Virginia Medicaid eligibility rules for long-term care change every year — and getting them wrong can cost a family tens of thousands of dollars or result in an unexpected denial. This article explains the current income and asset limits for Virginia Medicaid long-term care in 2026, who qualifies, and what the process involves. Numbers are updated to reflect 2026 figures where available and verified against federal and Virginia DMAS guidance.
This is general legal information only — not advice for your specific situation. Medicaid rules change frequently and are highly fact-specific. Always confirm current figures with DMAS or a licensed Virginia elder law attorney before making any planning decisions.
Who Is Virginia Medicaid Long-Term Care For?
Virginia Medicaid long-term care (also called LTSS — Long-Term Services and Supports) pays for nursing home care and home- and community-based services for eligible individuals. Virginia’s primary long-term care waiver is the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, which covers home and community-based services. Note: An assisted living facility (ALF) or memory care unit is not classified as a Medicaid medical institution under DMAS rules, and Medicaid coverage in those settings operates differently than nursing facility coverage for qualifying individuals who cannot afford to pay privately. It is means-tested, meaning you must meet both income and asset limits to be eligible.
Virginia’s Medicaid program is administered by the Department of Medical Assistance Services (DMAS). Federal law sets the framework; Virginia sets some parameters within that framework.
Virginia Medicaid Income Limits for Long-Term Care (2026)
For long-term care Medicaid in Virginia, income limits work differently than for other Medicaid programs. Virginia is a “medically needy” state for some programs, but for nursing home Medicaid, the general structure is:
- Institutional/Nursing Home Medicaid: Virginia does not have a strict monthly income cap for nursing home Medicaid. Instead, the individual contributes most of their income toward the cost of care (called the “patient pay amount”), and Medicaid pays the remainder. The applicant may retain a small Personal Needs Allowance (the exact amount varies by patient-pay context and setting; confirm the current figure with DMAS or your elder law attorney) and amounts may be diverted to a community spouse or dependent family member under specific rules.
- Home and Community-Based Waivers: For programs such as the CCC Plus Waiver, DMAS uses a 300% of SSI standard for certain long-term-care and waiver eligibility contexts. SSA set the 2026 individual federal SSI payment standard at $994/month, making 300% equal to $2,982 per month for 2026. Under DMAS guidance, a person whose income exceeds the 300%-of-SSI limit is not eligible under that covered group for the applicable waiver; Virginia does not recognize Miller Trusts (Qualifying Income Trusts) as an exempt Medicaid resource for this purpose. Individuals above the income limit should consult a Virginia elder law attorney to evaluate whether any other eligibility route applies to their situation.
Virginia Medicaid Asset Limits for Long-Term Care (2026)
Asset limits are where most families face the greatest challenge. Here are the key figures:
Single Applicants
A single person applying for long-term care Medicaid in Virginia may retain approximately $2,000 in countable assets. Assets above that level generally must be spent down before Medicaid will pay.
Married Couples: Community Spouse Resource Allowance (CSRA)
When one spouse enters a nursing facility and the other remains at home (the “community spouse”), Virginia follows the federal spousal impoverishment protection rules. The community spouse may retain a much larger share of the couple’s combined countable assets — up to the federally adjusted maximum. For 2026, DMAS’s January 2026 spousal resource standards set the CSRA at a minimum of $32,532 and a maximum of $162,660.
The minimum CSRA ensures that even if half the couple’s countable assets falls below $32,532, the community spouse retains at least that floor amount. The maximum protects up to $162,660 regardless of the 50-percent calculation.
Minimum Monthly Maintenance Needs Allowance (MMMNA)
In addition to the CSRA, the community spouse is entitled to a minimum income allowance. If their own income is insufficient, they may receive a portion of the institutionalized spouse’s income. The MMMNA for 2026 is $2,643.75 per month (minimum) and $4,066.50 per month (maximum), adjusted upward based on the community spouse’s excess shelter costs.
What Assets Are Exempt (Not Counted)?
Not all assets count toward the Medicaid limit. In Virginia, the following are generally exempt:
- Primary residence — exempt if the applicant intends to return, or if a spouse or dependent relative lives there. A home equity cap applies for single applicants; Virginia’s 2026 home equity limit is $752,000.
