Virginia Medicaid Income Limits 2026: Medicaid and FAMIS

Medicaid isn't a grant, and no one can charge you to apply. For how these numbers compare with other states, see our national Medicaid income limits guide.

Virginia Medicaid Income Limits by Household Size (January 2026)

$3,795 a month is the adult limit for a family of four, according to the Cover Virginia income guide for adults 19 to 64, and every column below comes from Cover Virginia's pages and the DMAS income charts effective January 13, 2026. These are monthly gross income limits under MAGI rules, and they already include the 5% disregard.

Sources: Cover Virginia income guidelines "as of January 13, 2026," and the DMAS Chapter M00 appendix charts effective January 13, 2026. Note: DMAS says a pregnant woman's household is at least two people, so the one-person row doesn't apply to pregnancy coverage. Base limits before the disregard are 133% for adults ($1,769 for one person), 143% for children and Medicaid for Pregnant Women ($1,902 for one) and 200% for FAMIS, FAMIS MOMS and FAMIS Prenatal ($2,660 for one).

Yearly equivalents

Source: Cover Virginia yearly income guidelines as of January 13, 2026, including the 5% disregard.

Parents and caretaker relatives (LIFC), by locality group

Virginia's separate parent and caretaker group uses flat dollar amounts that vary by locality, not a poverty percentage. According to the Medicaid.gov eligibility levels data (opens in a new tab), that works out to about 49% of poverty. These limits took effect July 1, 2026.

Source: DMAS Chapter M00 appendix, Low-Income Families with Children income limits effective July 1, 2026. Group III includes Arlington, Fairfax, Prince William and Montgomery counties and cities such as Alexandria, Charlottesville and Hampton; Group II includes Henrico, Chesterfield, Loudoun and cities such as Richmond, Norfolk and Virginia Beach; the rest of the state is Group I.

Older adults, people with disabilities and long-term care

Sources: DMAS Chapter M00 appendix (ABD and LTSS sections), the DMAS ABD fact sheet (opens in a new tab) and the DMAS Chapter M11 resource rules (opens in a new tab) (M1110.003). DMAS figures don't include the $20 unearned income disregard; Cover Virginia's ABD page (opens in a new tab) adds it, which is why it shows $1,084 for one person.

How Virginia Counts Your Income: MAGI, Non-MAGI and the 5% Disregard

2 sets of rules decide Virginia Medicaid, and the one that applies to you changes what counts.

MAGI rules (adults, parents, children, pregnancy, FAMIS). Income is modified adjusted gross income: the adjusted gross income from a federal tax return, plus untaxed foreign income, tax-exempt interest and non-taxable Social Security. Cover Virginia says family size is usually the number of people on the family's federal tax return; for families who don't file, it's the parents and children under 19 living together, stepparents and stepchildren included. There's no asset test.

What doesn't count under MAGI. The DMAS appendix lists child support received, workers' compensation, veterans' benefits that aren't taxable, gifts and inheritances, educational scholarships and grants, and parsonage allowances as not counted. Alimony counts only under divorce agreements finalized before January 1, 2019. Lottery and gambling winnings of $80,000 or more in a single payout are spread over up to 120 months.

The 5% disregard. Virginia applies the federal disregard in 42 CFR 435.603 (opens in a new tab) which subtracts 5% of the poverty line from income when that decides eligibility. Virginia's chart sets that at $67 a month for one person, $114 for three and $138 for four, effective January 13, 2026, and Cover Virginia's charts already include it.

Non-MAGI rules (aged, blind, disabled and long-term care). These count income the way SSI does, including Social Security, pensions, wages, interest and dividends, and the income of both spouses. Resources count too. People over the ABD limit can sometimes "spend down" to qualify by having enough medical bills; the medically needy income levels for one person, effective July 1, 2026, are $421.94 a month in Group I, $485.58 in Group II and $631.26 in Group III localities.

