How does Virginia Medicaid work?

Asked by: Nathanial Cummings  |  Last update: September 19, 2023
Score: 4.9/5 (63 votes)

The purpose of Virginia Medicaid is to improve the health of people in Virginia who might otherwise go without medical care for themselves and their children. There is no enrollment fee or premium for Medicaid coverage if you are eligible. Low co-pays are charged for some Medicaid services.

What does my Virginia Medicaid cover?

Medicaid covers a variety of inpatient and outpatient medical services. Benefits include behavioral health services, addiction and recovery treatment, dental services and prescription medicines. Consult your handbook to find out which benefits you are eligible to receive.

Who gets Medicaid in Virginia?

Adults who are age 65 or older or are disabled or blind may qualify for full Medicaid. A resource test may be required for the applicant. A person who does not qualify for full Medicaid because their income is over the limit may “spenddown” their income limit on certain medical bills.

Who qualifies for Medicaid in Virginia for adults?

Covered adults include individuals ages 19-64 with income at or below 138% of the federal poverty limit. Individuals in the adult group have comprehensive health care coverage provided through the Medicaid programs.

How do I get approved for Medicaid in VA?

Apply in one of these ways:
  1. Apply online at
  2. Call the Cover Virginia Call Center Monday through Friday, 8 a.m. to 7 p.m. and Saturday 9 a.m. to 12 p.m. at 833-5CALLVA (TDD: 1-888-221-1590).
  3. Apply online at the Health Insurance Marketplace at

Important Information for Virginia Medicaid Users

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What is the highest income to qualify for Medicaid?

Federal Poverty Level thresholds to qualify for Medicaid

The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. In 2023 these limits are: $14,580 for a single adult person, $30,000 for a family of four and $50,560 for a family of eight.

Does Virginia have state Medicaid?


Children are the largest eligibility group served by Virginia Medicaid, with more than 800,000 members. Other eligible populations include people with disabilities, older and low-income adults, and pregnant individuals.

What is the highest income to qualify for Medicaid 2023?

Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Can you have Medicare and Medicaid in Virginia?

Some people qualify for both Medicare and Medicaid and are called 'dual eligibles. ' If you have Medicare and full Medicaid coverage, most of your health care costs are covered. The Medicaid program is administered by the local Department of Social Services in the city or county where you live.

What states have the highest Medicaid income limits?

The state with the highest income limits for both a family of three and individuals is Washington, D.C. If you live in this area, a family of three can qualify for Medicaid if their income is at 221% of the FPL. For other adults, the limit is set at 251% of the FPL.

Does my Medicaid cover dental in Virginia?

Virginia Medicaid made dental benefits available to adult members starting on July 1, 2021. All Medicaid members with full benefits now have access to dental services, including: Cleanings and Preventive Care.

Does Medicaid include dental Virginia?

Virginia Medicaid enrollees aged 21 and older have had access to comprehensive dental care benefits since July 2021 through a state budget amendment. The numerous services covered, including X-rays, cleanings and fillings, focus on preventing problems and restoring damaged teeth.

What is the income limit for food stamps in Virginia 2023?

Gross monthly income — that is, household income before any of the program's deductions are applied — generally must be at or below 130 percent of the poverty line. For a family of three, the poverty line used to calculate SNAP benefits in federal fiscal year 2023 is $1,920 a month.

How long will the increase in food stamps last in Virginia 2023?

The temporary boost to SNAP benefits put in place during the COVID-19 pandemic, known as emergency allotments, ended nationwide after the February 2023 issuance. More details can be found below, on the FNS blog (also available in Spanish), and in the Recent Changes to SNAP Benefits infographic.

Does Virginia get extra SNAP benefits?

While SNAP benefits have already returned to normal in many states, Virginia is one of several that chose to continue with the emergency allotments until March 2023, at which point the benefit amount will return to the pre-pandemic normal.

What qualifies you for Section 8 in VA?

Virginia uses the definition of "low income" set by the U.S. Department of Housing and Urban Development (HUD) to determine Section 8 eligibility requirements. HUD defines three tiers of financial hardship: Low income. Individuals and families who are low income earn less than 80% of the median income for the area.

What is the poverty line in Virginia?

The new Virginia Poverty Measure finds 11.9 percent of Virginians (936,000 people) below the poverty line (an average of about $29,000 in annual income for a two adult, two child family).

Is medical based on gross income?

The Modified Adjusted Gross Income (MAGI) Medi-Cal method uses Federal tax rules to decide if you qualify based on how you file your taxes and your countable income. Property rules: No property limits. Non-MAGI Medi-Cal includes many special programs.

What is federal poverty level 2023?

You qualify for federal aid for 2023 if you make one to four times the 2022 federal poverty level for your household size. For a family of four, that range is from $26,200 to $104,800.