- One automobile — regardless of value
- Household goods and personal effects
- Irrevocable prepaid funeral/burial arrangements
- Term life insurance (no cash value); whole/universal life policies with cash value above $1,500 may be countable
- Retirement accounts in payout status — treatment is complex; consult an attorney
The Five-Year Lookback Period
Virginia Medicaid reviews all asset transfers made during the 60 months (five years) before the application date. Transfers for less than fair market value during this period — including gifts to children, transfers to trusts, or charity donations — can trigger a penalty period during which Medicaid will not pay for care.
The penalty period is calculated by dividing the total value of disqualifying transfers by the average daily private-pay nursing home cost in Virginia (set by DMAS and updated periodically). This makes early planning — ideally five or more years before you anticipate needing care — especially powerful.
For a full explanation of spend-down strategies and the lookback period, see our article on Medicaid spend-down rules in Virginia.
How to Apply for Virginia Medicaid Long-Term Care
Virginia long-term care Medicaid applications are processed through the local Department of Social Services (DSS) in the applicant’s county or city. Here is the general process:
- Step 1: Gather documentation — identity, residency, income (Social Security award letters, pension statements), and asset documentation (bank statements for 60 months, investment accounts, real estate deeds, insurance policies).
- Step 2: Complete the Medicaid application (available through coverva.org or your local DSS office).
- Step 3: Submit the application and respond to any requests for additional documentation from DSS.
- Step 4: DSS reviews the application and issues an eligibility determination. This process can take 45–90 days or longer.
An elder law attorney can help prepare and submit the application, ensure all documentation is complete, and respond to any issues that arise — including disputes about the lookback period or countable assets.
Virginia Medicaid and Nursing Home Planning: Key Takeaways
- Virginia Medicaid long-term care has strict asset limits (~$2,000 for single applicants).
- Married couples have substantially more protection through the CSRA and MMMNA.
- The home is generally exempt during your lifetime but may be subject to estate recovery after death.
- The five-year lookback period means last-minute asset transfers can backfire.
- Early planning — ideally five or more years in advance — provides the most options.
- Crisis planning options do exist, particularly for married couples, even when a nursing home admission is imminent.
Talk to a Virginia Elder Law Attorney
Medicaid planning is one of the most complex areas of elder law. The rules change each year, vary by program, and interact in ways that can produce unexpected results without careful planning. At Prior Law, we serve families throughout the Shenandoah Valley with compassionate, practical elder law and Medicaid planning guidance. We offer free consultations and can help you understand your options — whether you’re planning well in advance or facing an urgent situation.
Schedule a free consultation with Prior Law →
Frequently Asked Questions
What is the income limit for Medicaid in Virginia in 2026?
For nursing home Medicaid, Virginia does not use a strict income cap. Instead, the applicant contributes nearly all income toward the cost of care — retaining a small personal needs allowance (the applicable amount varies by setting and patient-pay context; confirm the current figure with DMAS or your elder law attorney) — and Medicaid pays the balance. For home- and community-based waivers, income limits may apply — confirm current figures with DMAS or a Virginia elder law attorney.
What is the asset limit for Medicaid in Virginia in 2026?
For a single applicant, approximately $2,000 in countable assets. For a married couple, the community spouse may retain between $32,532 (minimum) and $162,660 (maximum) in countable assets under the 2026 CSRA limits. Exempt assets like the primary home, one vehicle, and prepaid burial arrangements do not count toward the limit.
Does Virginia Medicaid count my IRA?
The treatment of IRAs under Virginia Medicaid is complex. An IRA in payout status (where the owner is taking required minimum distributions) may be treated as income rather than an asset. An IRA not in payout status is typically counted as a resource. The rules vary by circumstance and should be analyzed by an elder law attorney.
Can I give away assets to qualify for Medicaid?
Giving away assets to qualify for Medicaid is subject to the five-year lookback rule. Transfers for less than fair market value within five years of applying can trigger a penalty period during which Medicaid will not pay for care. There are narrow exceptions. Do not make transfers without consulting an elder law attorney first.
Disclaimer: This article is for general informational purposes only and does not constitute legal advice. Medicaid rules change frequently and vary by individual circumstance. Figures cited are approximate and should be verified with DMAS or a licensed Virginia elder law attorney before making any decisions. No attorney-client relationship is formed by reading this article.
