Virginia Medicaid for Seniors & Long-Term Care

The income limit for nursing facility Medicaid in Virginia is 300% of the Social Security Federal Benefit Rate — approximately $2,982 per month as of 2026. This is an individual income limit; a spouse's income is not counted toward the institutionalized person's eligibility.

The asset (resource) limit for a single nursing facility applicant is $2,000. For a married couple, the community spouse may retain between $32,532 and $162,660 under federal spousal impoverishment protections — the exact amount depends on the total countable assets at the time of application.

CCC Plus is Virginia's primary managed long-term services and supports (MLTSS) waiver, a Section 1915(c) HCBS waiver. On October 1, 2023, Virginia merged its two Medicaid managed care programs — Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4 — into a single program called Cardinal Care Managed Care. The CCC Plus Waiver itself continues to operate under the Cardinal Care umbrella, and members still refer to it as CCC Plus. As of July 2025, Cardinal Care Managed Care members choose from five health plans — Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Health Plans, and UnitedHealthcare Community Plan — which manage both medical and long-term care services for dual-eligible members (people enrolled in both Medicare and Medicaid) and members who need long-term services and supports.

The waiver allows Virginia to provide home and community-based alternatives to nursing home care. Members who qualify for nursing facility level of care may choose to receive equivalent services at home through personal care aides, adult day health, and other supports — typically at lower cost to the state and with better outcomes for members. CCC Plus waiver slots for home-based services have waiting lists in some regions, so applying early — even before a crisis — can secure a position.

When one spouse needs nursing home care, federal law (42 U.S.C. § 1396r-5) protects the other spouse from complete impoverishment. The community spouse (the one remaining at home) may retain between $32,532 and $162,660 in countable assets under the Community Spouse Resource Allowance (CSRA), with the exact amount determined by a formal asset assessment at the time of application. If the community spouse's own income is insufficient, a portion of the institutionalized spouse's income may be allocated to them as a Minimum Monthly Maintenance Needs Allowance (MMMNA).

Virginia participates in the federal Medicaid Estate Recovery Program (MERP). DMAS may seek reimbursement from the estate of a Medicaid member who received long-term care services after age 55, or who was a nursing facility resident at any age. Recovery is limited to the amount of Medicaid paid for covered services. Virginia allows certain hardship exceptions — consult an elder law attorney before estate planning if long-term care Medicaid is a possibility.