Virginia Medicaid Nursing Home Income and Asset Limits — 2026 Eligibility Rules

The first question every family asks: does my parent qualify? Virginia Medicaid long-term care eligibility comes down to two financial tests — income and assets — plus a clinical screening. The numbers are strict, but Virginia's medically needy pathway means that exceeding the income limit does not automatically disqualify your parent.

2026 Income Limits

The standard income limit for Medicaid long-term services and supports (LTSS) in Virginia is $2,982 per month, calculated as 300% of the SSI Federal Benefit Rate ($994 × 3).

All income sources count: Social Security benefits, pension payments, annuity distributions, rental income, investment dividends, and any other regular income.

If your parent's income is at or below $2,982/month, they meet the income test directly. If it exceeds $2,982, they are not disqualified — Virginia is a medically needy state. The excess income is simply applied toward care costs each month (a "spend-down"), and Medicaid covers the rest. No Miller Trust or Qualified Income Trust is required.

This is a major advantage over income-cap states like Florida, Texas, or Alabama, where exceeding the income threshold requires setting up a legal trust before eligibility can be established.

2026 Asset Limits

Single applicant: Countable assets must be at or below $2,000.

Married couple, both applying: Combined countable assets must be at or below $4,000.

Married, one spouse applying: Spousal impoverishment protections apply. The community spouse keeps their Community Spouse Resource Allowance (minimum $32,532, maximum $162,660 in 2026). The applicant spouse must spend down to $2,000.

What Counts as a Countable Asset

Virginia Medicaid counts nearly all liquid and investment assets:

• Checking and savings accounts
• Certificates of deposit (CDs) and money market accounts
• Stocks, bonds, and mutual funds
• IRAs and 401(k) accounts — Virginia counts the full value as a resource. Unlike some states that exclude retirement accounts if the owner is taking required minimum distributions, Virginia counts the entire balance. This catches many families off guard.
• Cash value of whole life insurance (if combined face values exceed $1,500)
• Non-primary real estate
• Additional vehicles beyond one

What Is Exempt

Exempt assets are not counted toward the $2,000 limit:

• Primary residence: Exempt if home equity is below $752,000 and the applicant has documented intent to return home (or a spouse or dependent resides there). The home remains exempt even during nursing home placement as long as the intent-to-return statement is on file.
• One vehicle: Regardless of value, used for transportation to medical appointments
• Personal belongings and household goods: Furniture, clothing, appliances
• Prepaid irrevocable burial trust and plot: A common spend-down strategy — purchase a funeral plan before applying
• Term life insurance: No cash value, so not countable
• Whole life insurance: Exempt if combined face values are $1,500 or less
• Income-producing property: Business property essential for self-support

The IRA Trap

This deserves emphasis because it is the most common eligibility surprise in Virginia. A parent with $2,000 in the bank but $80,000 in an IRA is not eligible. Virginia counts the full IRA balance as a countable resource. The IRA must be spent down — either by withdrawing and spending on approved items (home modifications, debt payoff, burial trust) or by converting it into an income stream through systematic withdrawals or an annuity.

Converting an IRA to a Medicaid-compliant annuity — one that is irrevocable, non-assignable, actuarially sound, and names the Commonwealth of Virginia as the remainder beneficiary — can remove the principal from the asset count while creating a monthly income stream (which is then subject to the income rules and patient pay).

This is one area where consulting an elder law attorney or Medicaid planner is often worth the cost. Getting the annuity structure wrong can result in both the asset counting against eligibility and the income increasing patient pay.

Applying the Rules: A Typical Scenario

A 78-year-old Virginia resident has:

• Social Security: $2,200/month
• Small pension: $400/month
• Checking account: $8,500
• IRA: $45,000
• Home (lives alone, equity $280,000)
• Prepaid burial trust: $6,000

Income test: $2,600/month — below the $2,982 limit. Passes directly.

Asset test: Checking $8,500 + IRA $45,000 = $53,500 countable. Home is exempt (equity under $752,000). Burial trust is exempt (prepaid and irrevocable). Must spend down $51,500 to reach the $2,000 limit.

The Virginia Medicaid Long-Term Care & Asset Protection Guide includes an eligibility calculator worksheet that walks through every asset and income source, identifies what is countable vs. exempt under Virginia rules, and calculates the exact spend-down amount needed to qualify.

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