You can apply for Virginia Medicaid three ways: online through CommonHelp, by phone with Cover Virginia at 1-855-242-8282, or in person at your local Department of Social Services. This guide walks through each channel, what happens after you submit, the documents to gather, and how to appeal a denial.

In This Guide

For the most current details, visit coverva.dmas.virginia.gov.

Apply Online Through CommonHelp

CommonHelp is Virginia's self-service portal for Medicaid and other benefits. Go to commonhelp.virginia.gov and select "Apply for Benefits." You can create an account, which lets you save your progress, upload documents, and check status later, or apply as a guest.

The online application asks about your household, income, assets, and any current health coverage. Once submitted, it routes to your local DSS for processing.

CommonHelp is the fastest path for community Medicaid (coverage for adults and seniors who are not seeking nursing-facility or waiver care). Long-term care applicants can also start here, but the application then triggers a separate level-of-care screening described below.

Apply by Phone Through Cover Virginia

Cover Virginia is the state's central call center for Medicaid enrollment. Call 1-855-242-8282 and a representative can take your application over the phone, answer eligibility questions, and tell you which documents you'll need. Phone is a good option if you'd rather not fill out the online form yourself or if you have questions about which program fits your situation.

Cover Virginia can also help you check on an application already in progress and connect you to your local DSS.

Apply in Person at Your Local DSS

Every Virginia city and county has a local Department of Social Services. Staff there process Medicaid applications and can help you complete the paperwork on the spot, including the long-term care application. Applying in person is often the most practical route for nursing-facility and waiver cases, where a caseworker can explain the asset, income, and transfer rules face to face.

To apply in person, bring the documents listed below. If you can't get to the office, a family member or someone you authorize in writing can apply on your behalf.

Not sure which channel fits your situation? Chat with Brevy's care navigator at brevy.com to check your eligibility before you start.

What Happens After You Apply

Once your application reaches your local DSS, a caseworker reviews it in a few steps.

Financial determination. The caseworker verifies your income and countable assets against the program limits. For long-term care, a single applicant must have no more than $2,000 in countable assets in 2026; a married couple with both spouses applying is limited to $4,000. The home (within an equity cap), one vehicle, household goods, and a prepaid burial are exempt. If your income is over the $2,982 per month long-term care standard, Virginia's medically needy rules let you spend the excess down on medical and care costs to qualify. The caseworker also reviews any asset transfers in the 60-month look-back for gifts or below-market sales, which can create a penalty period.

Level-of-care screening (long-term care only). If you're applying for nursing-facility or waiver coverage, you must also meet a functional standard. A screening team assesses whether you need that level of care. This is separate from the financial review, and both have to clear before long-term care coverage starts.

Managed care enrollment. Most Virginia Medicaid members receive care through Cardinal Care managed care plans. After approval, you'll be enrolled in a health plan, and in most cases you can choose among the available plans in your area.

Personal needs allowance. A Medicaid-eligible nursing-facility resident contributes nearly all monthly income toward the cost of care but keeps a $40 per month personal needs allowance, plus allowances for a community spouse and certain health-insurance premiums.

Eligibility decisions generally arrive by mail. Application processing timelines vary by case complexity, and long-term care applications that require a level-of-care screening typically take longer than community coverage. If you haven't heard back within the expected window, call Cover Virginia or your local DSS for a status update.

If Your Virginia Medicaid Application Is Denied

A denial notice will state the reason and explain your appeal rights. If you disagree, you can request a fair hearing (an appeal). Federal Medicaid rules give applicants the right to appeal an adverse decision, and the denial notice lists the deadline and how to file.

Common reasons for denial include income or assets over the limit, a transfer penalty from the look-back review, missing documents, or a missed verification deadline. Many denials are procedural rather than substantive, meaning the applicant didn't return a requested document in time. If that's what happened, respond to the request right away and ask your DSS caseworker how to proceed.

At the hearing, you can present documents and explain your situation, and you may bring a representative or attorney. If the denial turned on a financial or transfer issue, an elder law attorney or your local Area Agency on Aging can tell you quickly whether the decision was correct.

Documents to Gather Before You Apply

Having paperwork ready prevents the most common cause of delay. Gather these before you start any channel:

Identity and citizenship:

  • Social Security card or number
  • Proof of U.S. citizenship or qualifying immigration status (a passport or birth certificate works); already on Medicare counts as proof of citizenship
  • A Virginia driver's license or state ID

Income:

  • Social Security award letter or SSA-1099
  • Pension and retirement income statements
  • Recent pay stubs if anyone in the household is working

Assets:

  • Recent bank statements for all checking and savings accounts
  • Statements for retirement accounts, CDs, stocks, and bonds
  • Life insurance policies (face value and cash surrender value)

For long-term care applicants:

  • Records of any gifts or property transfers in the past five years, for the look-back review
  • Property deeds and recent tax bills
  • Prepaid burial or funeral contracts

Ready to apply? Talk to Brevy's care navigator and they'll help you organize your documents first.

Frequently Asked Questions

Start an application online at CommonHelp, by phone with Cover Virginia at 1-855-242-8282, or in person at your local DSS. Long-term care applicants go through both a financial determination and a separate level-of-care screening, so applying in person at your DSS is often the most practical route for nursing-facility and waiver cases.

For long-term care in 2026, the income standard is $2,982 per month and the countable asset limit is $2,000 for a single applicant ($4,000 for a couple with both applying). Virginia is a medically needy state, so an applicant over the income standard can still qualify by spending excess income down on medical and care costs. No Miller Trust is required.

No. Unlike income-cap states, Virginia uses medically needy spend-down rules. If your income exceeds the standard, you spend the excess down on care and medical costs rather than routing it through a Qualified Income Trust.

Yes. A family member, friend, or an authorized representative you designate in writing can submit the application, provide documents, and follow up with your DSS or Cover Virginia. If you can't sign because of incapacity, someone with legal authority such as a power of attorney or guardian can act for you.

Timelines depend on case complexity. Community Medicaid is generally decided faster than long-term care, which requires a level-of-care screening in addition to the financial review. If you haven't heard back within the expected window, call your local DSS or Cover Virginia for a status update.

Have questions about your situation? Chat with Brevy's care navigator. It's free and takes a few minutes.

Learn More

Find personalized help applying for Virginia Medicaid 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.

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Brevy Care Team

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