or your services facilitator before you plan around it.
What's the difference between the waiver and Virginia Medicaid nursing home coverage?
Both are ways Virginia Medicaid pays for long-term care, but the setting differs. The CCC Plus Waiver pays for care in your own home and community, while nursing home coverage pays for care delivered inside a facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA Both require a nursing-facility level of care and Medicaid financial eligibility. If you are weighing the two, our Virginia Medicaid and nursing home care guide compares them.
Is the CCC Plus Waiver the same as Cardinal Care?
No. Cardinal Care is the name Virginia gave its Medicaid managed-care program in 2023, while the CCC Plus Waiver is the home- and community-based services waiver itself.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — VA Commonwealth Coordinated Care Plus Waiver (0321.R05.00) factsheet. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/VA You may hear the two discussed together because the waiver operates with concurrent managed-care authority, but they are not the same thing, so the rebrand did not change the waiver you apply for.
Learn More
Find personalized help understanding Virginia's CCC Plus Waiver and starting your application 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.