To qualify for Virginia Medicaid as an adult between 19 and 64, your household income must fall at or below 138% of the federal poverty level, which in 2026 is $22,025 a year for a single person and $45,540 for a family of four.1CoverVA Department of Medical Assistance Services. Adults 19-64 Years Old Virginia Medicaid income limits vary by category, though: children, pregnant individuals, seniors, and people with disabilities each follow their own thresholds, and some of those groups also have an asset test on top of the income rules.
Income Limits for Adults 19 to 64
Most working-age adults qualify through Virginia’s Medicaid expansion. The 2026 ceilings, which include a standard 5% FPL disregard, are effective January 13, 2026:
- 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.1CoverVA Department of Medical Assistance Services. Adults 19-64 Years Old
For this group, there is no asset or resource test. If your income fits under the ceiling and you meet the basic residency and citizenship rules, your savings, car, or home do not disqualify you.
What Counts as Income
Virginia uses Modified Adjusted Gross Income (MAGI) to decide eligibility for adults, children, and pregnant individuals. MAGI is your federal adjusted gross income plus any untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest. For most households, MAGI matches regular adjusted gross income almost exactly. Supplemental Security Income does not count toward MAGI.
That matters because the number you compare against the limits above is not your take-home pay or your gross wages alone. It’s the income figure that flows from your tax return, adjusted for a few specific add-backs.
Income Limits for Pregnant Individuals
Pregnant individuals qualify at higher income thresholds. Medicaid for Pregnant Women uses the same ceiling as Medicaid for Children: 148% of the federal poverty level. A pregnant woman with no other dependents counts as a two-person household because the unborn child adds one to household size, which puts the 2026 limit at $32,028 per year.2CoverVA. Cardinal Care Pregnancy and Postpartum Coverage Twins or triplets each add further to the household count.
Income between 148% and 205% FPL may qualify through FAMIS MOMS or FAMIS Prenatal Coverage. For that same two-person household, the 205% threshold is $44,362 per year. Coverage runs through the pregnancy and for 12 months after it ends, and Medicaid can also pay for medical expenses incurred up to three months before you apply.3Department of Medical Assistance Services. Medicaid for Pregnant Women
Income Limits for Children
Virginia covers kids through two tiers:
- Medicaid for Children (FAMIS Plus) covers children in families up to 148% FPL. For a family of three in 2026, that’s $40,434 per year.
- FAMIS covers uninsured children in families up to 205% FPL, which is $56,006 per year for a family of three.
FAMIS Plus delivers standard Medicaid benefits; FAMIS functions more like a private insurance plan. Both require the child to live in Virginia, be under 19, and be a U.S. citizen or lawfully residing immigrant.4Department of Medical Assistance Services. Medicaid for Children and FAMIS
Children enrolled in either program keep 12 months of continuous coverage from their enrollment date, so minor income swings during the year don’t knock them off.
Income and Asset Limits for Seniors and People With Disabilities
If you are 65 or older, blind, or have a qualifying disability, you fall under Aged, Blind, or Disabled (ABD) rules instead of MAGI. Both income and countable resources are tested.
For regular ABD Medicaid in 2026, the monthly income limit is $1,064 for a single applicant and $1,442 for a couple. Countable resources cannot exceed $2,000 for an individual or $3,000 for a couple.5Social Security Administration. SSI Spotlight on Resources Not every asset counts: your primary home, one vehicle, household goods, and burial funds up to $1,500 are typically excluded.
If you receive Supplemental Security Income, you already meet ABD income criteria, but Virginia does not auto-enroll SSI recipients. You still have to submit an application.6Department of Medical Assistance Services. Medicaid for Persons Who Are Aged, Blind, or Disabled (ABD)
Long-Term Care Medicaid
If you need nursing home care or home and community-based waiver services, the income test changes to 300% of the federal SSI benefit rate, which is $2,982 per month in 2026. The $2,000 individual resource limit still applies.
