Virginia Medicare Savings Program Income Limits 2026

2026 Income Limits by Program

Virginia's Medicare Savings Program income ceilings are derived from the Federal Poverty Level published annually by HHS. Every figure below includes the mandatory $20 monthly general unearned income disregard that DMAS applies before comparing income to the threshold.

These limits update every year, usually in February or March, when HHS publishes new poverty guidelines. Virginia DSS offices are required to hold the prior year's limits until the new ones are formally implemented.

Resource (Asset) Limits

Several assets don't count: your primary home (up to $752,000 in equity), one vehicle, burial plots and irrevocable burial trusts, term life insurance, and up to $3,500 in designated burial funds per person. Household goods and personal effects are also exempt.

How Virginia Calculates Countable Income

The number that matters is gross income — before any deductions. For Social Security, that means the benefit amount before Part B premiums, tax withholdings, or Medicare Advantage plan withholdings are subtracted. If the bank deposit is $1,280 but SSA's statement shows a gross benefit of $1,483, the $1,483 is what Virginia uses.

After establishing gross income, Virginia applies specific disregards:

• $20 general unearned income disregard — applies to the household's total unearned income first
• Earned income disregard — the first $65 of monthly earnings plus half the remainder is excluded
• VA benefits — Aid and Attendance, housebound allowances, and unusual medical expense reimbursements from the VA are excluded
• Irregular income — excluded if under $20/month (unearned) or $10/month (earned) and infrequent

A worked example: your mother receives $1,280/month gross Social Security and an $80/month pension. Total gross unearned income is $1,360. Subtract the $20 disregard and her countable income is $1,340 — under the QMB limit of $1,350.

Spousal Income Rules

When a married couple lives together but only one applies, Virginia uses spousal deeming rules. The non-applying spouse's income is counted, but allowances for the spouse and any dependent children are deducted first. The remaining combined income is compared against the couple limit.

If both spouses apply, each person's income is evaluated individually against the couple threshold. Having a spouse with a slightly higher income doesn't automatically disqualify the lower-income partner — the deeming calculation often produces a different result than simply adding both incomes together.

The January COLA Protection

Every January, Social Security benefits get a cost-of-living adjustment. But updated federal poverty guidelines don't take effect until February or March. Under federal law (42 U.S.C. § 1396a(r)(2)(D)), Virginia must disregard the COLA increase during this gap — preventing anyone from losing MSP eligibility just because the COLA hit before the new FPL was published.

Retirement Accounts and Joint Bank Accounts

IRAs, 401(k)s, and Keogh accounts count as resources unless they're in active periodic payout status. If the account is being drawn down in regular monthly installments, the account balance is excluded and only the monthly disbursement counts as income.

Joint bank accounts are presumed to belong entirely to the applicant unless documentation proves the co-owner contributed their share. If your parent shares a checking account with a sibling, gather deposit records showing whose money went in.

The Virginia Medicare Savings Programs & Extra Help Guide includes an income and asset worksheet that walks through these calculations step by step, with Virginia-specific exclusions and the worked examples caseworkers actually use.

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