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Our programs

Virginia Medicaid has low-cost and no-cost health coverage programs. There are programs for children, pregnant women and adults, including those with disabilities. To learn more about each program, use the links below.

Monthly income limits by program

To learn if you may qualify for one of Virginia’s Medicaid programs, read the chart below. You may qualify if your household monthly income is at or below the amount listed for your household size.

Medicaid for children under age 19 and pregnant women

Medicaid for children under age 19 and pregnant women
Household size Monthly income
1 $1,589
2 $2,149
3 $2,709
4 $3,269
5 $3,829
6 $4,389
7 $4,949
8 $5,509
Each additional $560

2021 Income Guidelines as of January 10, 2021

Medicaid for adults age 19-64

Medicaid for adults age 19-64
Household size Monthly income
1 $1,482
2 $2,004
3 $2,526
4 $3,048
5 $3,570
6 $4,092
7 $4,614
8 $5,136
Each additional $523

2021 Income Guidelines as of January 12, 2021 

FAMIS for children under 19, FAMIS MOMS for pregnant women & Plan First

FAMIS for children under 19, FAMIS MOMS for pregnant women & Plan First
Household size Monthly income
1 $2,201
2 $2,976
3 $3,752
4 $4,528
5 $5,303
6 $6,079
7 $6,854
8 $7,630
Each additional $776

2021 Income Guidelines as of January 13, 2021

Medicaid for aged, blind and disabled (ABD) & Medicaid Works

Medicaid for aged, blind and disabled (ABD) & Medicaid Works
Household size Monthly income
1 $859
2 $1,162

2021 Income Guidelines as of January 13, 2021

Medicare Savings Programs

Medicare Savings Programs
Household size Monthly income
1 $1,449
2 $1,960

2021 Income Guidelines as of January 13, 2021

Eligibility for health coverage is based on income plus other factors. This tool screens for income only. You may qualify for coverage based on other things like age or disability. To get a full review, you need to apply. To learn more, go to Apply.

Coverage for children

There are two health coverage programs for children in Virginia who qualify. Both programs have full benefits. There are no enrollment costs or monthly premiums. Medicaid for children and the FAMIS program are for children up to age 19 whose household income is within the limits. Children under age 21 who are in foster care or subsidized adoptions may qualify. Newborns of mothers who are enrolled in Medicaid or FAMIS MOMS  qualify for coverage for the first year.

Coverage for pregnant women

There are two health coverage programs for pregnant women in Virginia who qualify. If the household’s income is within the limits, the pregnant woman may qualify for Virginia Medicaid or FAMIS MOMS. Both programs offer full health coverage while a woman is pregnant and for two months after her baby’s birth.

Coverage for adults

Adults 19-64 years old
Medicaid has health coverage programs for adults in Virginia who qualify. There are no enrollment costs and no monthly premiums for adults between 19-64 years old who qualify. Their income must be within the limits.

Medicaid for aged, blind, or disabled (ABD) individuals

Adults who are age 65 or older or are disabled or blind may qualify for full Medicaid. A resource test may be required for the applicant. A person who does not qualify for full Medicaid because their income is over the limit may “spenddown” their income limit on certain medical bills. They must have a certain amount in medical bills before they can be approved for Medicaid. The amount of medical costs needed to qualify depends on household size and income.

Plan First

Plan First is Virginia’s family planning services program. It is for men and women who do not meet the income rules for full Medicaid. Plan First has limited benefits. It covers yearly family planning exams for men and women, pap tests, sexually transmitted infection testing, family planning education and counseling, tubal ligation and vasectomies. It also covers approved over-the-counter and prescribed contraceptives and transportation to a family planning service.

Premium assistance

Virginia has two Medicaid-related premium assistance programs that help pay for all or part of the costs of employer-sponsored health insurance: FAMIS Select and the Health Insurance Premium Program (HIPP).

Emergency services for non-citizens

Some immigrants may qualify for full Medicaid coverage. Others may qualify for Medicaid payment only for emergency services.

Emergency Services Medicaid covers some services that are medically necessary for short time periods. This includes services such as dialysis or labor and delivery. Your notice of coverage will tell you when your coverage starts and ends.

For answers to common questions, read Frequently asked questions about Medicaid for non-citizens.

Apply for Virginia Medicaid programs

If you think you may qualify for one of the programs above, please apply.

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