To make it specific: for example, a family of three in Virginia earning $4,000 a month in wages is over the $3,142 adult limit, so the two parents don't qualify through Medicaid Expansion. Their child is over the $3,370 Medicaid line but under FAMIS's $4,668, so the child gets FAMIS at no cost. If the mother is pregnant, the expected baby counts in her household, making it four people, and $4,000 is under the $4,070 limit for Medicaid for Pregnant Women. She'd get full Medicaid through 12 months after the pregnancy ends.

Resource Limits: $2,000 for One Person, $3,000 for a Couple

$2,000 for one person and $3,000 for a couple are the resource limits for Virginia's aged, blind and disabled groups, according to the DMAS resource limits data in eligibility manual section M1110.003, revised January 1, 2026. The DMAS fact sheet says your home and adjoining property, one car, burial plots, home furnishings and personal jewelry don't count. Bank accounts, stocks, bonds, the cash value of some life insurance and property that doesn't adjoin your home do.

Source: DMAS Chapter M00 appendix, Long Term Services and Supports reference table (section revised July 2026) and Categorically Needy 300% of SSI chart.

Long-term care also needs a screening that shows you need a nursing-facility level of care, according to Cover Virginia's long-term services page (opens in a new tab). Some members pay part of the cost of care each month, called patient pay.

None of the asset rules apply to MAGI groups. A working parent with savings can still get Medicaid if income is under the line.

Expansion State vs Non-Expansion State: What Virginia's Adult Limit Means

138% of poverty for adults 19 to 64 exists because Virginia expanded Medicaid, according to the Medicaid.gov eligibility levels table (opens in a new tab), which lists Virginia's expansion limit at 133% (138% with the disregard) and its parent limit at 49%. In a state that didn't expand, such as Texas, most adults without children can't get Medicaid at any income, and parents face a very low cutoff.

That's why the LIFC parent chart rarely decides anything in Virginia. A parent in the city of Richmond earning $1,000 a month for a family of three is over the Group II parent limit of $788, but well under the $3,142 Expansion limit, so the parent still qualifies.

What changes in 2027. Under the 2025 federal budget law and CMS's interim final rule published June 3, 2026 (opens in a new tab), DMAS says on its federal work requirements page (opens in a new tab) that:

• Applicants applying on or after January 1, 2027 must show they met the requirement in the month before they apply.
• Current members are checked at renewals scheduled for March 31, 2027 or later, for at least one month since their last renewal.
• The requirement is 80 hours a month of work, job training, school or volunteering, half-time school enrollment, or at least $580 a month in earnings.
• Exemptions include parents and caregivers of a child under 14, pregnancy and 12 months postpartum, serious medical or mental health conditions, disability, tribal members, veterans with a 100% disability rating and people in high-unemployment localities.
• These adults will also renew every 6 months instead of 12.

Current members got a letter by the end of September 2026. The rule applies only to Medicaid Expansion; it doesn't touch children, pregnancy coverage, ABD Medicaid or people 65 and older. Income limits don't change.

What DMAS and Cover Virginia Don't Tell You

Grantsights found 6 things the official charts leave out or make easy to misread:

1. Pregnancy charts start at one person, but DMAS says the household is at least two. Cover Virginia's pregnancy table has a one-person row ($1,969), but the DMAS chart notes that a pregnant woman's household is at least two individuals. A single pregnant woman should use the two-person limit: $2,669 for Medicaid for Pregnant Women or $3,697 for FAMIS MOMS.
2. FAMIS MOMS and FAMIS Prenatal require you to be uninsured. If you have private coverage, you'd need to qualify through Medicaid for Pregnant Women's 148% limit instead. FAMIS Prenatal is open regardless of immigration status but ends 60 days after the pregnancy, while FAMIS MOMS and Medicaid for Pregnant Women continue 12 months.
3. The appendix lists the nursing-home limit two ways. The long-term care reference table on page 20 shows "300% SSI Limit $994," which is the SSI rate itself. Page 17 of the same appendix lists the 300% limit as $2,982, which is the correct figure.
4. The SSI couple rate is off by $1. The appendix lists $1,490 for a couple in 2026; Social Security's rate chart (opens in a new tab) says $1,491.
5. The Medicaid.gov eligibility table (opens in a new tab) is old. It reflects state choices as of December 1, 2023. Its percentages still match Virginia's 2026 charts, but use DMAS for dollar amounts.
6. Losing coverage at renewal isn't the end. DMAS gives you 90 days after coverage ends to return renewal paperwork, which is usually faster than an appeal.

