Virginia Medicaid Eligibility for Seniors: Income and Asset Limits

To qualify for Virginia Medicaid as a senior, a person age 65 or older generally must have no more than $1,084 in monthly income and $2,000 in countable assets if applying as an individual, or $1,463 in monthly income and $3,000 in assets as a couple. Those are the standard figures for the Aged, Blind, or Disabled (ABD) category as of January 2026.¹ Seniors who need nursing home care, who are married with a spouse remaining at home, or who have high medical bills but income just above the cap are measured against different, more generous rules. The sections below walk through each set of limits that applies to seniors.

Standard Income Limit for Senior (ABD) Medicaid

For regular ABD Medicaid, which covers routine medical care rather than long-term care, the monthly income ceilings as of January 2026 are:

$1,084 for an individual
$1,463 for a couple

These limits already build in a $20 standard unearned income disregard on top of the federal poverty level.¹ Social Security retirement benefits, pensions, annuities, and withdrawals from retirement accounts all count toward the monthly figure.

Income Limit for Nursing Home and Waiver Care

Seniors who need nursing facility care or home and community-based waiver services are measured against a much higher threshold known as the Special Income Level, set at 300% of the Supplemental Security Income federal benefit rate. In 2025, that figure was $2,901 per month in gross income.²

A senior whose gross income is at or below that cap can qualify for Medicaid-covered institutional or waiver care. A senior whose income runs above it is not automatically shut out; instead, the application is evaluated under the medically needy spend-down pathway described further down.

The main home and community-based option for seniors who would otherwise need a nursing home is the Commonwealth Coordinated Care Plus (CCC Plus) waiver, which covers personal care, respite care, home modifications, and personal emergency response systems. There is no waiting list.³ Financial eligibility runs through the same ABD and Special Income Level rules described here, with an added functional screening to confirm the level of care need.

Medicare Savings Program Limits

Seniors whose income is too high for full ABD Medicaid may still qualify for a Medicare Savings Program, which helps pay Medicare premiums, deductibles, and copayments. The income ceilings are:

$1,816 per month for an individual
$2,455 per month for a couple

The resource caps for these programs are also higher: $9,660 for one person and $14,470 for a couple under the QMB, SLMB, and QI programs.¹² A senior who qualifies for a Medicare Savings Program does not get full Medicaid coverage but does get meaningful help with Medicare’s out-of-pocket costs.

Asset Limits and What Counts

For the standard ABD Medicaid categories, both Categorically Needy and Medically Needy, the countable resource limit is $2,000 for one person and $3,000 for a couple.⁴ Countable resources generally include checking and savings accounts, certificates of deposit, stocks, bonds, additional vehicles, and second homes or investment property.

Not everything a senior owns is counted. Virginia excludes several categories entirely:

The primary residence is generally exempt if the applicant, a spouse, or certain relatives live there. Home equity is exempt up to $730,000 as of 2025.⁵
One vehicle, household goods, and personal effects are excluded.
Burial plots and certain prepaid burial arrangements that meet state guidelines are excluded.

Real property is valued at 100% of the local tax-assessed value or a certified appraisal, whichever is more favorable to the applicant. Joint bank accounts are generally presumed to belong in equal shares to each listed account holder.⁶

Married Couples: Protections for the Spouse at Home

When one spouse enters a nursing home and the other continues living in the community, Virginia applies spousal impoverishment rules so the at-home spouse is not stripped of income and savings. The figures are updated annually.

Community Spouse Resource Allowance

The Community Spouse Resource Allowance (CSRA) sets how much of the couple’s combined countable assets the at-home spouse may keep. For 2025, the maximum CSRA is $157,920 and the minimum is $31,584.⁵ At application, the at-home spouse’s protected share is the greatest of: the minimum resource standard, half of the couple’s total countable resources (up to the maximum), or an amount set by a court support order or hearing officer.⁷

Once eligibility is established, the institutionalized spouse’s continued eligibility is based only on assets held in their own name, provided the community spouse’s resources were properly assessed at the start. A 90-day protected period after approval allows for the legal transfer of resources into the community spouse’s name to meet the CSRA.

