Medicaid income limits VA vary because Virginia uses different financial rules for adults, children, pregnant applicants, and people who are aged, blind, or disabled. There is no single income ceiling that applies to every household.
This guide breaks down the current Virginia Medicaid income limits by group, explains how income and household size are calculated, and shows what options may remain if your income is above one threshold.
1. Medicaid Income Limits VA: Which Category Applies To You?
Virginia considers age, pregnancy, disability, household size, Medicare status, and coverage program. One income ceiling cannot answer every application.
Adults ages 19-64 under Medicaid expansion
| Household Size | 2026 Annual Limit, Including Disregard |
| 1 | $22,025 |
| 2 | $29,864 |
| 3 | $37,702 |
| 4 | $45,540 |
| 5 | $53,379 |
| 6 | $61,217 |
| 7 | $69,056 |
| 8 | $76,894 |
Note: Medicaid household size can differ from the number of people living together and depends on tax relationships, dependents, pregnancy, and eligibility rules.
Expansion generally excludes people enrolled in or eligible for Medicare. Other eligibility requirements also apply.
Children: Medicaid vs FAMIS income limits
For children under 19, Medicaid generally reaches 148% FPL, including the disregard. FAMIS, Virginia’s separate children’s insurance program, reaches 205% FPL, including the disregard.
For a four-person household, those published monthly ceilings are $4,070 and $5,638, respectively. Comparing Medicaid income limits VA should not merge these two programs.
Pregnancy Medicaid vs FAMIS MOMS
Pregnancy Medicaid generally uses 148% FPL; FAMIS MOMS uses 205% FPL, including the disregard. Pregnancy adds expected children to household size.
Both generally continue through 12 months postpartum. FAMIS Prenatal has different eligibility provisions and generally continues through 60 days postpartum.
Adults age 65+, blind, or disabled
People who are age 65 or older, blind, or disabled may qualify through non-MAGI Medicaid pathways that use different income and resource rules from Medicaid expansion.
For Virginia’s standard aged, blind, or disabled pathway in 2026, the published monthly income limit is $1,084 for one person and $1,463 for two people. The general resource limits are $2,000 for one person and $3,000 for two people, although some assets are excluded.
These figures should not be applied to every applicant who is older or disabled. Medicaid Works, medically needy coverage, long-term care Medicaid, and other pathways use different financial rules, so the correct category must be identified first.
2. How Does Virginia Count Income And Household Size?
Comparing your earnings with Medicaid income limits VA requires the right calculation. Virginia uses MAGI rules for many children, pregnant applicants, and expansion adults, while aged, blind, or disabled pathways generally follow non-MAGI rules.
MAGI income and household rules
Wages and taxable income: MAGI generally follows federal tax-based income rules, with certain adjustments. Wages usually count before payroll deductions, alongside other countable income.
Household composition: Spouses, tax dependents, and filing relationships help determine household size. Special rules apply in some situations, so people sharing an address are not automatically one Medicaid household.
Self-employment: The calculation generally considers net business income after allowable business expenses, rather than total sales or customer payments.
Irregular income: When assessing Medicaid income limits VA, report seasonal work, fluctuating hours, and income changes. Pay records and expected earnings help determine eligibility.
Take-home pay: Your bank deposit does not show the full eligibility calculation. Taxes withheld and other paycheck deductions do not necessarily reduce countable income.
Non-MAGI income and resource rules
Countable income: These pathways use category-specific budgeting rules. The agency reviews your income sources and determines which amounts count toward the applicable limit.
Social Security and pensions: Social Security retirement, disability benefits, and pension payments generally count, although their treatment depends on the eligibility category.
Deductions and disregards: Applicable exclusions can reduce the amount counted. They differ by pathway and should not be confused with the five-percentage-point FPL disregard used in certain MAGI calculations.
Savings and resources: Bank accounts, investments, and other assets may be assessed separately from income. Some resources are excluded, so not everything you own necessarily counts.
Why the rules differ: Applicants age 65 or older, blind, or disabled may qualify through categories that impose both income and resource requirements. MAGI coverage generally has no asset test, making the choice of pathway essential to an accurate comparison.
>>> Read more: West Virginia Medicaid Phone Number: Get Help Fast
3. What If Your Income Is Above The Virginia Medicaid Limit?
Exceeding one of the Medicaid income limits VA does not necessarily eliminate affordable coverage.
FAMIS: Children may qualify above the children’s Medicaid threshold.
FAMIS MOMS/FAMIS Prenatal: Pregnancy-related alternatives may apply, depending on income, insurance, and immigration circumstances.