Grantsights analysis of the DMAS January 13, 2026 income charts found that children in a family of four can stay on FAMIS up to $5,638 a month, $1,843 above the $3,795 adult Expansion limit for the same family. Many Virginia households earn too much for the parents to qualify but not too much for the kids.

Common Mistakes and Red Flags

These 6 errors cost Virginians coverage they could have had:

• Common mistake: using take-home pay. MAGI starts with gross income from your tax return, so pre-tax retirement and health premiums come out, but tax withholding doesn't.
• Counting child support as income. Under MAGI, child support you receive doesn't count.
• Assuming savings disqualify you. There's no asset test for adults, children, parents or pregnancy. If you're close to the line, applying is worth it: the eligibility worker, not a chart, makes the call.
• Applying only for yourself. Even if you're over the adult limit, your children may qualify for Medicaid or FAMIS. Apply for everyone.
• People underestimate the pregnancy limits. At up to 205% of poverty, many working households qualify during pregnancy. Report a pregnancy right away through Cover Virginia's Specialized Pregnancy Unit.
• Red flag: anyone charging to apply. Applications are free, and Cover Virginia lists free application assisters. A website or person asking for a fee, a gift card or your CommonHelp password isn't part of the program.

How to Apply for Virginia Medicaid and FAMIS

4 ways to apply, all free, according to Cover Virginia's how to apply page (opens in a new tab):

• Online: CommonHelp (opens in a new tab), where you can also apply for SNAP.
• By phone: Cover Virginia, 1-855-242-8282 (TTY: 1-888-221-1590), Monday through Friday, 8 a.m. to 7 p.m. The call center closed on Saturdays starting April 4, 2026.
• By mail: Cardinal Care Correspondence Center, P.O. Box 1820, Richmond, VA 23218.
• In person: your local Department of Social Services, which you can find through the Virginia DSS local agency directory (opens in a new tab).

Virginia's Insurance Marketplace (opens in a new tab) also makes Medicaid decisions. If it finds you eligible, you're enrolled automatically. Have names, birth dates, Social Security numbers for people applying, immigration document numbers, pay stubs or W-2s and any other insurance information ready. If DMAS asks for more documents and you don't reply, your application can be denied.

How long it takes. Virginia has up to 45 days under 42 CFR 435.912 (opens in a new tab) to decide most applications and 90 days when eligibility depends on a disability. Once approved, Medicaid for Pregnant Women and ABD Medicaid can start the month you applied, and both can cover up to 3 months before that if you were eligible.

What to Do If You're Denied

30 days from the date on your notice, plus 5 days for mailing, is your deadline to appeal, according to the DMAS Client Appeals Process At-A-Glance (opens in a new tab). You can file:

• Online through the DMAS appeals portal on the applicant and member appeals page (opens in a new tab)
• By email to appeals@dmas.virginia.gov
• By phone at 804-371-8488 or fax at 804-452-5454
• By mail or in person at the Appeals Division, DMAS, 600 E. Broad Street, Richmond, VA 23219

Include a full copy of your notice and any documents you want reviewed. If good cause delayed your appeal, DMAS can make an exception. For decisions by your Cardinal Care health plan, you appeal to the plan first, then have 120 days after its final decision to appeal to DMAS, and that window can't be extended.

