Medicaid for Persons Who are Elderly and Disabled

Program Description

Individuals who are aged (65 or older), have a disability, or are blind (ABD) may qualify for Medicaid through the one of the ABD programs. Information about both income and resources are needed and should be provided when applying to determine eligibility.

The following five categories are offered under Medicaid for persons who are Elderly or Disabled:

Full Medicaid Coverage, pays for doctors, hospitals and prescriptions
Limited Medicaid, also known as Medicare Savings Plans, pays for Medicare coinsurance, premiums and deductibles, or may pay for premiums only. Available only to persons who have Medicare.
Long Term Care Medicaid, pays for nursing home costs and home care (community based care services)
Emergency Medicaid, is available to immigrants not eligible for regular Medicaid, pays for coverage for emergency hospitalizations only
Spend-down, is available to applicants that have incomes higher than full coverage income limit shown below for non-institutional individuals. After an established deductible is met, the client may be enrolled in Medicaid for all or a portion of the six month period depending on when the deductible is met.

Eligibility

Age 65 or older
Persons who are disabled (receive SSA or SSI disability benefits or are considered disabled by the Medicaid Disability Unit).
Meets income and resource requirements.
U.S. Citizen, Permanent Resident Alien (admitted to the US prior to August 22, 1996, or admitted after August 22, 1996 with 40 quarters of employment earnings - effective April 1, 2021, only 5 years of residency required), Refugee or Asylee.
- Note: For Emergency Medicaid only the citizenship/alienage requirements listed above do not apply.

Financial Requirements

Non-institutional Medicaid

Single individual's income cannot exceed $1,084 for full coverage or $1,816 for limited coverage. Resources cannot exceed $2,000 for full coverage or $7,800 for limited coverage.

Nursing Home Residents

Single individuals income must be less than the private monthly cost in the nursing facility. Resources cannot exceed $2,000.

Married individuals with one person in a nursing facility and one person living at home: Income of the institutionalized person must be less than the private monthly cost in the nursing facility. Income of the non-institutionalized spouse is not counted. Separate rules apply to the amount of resources that may be held by the couple. Allowable amounts are significantly higher than $2,000 and must be evaluated on a case by case basis.

Community Based Care (CBC) Recipients

Income limit is $2,982 per month. Persons with income over $2,982 per month may still qualify depending on the number of hours of care received. Resources cannot exceed $2,000.

Married individuals with one person receiving CBC services: Income limit for the CBC eligible spouse is $2,982 per month. Income of the non-CBC spouse is not counted. Persons with income over $2,982 per month may still qualify depending on the number of hours of care. Separate rules apply to the amount of resources that may be held by the couple. Allowable amounts are significantly higher than $2,000 and must be evaluated on a case by case basis.

Emergency Medicaid Coverage

Emergency Medicaid coverage is limited to emergency hospitalizations for persons who do not meet the citizenship/alienage criteria above, but are otherwise eligible.

Medicaid Expansion Income Limits

Effective January 1, 2026 Virginia Medicaid Expansion income limits:

Household Size	Monthly Income Limit
1	$1,769
2	$2,399
3	$3,028
4	$3,658
5	$4,288
6	$4,917

There is no disability requirement for this group, and there is no resource or asset test. Persons receiving Medicare are not eligible under the expanded Medicaid group but may qualify under one of the groups listed below.

Effective January 13, 2026.

The term income refers to gross monthly income and the term resources refers to funds held in all financial accounts as well as the value of real property, other than the home.

How to Apply

Apply online at CommonHelp
Apply in person or via mail:

Bureau of Assistance Programs
2100 Washington Boulevard, 1st Floor
Arlington, VA 22204

Call 703-228-1350 to have an application mailed to you.
Call the Cover Virginia Call Center at 1-855-635-4370 to apply over the phone.

Documents Required

Complete Cover Virginia Application for Health Coverage and Help Paying Costs (including separate form Appendix D).
Social Security Number or proof of application
Copy of health insurance cards, if applicable
Proof of current income for the individual applying and spouse, if applicable
Proof of current resources
If not born in the United States, copy of the front and back of immigration documents, alien registration card, I-94 or passport

Contact Us

Economic Independence Division

2100 Washington Blvd.
Arlington, VA 22204
Map and Transit Information

Phone: 703-228-1350
TTY 711

Email: dhs@arlingtonva.us

Manage Your Benefits Online!

You can check your eligibility, apply for public assistance programs, and manage your account online through Virginia CommonHelp. Visit our CommonHelp page to learn what documentation and information you will need when you apply.

Popular Forms

These are common forms and documents used within the Clinical Coordination Program (CCP) Centralized Access System (CAS) for access to housing programs and other resources.

Policies and Procedures

Permanent Supportive Housing Policies and Procedures(PDF, 548KB) (updated September 2025)
Eligibility Memo(PDF, 218KB)

Fraud Reporting and Investigations

Public assistance fraud occurs when a person knowingly makes false statements, withholds information or fails to report information necessary to determine eligibility or benefits. Learn more about fraud and how to report it.

Stay Connected

Subscribe to the DHS Weekly Bulletin!

Click to Subscribe

Follow us on Social Media!