Minimum Monthly Maintenance Needs Allowance

The Minimum Monthly Maintenance Needs Allowance (MMMNA) sets the floor for the at-home spouse’s monthly income. Effective July 1, 2025, the MMMNA is $2,643.75 per month, with a maximum allowance of $3,948.⁵ If the community spouse’s own income falls below the MMMNA, part of the institutionalized spouse’s income can be redirected to make up the shortfall. Housing costs above 30% of the maintenance needs standard can push the allowance higher, up to the maximum cap.⁷

Over the Limit? The Medically Needy Spend-Down

Seniors whose income exceeds the standard ABD cap but who have significant medical expenses may still qualify through the Medically Needy Spenddown program. Eligibility is reached by incurring a specific amount of medical bills, with the required amount varying by household size and income.⁸

Once a person’s medical costs reach the required threshold within the eligibility period, Medicaid coverage begins for the remainder of that period. To apply, seniors submit Appendix E (Medically Needy Spenddown) along with the standard Cardinal Care application.⁹

Watch the Five-Year Look-Back Before Transferring Assets

Seniors sometimes assume they can give money or property to family members to fall under the asset limit. For long-term care Medicaid, this does not work. Virginia applies a 60-month (five-year) look-back when evaluating applications for nursing home care or home and community-based waiver services, reviewing all asset transfers made during the five years before the application date to find any that were given away or sold for less than fair market value.¹⁰ The look-back does not apply to regular, non-long-term-care Medicaid.

If disqualifying transfers are found, a penalty period of ineligibility is imposed. The penalty equals the total uncompensated value of the transferred assets divided by the average monthly cost of private nursing home care in Virginia, producing the number of months the applicant cannot receive Medicaid-covered long-term care. There is no cap on the length of the penalty.¹⁰

One point that trips people up: gifts that fall under the federal gift tax exclusion are not automatically safe from Medicaid penalties. The two systems operate independently, so a gift under the IRS annual limit can still trigger a Medicaid transfer penalty.

Several transfers are exempt. A home can be transferred without penalty to a spouse, to a child under 21 or a child who is blind or disabled, to a sibling with an equity interest who lived there for at least a year before the applicant entered a facility, or to a son or daughter who lived in the home and provided care for at least two years before institutionalization where that care allowed the parent to delay a nursing home stay. Transfers to a spouse or for a spouse’s sole benefit, transfers to a trust for the sole benefit of a blind or disabled child, and transfers to a trust for the sole benefit of a disabled person under 65 are also exempt.¹⁰

A penalty may also be reduced or eliminated if the applicant shows the transfer was made for fair market value, was made exclusively for a purpose other than qualifying for Medicaid, or if the transferred assets are returned. Virginia recognizes an undue hardship exception when denial of benefits would cause severe harm.

How to Apply Once You Meet the Limits

Seniors applying for Virginia Medicaid complete the Virginia Cardinal Care Application along with Appendix D, the ABD-LTC supplement. Appendix D is required for anyone age 65 or older, anyone eligible for Medicare, or anyone applying for long-term services and supports, and it cannot be submitted on its own.⁹ Seniors applying through the spend-down pathway also submit Appendix E.

Applications can be filed:

Online through CommonHelp (commonhelp.virginia.gov) or the Virginia health insurance marketplace
By phone through the Cover Virginia Call Center at 1-855-242-8282 (Monday through Friday, 8 a.m. to 7 p.m.; Saturday, 9 a.m. to noon)
By mail to the Cardinal Care Correspondence Center, P.O. Box 1820, Richmond, VA 23218
In person at a local Department of Social Services office

Have ready, for each household member: full legal names, dates of birth, Social Security numbers, immigration documents if applicable, employer and income information such as pay stubs or W-2s, and details about any existing health insurance including Medicare.¹¹ If more documentation is needed after submission, the state sends a letter, and responses can be returned online, by email, by fax, or at a local office.¹²

1
CoverVA. Medicaid for Persons Who Are Aged, Blind, or Disabled (ABD)
2
Virginia DMAS. Medical Assistance Eligibility Manual TN DMAS-34
3
Virginia DMAS. CCC Plus Waiver
4
Virginia DMAS. ABD Resources Manual
5
Medicaid.gov. CMS Spousal Impoverishment Standards Bulletin
6
Virginia DMAS. ABD Resources Manual
7
Virginia Code Commission. Spousal Impoverishment Protections, 12VAC30-110
8
Virginia DMAS. Aged, Blind, or Disabled Population Information
9
CoverVA. Applications
10
Virginia Code Commission. Transfer of Assets, 12VAC30-40-300
11
CoverVA. How to Apply
12
Virginia DMAS. Applying for Medicaid