Nursing Home Medicaid and Spousal Protections in Virginia

Last verified: October 2026. Figures and rules are re-checked against primary sources.

What are the 2026 Virginia Medicaid limits for a nursing home resident?

For 2026, a nursing facility applicant can have income up to $2,982 a month, which is 300 percent of the $994 federal SSI benefit rate, and countable assets of $2,000 for a single person. Once approved, the resident keeps a $40 monthly personal needs allowance and the rest of income goes to the facility.

The Department of Medical Assistance Services (DMAS) runs Virginia Medicaid. The figures come from the CMS 2026 standards and 12VAC30-110-950, and they change each year. Confirm them with your local department of social services before relying on them. A resident whose income is below the cap keeps only the $40 allowance, so budget for clothing, haircuts and phone service from that amount.

How much can the at-home spouse keep in Virginia?

The spouse living at home can keep a share of the couple's assets, called the community spouse resource allowance (CSRA), between $32,532 and $162,660 in 2026. The spouse can also keep monthly income up to the minimum monthly maintenance needs allowance (MMNA), which tops out at $4,066.50.

The MMNA minimum was $2,643.75 through June 30, 2026, and it is recalculated each July 1. Spousal figures also change each January, so ask DSS for the current numbers. If the spouse's own income falls below the MMNA, part of the resident's income may be shifted to make up the shortfall. These protections keep a Chesapeake or Portsmouth husband or wife from being left in poverty.

How does the five-year look-back work for Virginia Medicaid?

Virginia looks back five years from the application date for transfers of assets, such as gifts to children or sales below market value. A transfer found in that window can trigger a penalty period during which Medicaid will not pay for nursing facility care.

Giving money away to qualify is a common and costly mistake, especially when a parent helps a grandchild with tuition or a down payment. Some transfers are allowed, particularly between spouses. Before moving assets, speak with an elder law attorney, who can explain the exceptions. Keep five years of statements; the application will ask for them, and missing records delay approval.

Does Virginia count the family home for nursing home Medicaid?

Virginia applies the federal minimum home equity limit, $752,000 for 2026. A home with equity above that figure can disqualify an applicant, so check a recent assessment or appraisal against it. A home is usually not counted while a spouse lives there, or when the resident intends to return.

Equity is the value of the home minus any mortgage. If the resident moves permanently to a nursing home and no spouse or dependent lives there, expect questions from DSS about the house. Ask the caseworker whether the state can make a claim against the property and under what conditions, before you list, rent or transfer it.

Is Medicaid expansion the same as nursing home Medicaid in Virginia?

No. Virginia expanded Medicaid to adults under the Affordable Care Act effective January 1, 2019, but expansion is a separate, income-based pathway. Long-term services for seniors still use the aged, blind and disabled rules, with their own income and asset tests, so an older adult cannot rely on the expansion rules to qualify for nursing home care.

Most Virginia Medicaid members who use long-term services, including nursing home residents, are covered through the Cardinal Care managed care program. It took over from the older CCC Plus managed care program, though the home-based waiver kept the CCC Plus name. For the practical effect, ask the nursing home which Cardinal Care health plan it contracts with before admission, since that affects authorizations and billing.

How do Hampton Roads families apply for nursing facility Medicaid?

Apply through your local department of social services in the city or county where the applicant lives. DSS will request bank statements, income proof, insurance cards and the look-back records, and a screening confirms the person meets nursing facility level of care.

The nursing home's business office can help with paperwork but is not neutral, since it is owed payment. Medicare may cover the first stretch after a hospital stay, as described on our Medicare page. For a quick check of how the program compares with care at home, read about the CCC Plus Waiver.