Virginia Medicaid & Elder Care
Virginia's Medicaid offers crucial long-term care support for seniors through its CCC Plus waiver, though strict income and asset limits necessitate careful planning.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardVirginia Monthly Costs
Virginia's average monthly nursing home costs are approximately 6.5% lower than the national average.
Waiver Programs
Commonwealth Coordinated Care Plus Waiver
Also called: CCC+, Cardinal Care Managed Care
The CCC Plus Waiver provides home and community-based services for older adults and individuals with physical disabilities who require a nursing facility level of care, aiming to prevent institutionalization. It offers a comprehensive range of supports to help individuals remain in their homes and communities.
- check_circle Personal Care Assistance
- check_circle Respite Care
- check_circle Adult Day Health Care
- check_circle Assistive Technology
- check_circle Environmental Modifications
- check_circle Private Duty Nursing
- check_circle Services Facilitation
- check_circle Transition Services
- check_circle Case Management
- check_circle Medical Benefits
- check_circle Behavioral Health Services
insights Program Snapshot
- Enrollment
- Approximately 50,645 authorized beneficiaries per year
- Functional criterion
- Nursing Home Level of Care (NHLOC)
- Administered by
- DMAS Office of Community Living
- Self-direction
- Available for personal care and respite services
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $2,982 | $5,964 |
| Asset Limit | $2,000 | $4,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
Virginia's Medicaid Estate Recovery Program is aggressive, seeking reimbursement for long-term care costs from deceased beneficiaries' probate and non-probate estates. Protections exist for surviving spouses and certain children, and undue hardship waivers are available.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or asset transfers made within 60 months of applying for long-term care Medicaid can trigger a penalty period of ineligibility.
- warning Excess Income: Failing to establish a Miller Trust if monthly income exceeds the state's income cap for long-term care.
- warning Joint Accounts: The full balance of a joint bank account is often presumed to belong to the applicant unless clear evidence proves otherwise.
First Steps for Families
Locate your ADRC
Contact your local Virginia Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,000.
Resource Contact
Virginia Department of Medical Assistance Services
How to Apply for Virginia Long-Term Care Medicaid
Assess Level of Care
Obtain medical certification of Nursing Home Level of Care (NHLOC) through a pre-admission screening conducted by a Community Based Screening Team or hospital discharge planner.
Gather Records
Collect comprehensive financial statements for the past 60 months, income verification, medical records, and identity documents.
Setup Miller Trust
If your monthly income exceeds the Medicaid cap, establish a Miller Trust (Qualified Income Trust) to become income-eligible.
Submit Application
Apply online via CommonHelp, by phone through the Cover Virginia Call Center, or by mailing/dropping off a paper application to your local Department of Social Services (DSS).
Interviews
Participate in any required interviews or evaluations with a Medicaid eligibility caseworker to review your application and supporting documentation.
Approval & Care
Receive a Notice of Action regarding your eligibility. If approved, benefits will activate, and you can begin receiving covered long-term care services.
Documents You'll Need
Financial Verification
- 5 years of bank statements
- Stock/bond certificates
- Retirement account information
- Proof of other investments/assets
Income Verification
- Social Security award letters
- Pension statements
- VA benefit statements
- Other income sources (e.g., rental income)
Medical/Identity
- Social Security card
- Medicare card
- Doctor's clinical assessments for level of care
- Proof of citizenship or legal immigration status
Property/Residency
- Home deed
- Vehicle registration
- Proof of Virginia residency (e.g., utility bills, driver's license)
Frequently Asked Questions About Virginia Medicaid
Does Virginia Medicaid pay for assisted living?
Virginia Medicaid, primarily through the Commonwealth Coordinated Care Plus (CCC Plus) waiver, can cover services provided in assisted living facilities for eligible seniors. However, it does not cover the cost of room and board in these facilities. Beneficiaries must meet specific financial and functional eligibility criteria, including requiring a Nursing Home Level of Care.
What is the Virginia Medicaid income limit for seniors in 2026?
For a single senior applying for long-term care Medicaid in Virginia in 2026, the monthly income limit is $2,982. For married couples where both spouses are applying, the combined income limit is $5,964. If income exceeds these limits, a Miller Trust may be required to qualify.
How long is the HCBS waiver waitlist in Virginia?
The Commonwealth Coordinated Care Plus (CCC Plus) waiver, Virginia's main Home and Community-Based Services waiver for seniors, is not an entitlement program. This means there can be a waitlist for services. While no specific current waitlist numbers or average wait times are publicly available, slots are limited, and priority is typically determined by the application date.
Will Medicaid take my parent's house in Virginia?
Virginia Medicaid will not immediately take a parent's house. The primary home is generally an exempt asset for eligibility purposes, especially if a spouse, a child under 21, or a blind/disabled child resides there. However, after the Medicaid recipient's death, Virginia's Estate Recovery Program can seek reimbursement for long-term care costs from the estate, which may include the home.
Can I be paid to care for my parent through Virginia Medicaid?
Yes, Virginia Medicaid offers consumer-directed options within its Home and Community-Based Services waivers, such as the Commonwealth Coordinated Care Plus (CCC Plus) waiver, that allow eligible individuals to hire family members (excluding spouses or legal guardians) as paid caregivers for personal care and respite services. The care recipient must meet a nursing home level of care.
Medicaid vs Medicare for long-term care in Virginia?
Medicare is federal health insurance primarily for acute medical care and does not cover long-term custodial care, such as assistance with daily activities over an extended period. Virginia Medicaid, a joint federal-state program, is the primary payer for long-term care services, including nursing home care and home and community-based services, for eligible low-income seniors who meet functional criteria.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE VIRGINIA
Last updated: April 24, 2026. Sources: Virginia Department of Medical Assistance Services, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.