The Virginia Medicaid application PDF is available as a free download from the Cover Virginia website at coverva.dmas.virginia.gov/apply/applications/, where it’s listed as the “Virginia Cardinal Care (Medicaid and FAMIS) Application.”1CoverVA. Applications The form itself is titled “Application for Health Coverage & Help Paying Costs” and covers both Medicaid and FAMIS (Virginia’s Children’s Health Insurance Program), so a single form works for everyone in your household.
Where to Download the Form
Go to the Cover Virginia applications page and click the “Virginia Cardinal Care (Medicaid and FAMIS) Application” link. The file opens as a printable PDF you can save or print at home.1CoverVA. Applications Print all pages, fill it out by hand, and sign it. An unsigned application will not be processed.
The Department of Medical Assistance Services (DMAS) administers Virginia Medicaid, which covers more than two million residents.2Virginia Medicaid. Home
How to Submit the Completed PDF
The PDF instructs you to send the signed application to the local Department of Social Services (DSS) office in the city or county where you live.3Virginia Department of Medical Assistance Services (Cover Virginia). MAGI Standard Application for Health Coverage and Help Paying Costs You can mail it, drop it off in person, or fax it. If you mail the application, certified mail gives you a dated receipt proving when it arrived, and that date can affect when your coverage starts.
What to Have Ready Before You Fill It Out
Missing documentation is the most common reason applications stall. Gather these items first:
- Proof of U.S. citizenship or eligible immigration status for each person seeking coverage. A U.S. passport, birth certificate, or certificate of naturalization all work. Lawfully present immigrants need documents showing their status.4Virginia Department of Medical Assistance Services. Virginia Medical Assistance Eligibility – Chapter M02 Nonfinancial Eligibility Requirements
- Proof of Virginia residency, such as a utility bill, lease, or Virginia driver’s license.5Virginia Department of Social Services. Proof of U.S. Citizenship and Identity for Medicaid
- Names, dates of birth, and Social Security numbers for everyone in the household, plus how members are related.
- Recent pay stubs, W-2s, tax returns, or Social Security benefit statements for all household members, not just the applicant.
- Details about any current health coverage, including Medicare or employer plans.
Applicants who qualify based on age, blindness, or disability also need documentation of assets: bank statements, property records, vehicle titles, and information about life insurance policies.
Faster Ways to Apply
Paper is not the only option, and it’s not the fastest. Cover Virginia lists four submission methods, all leading to the same eligibility determination:6Department of Medical Assistance Services. How to Apply
- Online at commonhelp.virginia.gov. You get a confirmation number immediately as proof of your submission date.
- By phone through the Cover Virginia Call Center at 1-855-242-8282 (TTY: 1-888-221-1590), Monday through Friday, 8 a.m. to 7 p.m. A representative can take the application over the phone.
- Through Virginia’s Insurance Marketplace at marketplace.virginia.gov. If the Marketplace finds you eligible for Medicaid or FAMIS, you’re automatically enrolled and sent a notice.
- The paper PDF, submitted to your local DSS office as described above.
The online and phone options usually move faster because there’s no mail delay and fewer opportunities for missing information to slow things down.
Who Qualifies
Virginia expanded Medicaid in 2019. Adults between 19 and 64 with household income below 138% of the Federal Poverty Level (FPL) now qualify, as long as they don’t have Medicare.7CoverVA. Adults 19-64 Years Old For 2026, the federal poverty level for one person is $15,960, so 138% works out to roughly $22,025 in annual income.8U.S. Department of Health and Human Services. 2026 Poverty Guidelines For a family of four, the poverty line is $33,000, making the Medicaid income cutoff about $45,540.
Children and pregnant individuals qualify at higher income levels. Virginia covers pregnancy and postpartum care under the Cardinal Care Pregnancy and Postpartum Coverage program, with a built-in 5% FPL disregard applied on top of the base threshold.9CoverVA. Cardinal Care Pregnancy and Postpartum Coverage Children’s coverage through Medicaid and FAMIS extends to families above the adult income limit.
For most applicants, Virginia measures eligibility using Modified Adjusted Gross Income (MAGI), which is essentially your adjusted gross income from your tax return plus certain items like tax-exempt interest.10Centers for Medicare & Medicaid Services. Income Eligibility Using MAGI Rules The state counts income for everyone in your tax household.
Applicants Aged 65+, Blind, or Disabled
If you’re applying based on age (65 or older), blindness, or a disability, different rules apply. Alongside income limits, there’s an asset test. Countable assets are generally capped at $2,000 for an individual. Your primary home (up to $730,000 in equity), one vehicle, household furnishings, and irrevocable funeral trusts don’t count toward that limit. When one spouse enters a nursing home and the other stays in the community, the at-home spouse can keep a portion of the couple’s combined assets under the Community Spouse Resource Allowance, which is federally set and adjusted annually.
How Long Processing Takes
Virginia has set maximum processing timeframes that vary by applicant type:11Virginia Department of Medical Assistance Services. Virginia Medicaid – Eligibility, Application, and Coverage
- Pregnant individuals: 7 calendar days
- Breast and Cervical Cancer Prevention and Treatment Act applicants: 10 working days
- All other applicants: 45 calendar days
- Applicants needing a disability determination: 90 calendar days
Clean, complete applications often move faster than the maximum. During review, an eligibility worker may mail you a request for additional verification. If you don’t respond by the deadline in that letter, your application can be denied for lack of response, even if you would have qualified. Watch your mail closely after submitting.
Coverage for Medical Bills You Already Have
If you’re approved, Virginia Medicaid can cover medical expenses from the three months before your application month, as long as you were eligible during that period. You don’t need to file a separate request. The eligibility worker evaluates retroactive coverage as part of the standard review. Keep receipts and billing statements for any care you received during those three months.
Hospital Presumptive Eligibility
Virginia hospitals can grant temporary Medicaid coverage called Hospital Presumptive Eligibility (HPE) to patients who appear to meet the basic qualifications. Coverage starts the day the hospital makes the determination and runs through the last day of the following month.12Virginia Department of Medical Assistance Services. HPE Limited Coverage for Pregnant Women FAQ If you submit a full Medicaid application before the temporary coverage expires, eligibility can continue without a gap while the application is processed. HPE is not a substitute for the full application. It ends on its own if you don’t file the regular application.
If Your Application Is Denied
Virginia sends a written notice explaining the decision. If you’re denied, the notice states the specific reason and includes instructions for appealing and the deadline to do so.13Department of Medical Assistance Services. Appeals Common denial reasons include income above the threshold, missing documentation, or failure to respond to a verification request.
Don’t let the appeal deadline pass. If the denial was for missing documents rather than ineligibility, you can also reapply with complete information, though a fresh application starts a new processing clock. If a verification request was mailed to an old address and you were denied for not responding, appeal immediately and explain what happened. The appeals process exists for exactly that situation.
A Note for Nursing Home and Long-Term Care Applicants
If you’re applying for Medicaid to pay for nursing home care or other long-term care, the standard application is only the starting point. Virginia looks back 60 months from your application date to identify any assets you gave away or sold below fair market value, and disqualifying transfers create a penalty period during which Medicaid won’t pay for your care.14Centers for Medicare & Medicaid Services. Transfer of Assets in the Medicaid Program Some transfers are exempt, including transfers to a spouse or to a trust for a disabled child, but the details matter and the financial consequences of getting them wrong are large. Get professional guidance before filing this kind of application.