When one spouse enters a nursing facility or applies for a home-care waiver and the other stays in the community, federal spousal impoverishment rules let the at-home spouse keep assets up to the Community Spouse Resource Allowance. In 2026, the CSRA maximum is $162,660 and the minimum is $32,532. The community spouse also keeps a monthly income allowance.7Department of Medical Assistance Services. Virginia Medical Assistance Eligibility Manual Transmittal TN DMAS 34
One more rule to know before you make any big financial moves: Virginia reviews all asset transfers made within the 60 months before a long-term care Medicaid application. Assets given away or sold for less than fair market value during that window trigger a penalty period during which Medicaid will not pay for long-term care. The penalty is the uncompensated value of the transferred assets divided by the average monthly cost of private nursing home care in Virginia at the time of application.8Virginia Code Commission. Virginia Administrative Code 12VAC30-40-300 – Transfer of Resources
If Your Income Is Over the Limit: Spend-Down
Being over the income limit is not always the end of the road. Virginia’s Medically Needy Spend-Down lets people with high medical expenses qualify for time-limited coverage. You must meet all non-financial requirements and have resources below $2,000 for one person or $3,000 for two.
The state sets a spend-down amount based on your income. Once your allowable medical expenses equal or exceed that amount, Medicaid starts paying. Qualifying expenses include doctor visits, hospital bills, prescriptions, dental care, behavioral health services, health insurance premiums (including Medicare premiums), and unpaid medical bills from the current period.9Cover Virginia. Cardinal Care Fact Sheet – Medically Needy Spenddown
People receiving long-term services get a one-month spend-down period; everyone else gets six months. Coverage begins the day the spend-down is met and runs through the end of that window, and the spend-down is re-evaluated at each annual renewal.9Cover Virginia. Cardinal Care Fact Sheet – Medically Needy Spenddown
Groups Where the Usual Income Rules Don’t Apply the Same Way
Former Foster Youth
If you were in foster care through any state’s child welfare system and were receiving Medicaid when you aged out at 18 or older, Virginia covers you until age 26 regardless of income. There is no earnings test. Virginia’s Department of Social Services and DMAS automatically enroll individuals aging out of foster care, though it’s worth confirming your enrollment if you’ve moved.10Virginia Medicaid. Medicaid and Managed Care Services for Youth in Foster Care
Plan First
Plan First covers family planning services for men and women up to 205% FPL, which is $32,718 per year for a single person in 2026. This is a limited-benefit program covering contraception, reproductive health screenings, and related services, not general medical care. It often fills the gap for people whose income is too high for full Medicaid.11CoverVA Department of Medical Assistance Services. Plan First
The Non-Financial Requirements You Also Have to Meet
Income by itself doesn’t qualify you. Three non-financial requirements apply to virtually every Virginia Medicaid applicant:
- You must live in Virginia. A permanent address isn’t required, but you do need to reside in the Commonwealth.
- You must be a U.S. citizen, U.S. national, or hold a qualifying immigration status.
- You need a Social Security number for every household member on the application, or proof that you’ve applied for one.
Green card holders generally face a five-year waiting period before accessing full Medicaid benefits, measured from the date of admission as a lawful permanent resident. Lawfully residing children under 19 and pregnant individuals skip the wait. Refugees, asylees, and people with other humanitarian statuses may qualify for up to seven years after entering the country. People without any qualifying immigration status can still receive coverage for emergency medical services.
If your numbers fit the category that applies to you and the non-financial rules check out, the next step is submitting an application through CommonHelp, the Cover Virginia Call Center at 1-855-242-8282, Virginia’s Insurance Marketplace, or your local Department of Social Services. Medicaid can also cover medical bills from up to three months before the month you apply, as long as you were eligible during those months and received a covered service.12Commonwealth of Virginia Department of Medical Assistance Services. Medical Assistance Handbook