Virginia Medicaid Income Limits: Adults, Children, and ABD

For a single adult under 65 in Virginia, the Medicaid income limit in 2026 is $22,025 a year, or 138% of the Federal Poverty Level. That is the headline figure, but Virginia Medicaid income limits actually vary quite a bit depending on who is applying: children, pregnant women, and people who are aged, blind, or disabled each have their own thresholds, and some are considerably higher than the adult limit while others are lower. The number that applies to you turns on your household size, which category you fit into, and, for some programs, whether you own countable assets.

Adults Ages 19 to 64

Virginia expanded Medicaid in January 2019 to cover adults between 19 and 64 who are not on Medicare. If your household income is at or below 138% of the Federal Poverty Level, you are likely eligible. The 2026 figures below already include the 5% FPL income disregard Virginia applies to every applicant:

1 person: $22,025 per year ($1,836 per month)
2 people: $29,864 per year ($2,489 per month)
3 people: $37,702 per year ($3,142 per month)
4 people: $45,540 per year ($3,795 per month)
5 people: $53,379 per year ($4,449 per month)
6 people: $61,217 per year ($5,102 per month)
7 people: $69,056 per year ($5,755 per month)
8 people: $76,894 per year ($6,408 per month)

Each additional household member adds $7,839 in yearly income allowance. These numbers are tied to the federal poverty guidelines, which update every January.¹ Adult expansion Medicaid has no asset or resource test. Savings, home equity, and vehicle value do not affect eligibility.

Children

Virginia covers children through two programs with different income ceilings. Medicaid for Children covers kids from birth through age 18 in households earning up to 148% of the FPL. FAMIS picks up where Medicaid for Children ends, covering children in households up to 205% of the FPL.

The 2026 income limits by household size:

2-person household: up to $32,028/year for Medicaid for Children; up to $44,362/year for FAMIS
3-person household: up to $40,434/year for Medicaid for Children; up to $56,006/year for FAMIS
4-person household: up to $48,840/year for Medicaid for Children; up to $67,650/year for FAMIS
5-person household: up to $57,247/year for Medicaid for Children; up to $79,294/year for FAMIS

Both programs use the same application, and Virginia automatically screens each child for the right program based on reported income.² Neither program has an asset test.

Pregnant Women

Pregnant women qualify at higher income levels than other adults. Medicaid for Pregnant Women covers household incomes up to 148% of the FPL. Women earning more than that but still under 205% FPL can qualify through FAMIS MOMS or FAMIS Prenatal coverage.

For a household of two, which is how Virginia counts a pregnant woman with no other dependents since the expected child is counted, the 2026 thresholds are:

Medicaid for Pregnant Women: up to $32,028 per year ($2,669 per month)
FAMIS MOMS or FAMIS Prenatal: up to $44,362 per year ($3,697 per month)

For a household of three, those figures rise to $40,434 and $56,006. Expected multiples raise the household count further.³ Coverage under both programs continues for a full year after the pregnancy ends, regardless of income changes during that postpartum period.

Aged, Blind, or Disabled

People who are 65 or older, legally blind, or who have a qualifying disability fall under Virginia’s Aged, Blind, and Disabled (ABD) Medicaid category. Two things make ABD stricter than expansion Medicaid: the income ceiling is lower, and there is an asset test.

For 2026, ABD Medicaid income limits sit at roughly 80% of the FPL:

Individual: $1,064 per month
Married couple: $1,443 per month combined

Countable resources cannot exceed $2,000 for an individual or $3,000 for a couple. Your home, one vehicle, personal belongings, household goods, and burial funds up to $1,500 per person do not count.⁴

ABD Medicaid does not use the MAGI method. Virginia counts most income sources and then applies specific deductions, including an earned income disregard for people who work. Social Security, pensions, and VA benefits all count.

Long-Term Care and Nursing Home Medicaid

Nursing home and long-term care coverage has its own income and asset rules, separate from ABD Medicaid. The 2026 income limit for a single applicant seeking nursing home Medicaid or a Home and Community Based Services waiver is $2,982 per month. The asset limit is $2,000, with the same exemptions that apply to ABD Medicaid.

The rules shift when one spouse needs nursing home care and the other stays at home. Only the applicant’s income is counted toward the $2,982 limit; the community spouse’s own income does not count against the applicant. The community spouse can keep between $32,532 and $162,660 in assets. If the community spouse’s income falls below a minimum threshold, they can receive a monthly maintenance needs allowance from the applicant spouse’s income, ranging from $2,643.75 to $4,066.50 per month in 2026. The home is exempt from countable assets as long as the home equity interest is below $752,000 and the community spouse or a dependent relative lives there.

How Virginia Counts Your Income

For adults, children, and pregnant women, Virginia uses the Modified Adjusted Gross Income (MAGI) method. MAGI starts with your adjusted gross income from your tax return and adds back items like tax-exempt interest. It counts wages, self-employment earnings, Social Security benefits, unemployment compensation, and investment income.⁵

Several things reduce your countable MAGI income: pre-tax contributions to employer retirement plans, student loan interest payments, and certain self-employment deductions. Gifts, loans, and child support received are generally not counted.

The 5% FPL Disregard

Every income limit CoverVA publishes already bakes in a 5% FPL disregard. For adult Medicaid, the statutory threshold is 133% FPL, but the disregard pushes the working limit to 138% FPL. The dollar figures in the tables above already reflect the disregard, so no separate calculation is needed.⁵

Non-MAGI Programs

ABD Medicaid and long-term care Medicaid do not use MAGI. These programs count income differently and impose asset tests that MAGI-based programs skip. Virginia looks at everything you own that could be converted to cash, with the exemptions noted above for your home, one vehicle, and personal effects.⁶

Medically Needy Spend-Down

If your income is over the ABD limit but you have substantial medical expenses, Virginia’s medically needy spend-down program may still cover you. You spend down the difference between your income and the medically needy income limit by incurring medical bills that use up your excess income.⁷

Virginia calculates spend-down liability over a six-month budget period. The state looks at your countable income for six months, subtracts the medically needy income limit for your household size and locality, and the remainder is your spend-down amount. Once your incurred medical expenses reach that amount, Medicaid covers the rest of the period. The medically needy income limit varies by locality, so there is no single statewide figure.

This pathway matters most for people in nursing homes or with chronic conditions whose medical costs regularly outstrip their income.

How to Apply

Virginia offers several ways to apply, and all of them lead to the same eligibility determination:

Online at commonhelp.virginia.gov or coverva.dmas.virginia.gov.
By phone at 1-855-242-8282 (TTY: 1-888-221-1590), Monday through Friday, 8 a.m. to 7 p.m.
In person or by mail through your local Department of Social Services office.

Virginia will screen you for every Medicaid category you might qualify for based on the information you provide, so you don’t need to identify the right program in advance.⁸⁹

1
CoverVA. Adults 19-64 Years Old
2
CoverVA. Medicaid for Children and FAMIS
3
CoverVA. Cardinal Care Pregnancy and Postpartum Coverage
4
Virginia Code Commission. Virginia Code 32.1-325 – Board to Submit Plan for Medical Assistance Services
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Virginia Department of Medical Assistance Services. Virginia Medical Assistance Eligibility M04 Modified Adjusted Gross Income
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Virginia Code Commission. Virginia Code 32.1-325.02 – Determinations of Assets
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Virginia Department of Medical Assistance Services. Virginia Medical Assistance Eligibility M13 – Spenddown
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CoverVA. How to Apply
9
Department of Medical Assistance Services. Applying for Medicaid