If You're Over the Limit: Medicare, FAMIS and the Marketplace

3 main routes cover most people who earn too much for Virginia Medicaid:

• FAMIS for children and FAMIS MOMS for pregnancy, up to 205% of poverty ($5,638 a month for four).
• Virginia's Insurance Marketplace, where adults over the Medicaid line can buy a plan and may qualify for premium tax credits. Members who lose Medicaid or postpartum coverage may be referred there.
• Medicare help for people 65 and older or on disability Medicare. Medicare Savings Programs pay Medicare premiums for people up to $1,816 a month for one person (QI, including the $20 disregard), according to the Cover Virginia ABD program guide, with resources up to $9,950. Medicaid Works lets people with disabilities ages 16 to 64 earn more and keep coverage. Our help for seniors guide and SSI income limits guide cover related programs.

People over the Medicaid line can also check Plan First, Virginia's family planning coverage, which goes up to 205% of poverty ($2,727 a month for one person).

If you're checking Medicaid, it's worth checking food help at the same time. Our Virginia food stamps guide has SNAP limits for the state, our WIC income limits guide covers pregnant women and children under 5, and our federal poverty guidelines guide explains the numbers behind these programs. Families paying for care can check our child care assistance guide.

Need to see what else your household might get? Grantsights' free eligibility checker points you to official programs for health coverage, food and rent. It doesn't decide Medicaid eligibility and doesn't file anything for you; only DMAS, Cover Virginia and your local Department of Social Services can do that.

FAQ: Virginia Medicaid Income Limits

What is the income limit for Virginia Medicaid in 2026?

For adults 19 to 64, $1,836 a month for one person and $3,795 for four, as of January 13, 2026, including the 5% disregard.

What is the FAMIS income limit?

205% of poverty: $2,727 a month for one person and $5,638 for four.

Does Virginia Medicaid have an asset limit?

Only for the aged, blind and disabled groups and long-term care: $2,000 for one person and $3,000 for a couple.

What is the income limit for nursing home Medicaid in Virginia?

$2,982 a month in 2026.

When do Virginia Medicaid work requirements start?

January 1, 2027, for Medicaid Expansion adults who aren't exempt.

How long do I have to appeal?

30 days from the date on your notice, plus 5 days for mailing.

Sources

1. DMAS: Virginia Medical Assistance Eligibility Manual, Chapter M00 Appendix, Income Charts (opens in a new tab), transmittal DMAS #39, July 1, 2026 (MAGI charts effective January 13, 2026; LIFC and medically needy charts effective July 1, 2026)
2. Cover Virginia: Adults 19-64 Years Old (opens in a new tab), income guidelines as of January 13, 2026
3. Cover Virginia: Medicaid for Children and FAMIS (opens in a new tab)
4. Cover Virginia: Cardinal Care Pregnancy and Postpartum Coverage (opens in a new tab)
5. Cover Virginia: Medicaid for Persons who are Aged, Blind, or Disabled (opens in a new tab) and DMAS ABD fact sheet (opens in a new tab)
6. DMAS: Eligibility Manual Chapter M11, ABD Resources (opens in a new tab), M1110.003 resource limits
7. Cover Virginia: Long-Term Services and Supports (opens in a new tab)
8. Cover Virginia: How to Apply (opens in a new tab)
9. DMAS: Applicant and Member Appeals Resources (opens in a new tab) and Client Appeals Process At-A-Glance (opens in a new tab)
10. DMAS: Federal Work Requirements (opens in a new tab)
11. Federal Register: Medicaid Program; Community Engagement Requirement for Certain Individuals (opens in a new tab), June 3, 2026
12. Medicaid.gov: Medicaid, CHIP and BHP Eligibility Levels (opens in a new tab), as of December 1, 2023
13. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab): $15,960 for one, $27,320 for three, $33,000 for four, plus $5,680 per extra person
14. SSA POMS SI 02001.020: SSI Federal Benefit Rate Chart (opens in a new tab): $994 individual and $1,491 couple for 2026
15. eCFR: 42 CFR 435.603, MAGI methodology (opens in a new tab) and 42 CFR 435.912, timeliness standards (opens in a new tab)