Medically Needy Spenddown: Some applicants in eligible medically needy groups may qualify for time-limited Medicaid coverage after meeting a calculated spenddown with allowable medical expenses. This option is not available to every person who exceeds a Medicaid income limit, and resource requirements may also apply.
Medicare Savings Programs: Eligible Medicare beneficiaries may receive help with premiums and, depending on the program, other costs.
Marketplace coverage: Virginia’s Insurance Marketplace can assess other coverage and financial assistance.
4. How To Check Your Eligibility And Apply
Once you have identified the Medicaid income limits VA that apply to your household, follow these steps to check your circumstances and submit an application for an official decision.
Step 1. Identify your category: Consider age, pregnancy, disability, and Medicare status to determine which coverage pathway may apply.
Step 2. Find the right threshold: Match your category and household size to the current Medicaid income limits VA, checking whether figures are monthly or annual.
Step 3. Calculate correctly: Apply the relevant income rules and any resource requirements. Gather recent earnings and benefit statements to support your calculation.
Step 4. Apply officially: Use CommonHelp, call Cover Virginia at 1-855-242-8282, or contact local social services. Keep your submission confirmation.
Step 5. Complete verification: Submit requested records by the stated deadline, then review your determination for the decision, coverage dates, and further instructions.
>>> Read more: How to Qualify for Medicaid in Virginia: Easy Eligibility Guide
5. Medicaid Income Eligibility May Lead To More Savings
Understanding Medicaid income limits VA helps you find a healthcare coverage pathway. If your application is approved, that enrollment can also help with a different monthly expense: keeping your phone service or internet service affordable.
The Federal Lifeline Program provides a monthly discount on qualifying communication service. Medicaid is one of the assistance programs Lifeline recognizes for eligibility. If you are already enrolled, you can qualify through that participation rather than the income route.
Without Medicaid, SNAP, SSI, Federal Public Housing Assistance, or household income at or below 135% of federal poverty guidelines may provide another way to qualify. You still complete Lifeline enrollment and verification, and each household is limited to one benefit.
Receiving the discount means choosing a participating provider. Lifeline supplies the funding, while an approved Eligible Telecommunications Carrier (ETC) delivers your service and applies the savings.
Cintex Wireless serves in that role, offering eligible customers wireless plans alongside free or discounted device promotions. Reviewing both can be useful if you want to lower your monthly bill and replace a phone that no longer works reliably.
The carrier also brings customers more device choices through its merger into AirTalk Wireless, extending the service and phone offers it already provided. Getting started involves four steps:
- Step 1. Enter your ZIP code on the carrier’s website to check service availability in your area.
- Step 2. Compare monthly allowances, available devices, and any charges, then choose what suits your needs.
- Step 3. Fill in the required information and upload proof of eligibility if requested.
- Step 4. Submit and await approval. Once approved, follow the instructions to activate your service.
Device promotions vary by eligibility, availability, and terms.
IMPORTANT: The government does not subsidize devices. Lifeline programs cover basic service costs only. Free or discounted devices, upgrade plans, or top-ups are exclusive benefits provided by Cintex and AirTalk Wireless as part of the promotional offers. Terms and conditions apply. Limited-time promotion—offers vary by state, stock availability, and eligibility.
6. FAQs
Does Virginia Medicaid use gross or net income?
It uses countable income, rather than either figure alone. MAGI generally follows tax-based rules, while non-MAGI applies category-specific deductions. Take-home pay alone does not determine eligibility.
Can my children qualify if I earn too much?
Yes. Children have higher Medicaid income thresholds, and FAMIS may provide coverage above those limits. Your child’s eligibility is assessed separately from yours.
Do savings count toward Medicaid eligibility?
No, generally for MAGI coverage. Non-MAGI pathways may apply resource limits, although certain assets are excluded. The category you apply under determines how savings are treated.
Can I qualify if I already have Medicare?
Yes. You may qualify through another Medicaid pathway or a Medicare Savings Program. The latter helps with Medicare costs but does not necessarily provide full Medicaid coverage.
Conclusion
Understanding Medicaid income limits VA starts with finding the eligibility category that matches your circumstances. Expansion adults, children, pregnant applicants, and people who are aged, blind, or disabled can face different income rules, and some pathways also consider resources.
Before deciding that your income is too high, compare it with the current limit for your specific category and household size. If you exceed one threshold, check whether FAMIS, a medically needy pathway, a Medicare Savings Program, or Marketplace assistance may offer another route. An official application is ultimately the best way to confirm eligibility.
