Virginia Medicaid helps low-income families, adults, seniors, children, and pregnant women get health care. It covers costs that might otherwise be too high. The program is key for staying healthy without financial stress.
Income limits changed in 2025 due to updated Federal Poverty Guidelines. These adjustments account for rising living costs. They set who can qualify for coverage.
This article breaks down all 2025 income limits, eligibility rules, coverage, and how to apply in Virginia. You’ll find charts for different groups and simple steps to get started.
Understanding How Virginia Medicaid Works (Quick Overview)
Virginia Medicaid is managed through the Virginia Department of Medical Assistance Services (DMAS). It provides health services to those who need them most.
It covers essential health services like doctor visits, hospital care, prescriptions, pregnancy care, and preventive care. Mental health and dental for kids are included too.
Programs include Medicaid for Adults, FAMIS for children, FAMIS MOMS for pregnant women, long-term care and disability Medicaid, and Aged, Blind & Disabled (ABD) Medicaid.
Virginia Medicaid Income Limits 2025; Full Breakdown
Limits are based on Federal Poverty Level (FPL). For 2025, FPL starts at $15,060 yearly for one person, plus $5,380 per extra member.
Income calculations include wages, benefits, child support, and more. Use modified adjusted gross income for most groups.
Different programs have different limits. Adults use 138% FPL. Children up to 148% for Medicaid, higher for FAMIS. ABD ties to SSI levels.
Virginia Medicaid Income Limits 2025 Chart (All Household Sizes)
This chart shows monthly and yearly limits for expansion adults (138% FPL). Add $690 monthly ($8,280 yearly) for each extra person beyond 8.
| Household Size | Monthly Income Limit | Yearly Income Limit |
| 1 | $1,732 | $20,784 |
| 2 | $2,343 | $28,116 |
| 3 | $2,953 | $35,436 |
| 4 | $3,564 | $42,768 |
| +1 | +$690 | +$8,280 |
Income Limits by Category
Medicaid for Low-Income Adults (19–64) 2025 Limits
Low-income adults qualify up to 138% FPL. No asset limit. This covers childless adults too, thanks to expansion.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $1,732 | $20,784 |
| 2 | $2,343 | $28,116 |
| 3 | $2,953 | $35,436 |
| 4 | $3,564 | $42,768 |
FAMIS (Children’s Medicaid) 2025 Limits
FAMIS covers kids under 19 up to 200% FPL. It’s CHIP for higher incomes. No premiums.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,512 | $30,144 |
| 2 | $3,398 | $40,776 |
| 3 | $4,283 | $51,396 |
| 4 | $5,169 | $62,028 |
FAMIS MOMS (Pregnant Women) 2025 Limits
Pregnant women qualify up to 205% FPL. Coverage lasts 12 months postpartum. Unborn child counts in size.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,575 | $30,900 |
| 2 | $3,484 | $41,808 |
| 3 | $4,392 | $52,704 |
| 4 | $5,301 | $63,612 |
Aged, Blind & Disabled (ABD) Medicaid 2025 Limits
ABD covers those 65+ or disabled up to SSI level ($967 monthly single). Assets up to $2,000 single. Spend-down if over.
| Household Size | Monthly Limit | Annual Limit | Asset Limit |
| 1 (Single) | $967 | $11,604 | $2,000 |
| 2 (Couple) | $1,450 | $17,400 | $3,000 |
Long-Term Care Medicaid; Key Income Rules
Long-term care has an income cap of $2,901 monthly. Single Assets $2,000. Spend-down uses medical bills to qualify. Spousal protections allow non-applicant to keep up to $3,948 monthly income.
Who Qualifies for Virginia Medicaid in 2025?
- Must be a Virginia resident.
- Meet income limits for your group.
- Be a U.S. citizen or qualified immigrant.
- Belong to a covered group like adult, child, pregnant, elderly, or disabled.
What Does Virginia Medicaid Cover in 2025?
- Primary and specialist care.
- Hospital services.
- Lab tests and imaging.
- Emergency care.
- Dental (limited for adults, full for children).
- Prescription medicines.
- Pregnancy and postpartum care.
- Behavioral and mental health.
- Long-term care (if eligible).
Required Documents for 2025 Application
- Identification.
- Proof of Virginia residency.
- Income documents (paystubs, tax forms).
- SSN or immigration documents.
- Medical proof (for pregnant or disabled applicants).
How to Apply for Virginia Medicaid (Step-by-Step)
- Apply online at CommonHelp (Virginia’s portal).
- Create an account and enter household info.
- Upload documents.
- Submit application.
- Get a decision within 45 days (pregnancy cases are often faster).
- If approved, receive your Medicaid card.
You can apply via phone (1-855-242-8282) or local DSS office. Renewal is yearly.
Frequently Asked Questions
What are the Virginia Medicaid income limits for 2025?
Limits vary: Adults $1,732 monthly for one at 138% FPL, children $2,512 at 200%, pregnant $2,575 at 205%, ABD $967.
Can adults without children get Medicaid in Virginia in 2025?
Yes, up to 138% FPL via expansion.
What are the FAMIS income limits for kids in 2025?
Up to 200% FPL, like $2,512 monthly for one.
ck bank accounts for Medicaid in 2025?
No for most; assets checked for ABD and long-term care, limit $2,000 single.
How long does it take to get approved for Virginia Medicaid in 2025?
Up to 45 days; faster for pregnancy.
What is the income limit for pregnant women in Virginia in 2025?
Up to 205% FPL, $2,575 monthly for one.
Does Virginia Medicaid cover dental services in 2025?
Full for children; limited emergencies for adults.
Conclusion
Income limits increased for 2025 in Virginia Medicaid. This helps more families get care. Eligibility varies by category, so check your group.Encourage early application or renewal. Visit CommonHelp for details.
