Medicaid for Persons Who are Elderly and Disabled
Virginia has temporarily suspended co-pays for any Medicaid or FAMIS covered services. Learn more about changes in financial assistance due to the Coronavirus pandemic here.
Apply online at CommonHelp
General Info
Provides medical and prescription coverage for persons who are elderly and disabled.
Program Description
The following five categories are offered under Medicaid for persons who are Elderly and Disabled:
- Full Medicaid coverage pays for doctors, hospitals and prescriptions
- Limited Medicaid, also know 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 the income limits for Medicaid. After an established deductible is met, the client may enroll in Medicaid for up to six months.
Eligibility
- Age 65 or older, or
- Persons who are disabled (receive SSA or SSI disability benefits or found disabled by the Medicaid Disability Unit)
- U.S. Citizen, Permanent Resident Alien (admitted to the US prior to 8/22/96), refugee or asylee
Note: For Emergency Medicaid only (see below) these citizenship/alienage requirements do not need to be met
Financial Requirements
The term income refers to gross monthly income and resources refers to funds held in all financial accounts as well as the value of real property, other than the home.
Non-institutional Medicaid
- Single individuals income cannot exceed $786 for full coverage or $1,313 for limited coverage.
- Resources cannot exceed $2,000 for full coverage or $7,080 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. 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 eligibility for CBC depends on the number of hours of care required each month, however, persons with income not greater than $2,130 qualify regardless of the number of hours. Resources cannot exceed $2,000.
- Married individuals with one person receiving CBC services: Income eligibility for CBC depends on the number of hours of care required each month, however, persons with income not greater than $2,130 qualify regardless of the number of hours. 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 (Limited to coverage of specific hospital stays)
- Single individuals income cannot exceed $745 and resources cannot exceed $2,000.
How to Apply
Apply online at CommonHelp
Apply in person or via mail to:
Bureau of Assistance Programs
2100 Washington Boulevard, 1st Floor
Arlington, VA 22204
Or
Call 703-228-1350 to have an application mailed to you
Documents Required
- Complete Department of Social Services Application for Benefits
- Social Security Number or proof of application
- If not born in the United States, front and back of Immigration documents, alien registration card, I-94 or passport
- Copy of health insurance cards, if applicable
- Proof of current income and that of spouse, if applicable
- Proof of current resources