Virginia Auxiliary Grant — How Medicaid Helps Pay for Assisted Living

When families learn that standard Virginia Medicaid does not cover room and board at an assisted living facility, the reaction is usually panic. Assisted living in Virginia costs a median of $6,513 per month — far beyond what most retirees on Social Security can afford. The Auxiliary Grant (AG) program exists specifically to bridge this gap, but it comes with strict eligibility rules and payment caps that most families do not discover until they are already in a crisis.

What the Auxiliary Grant Covers

The AG program pays the room and board portion of assisted living — the cost that Medicaid excludes. It is administered through the local Department of Social Services (DSS) and the Department for Aging and Rehabilitative Services (DARS). The grant supplements your parent's income to cover the facility's basic care rate.

In 2026, maximum monthly AG rates are:

• $2,130 for most of Virginia
• $2,450 for facilities in Planning District 8 (Northern Virginia — Fairfax, Arlington, Loudoun, Prince William, Alexandria, Manassas, Manassas Park)

The 15% rate differential for Northern Virginia reflects the higher operating costs in that region.

How the Payment Works

The Auxiliary Grant is not a check your parent receives. Instead, it works as a formula:

1. Your parent contributes nearly all of their monthly income (Social Security, pension) to the facility
2. They keep a $115 personal needs allowance for personal items
3. The AG covers the difference between your parent's contribution and the facility's approved rate, up to the $2,130/$2,450 cap

If your parent receives $1,400/month in Social Security, the math looks like this: $1,400 − $115 personal allowance = $1,285 contributed to the facility. The AG pays up to $2,130 − $1,285 = $845. The facility receives $2,130 total.

The catch: if the facility charges more than the AG maximum rate, your family is responsible for the difference. Many facilities have separate "private pay" and "AG" rate structures, and some do not accept AG residents at all.

Eligibility Requirements

Financial: Your parent's countable assets must be at or below $2,000. Income is not capped in the traditional sense — instead, the AG formula accounts for whatever income the parent has by requiring them to contribute it toward the facility.

Functional: Your parent must need assistance with activities of daily living (ADLs) but not require the level of skilled nursing care that would mandate nursing home placement. The local DSS will assess whether assisted living is the appropriate care level.

Facility: The assisted living facility must be licensed by the Virginia Department of Social Services and must participate in the AG program. Not all licensed ALFs accept AG residents — availability of "AG beds" is limited and waitlists are common, especially in Northern Virginia.

The Waitlist Problem

The most frustrating aspect of the AG program is that many quality assisted living facilities either do not participate or maintain very few AG-rate beds. Facilities have no obligation to accept AG residents, and the $2,130 monthly rate is well below the median $6,513 private-pay rate. Facilities that do participate often have months-long waitlists.

Start looking early. Contact the local Area Agency on Aging (AAA) — find yours through the Virginia DARS website or by calling 211 — for a list of AG-participating facilities in your area. Apply to multiple facilities simultaneously.

AG vs. CCC Plus Waiver

If your parent can remain at home with personal care support, the CCC Plus waiver may be a better fit. The waiver covers in-home personal care aides, adult day programs, and assistive technology, with a Personal Maintenance Allowance of $1,641/month (compared to the AG's $115 personal needs allowance). For many families, keeping the parent at home with waiver services preserves more of their monthly income and independence.

The AG makes sense when the parent's care needs have progressed beyond what home-based services can safely manage, but they do not yet require 24-hour skilled nursing.

The Virginia Medicaid Long-Term Care & Asset Protection Guide compares all three care settings — home (CCC Plus waiver), assisted living (Auxiliary Grant), and nursing home (full Medicaid) — with the financial thresholds and application steps for each.

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