01. Overview & references
Virginia’s Department of Medical Assistance Services publishes separate financial rules for regular aged, blind and disabled coverage and for long-term-care cases. Cardinal Care is the Medicaid umbrella, while CCC Plus is a particular home-and-community-based waiver. A person seeking that waiver needs Medicaid financial eligibility and an LTSS screening. The screening can be requested through local Social Services, with a hospital route available during discharge planning. Start by identifying which covered group the eligibility worker is using. The same pension can be evaluated differently under the regular ABD category and the institutional 300-percent SSI screen.
- State Medicaid program
- Virginia Medicaid / Cardinal Care
- Income pathway
- Medically needy / spend-down pathway
- Nursing-home look-back reference
- 60 months
- Home-equity reference
- $752,000
- Personal-needs allowance reference
- $40
- Reviewed
- 2026-11-16
Read the program row before using any number. A nursing-facility pathway, a particular home-care waiver and regular coverage for older or disabled adults can use different financial tests. A published financial standard does not establish the required level of care, reserve a waiver place or pay every assisted-living expense. Confirm the exact category with the agency.
02. Income & asset table
A countable-income standard is not the same as a gross-income ceiling. Deductions, disregards and ownership rules may affect what the agency counts. For a married applicant, ask whose income is being evaluated and whether the resource figure is individual or combined. Where the available source does not support one comparable number, this guide leaves it unspecified instead of estimating it.
| Care category | Income references | Countable-asset references | CSRA maximum reference |
|---|---|---|---|
| Medicaid nursing-facility 300% SSI routeDo not substitute regular ABD disregards into the 300% screen. Eligibility andpatient pay calculations are separate. | Single: $2,982300% SSI screening reference: the manual counts all income except items defined as not income. Medically-needy review may apply above it.Married, one applies: $2,982300% SSI screening reference: the manual counts all income except items defined as not income. Medically-needy review may apply above it. This is the applicant’s reference, not combined marital income.Married, both apply: Program-specific; see notesNo verified combined-couple threshold is published here; each spouse needs a separate eligibility review. | Single: $2,000Countable resources after exclusions.Married, one applies: $2,000Applicant-side resources after the spousal assessment; not a ceiling on all marital property.Married, both apply: Program-specific; see notesDo not double the single-person limit or apply a community-spouse allowance when both receive institutional care. | $162,660Community spouse only; program applicability and allocation must be assessed. |
| CCC Plus community-based waiver financial routeDo not substitute regular ABD disregards into the 300% screen. Eligibility andpatient pay calculations are separate. | Single: $2,982300% SSI screening reference: the manual counts all income except items defined as not income. Medically-needy review may apply above it.Married, one applies: $2,982300% SSI screening reference: the manual counts all income except items defined as not income. Medically-needy review may apply above it. This is the applicant’s reference, not combined marital income.Married, both apply: Program-specific; see notesNo verified combined-couple threshold is published here; each spouse needs a separate eligibility review. | Single: $2,000Countable resources after exclusions.Married, one applies: $2,000Applicant-side resources after the spousal assessment; not a ceiling on all marital property.Married, both apply: Program-specific; see notesDo not double the single-person limit or apply a community-spouse allowance when both receive institutional care. | $162,660Community spouse only; program applicability and allocation must be assessed. |
| ABD community coverage at 80% federal poverty levelThis is the ABD 80%FPL category, not the 300% SSI institutional screen or Medicaid Works. | Single: $1,064Countable-income reference from Virginia’s 2026 rounded monthly chart; other protected categories and spenddown may apply.Married, one applies: $1,443Couple/household reference where spouses are included together; exclusions and deeming require agency review. Countable-income reference from Virginia’s 2026 rounded monthly chart; other protected categories and spenddown may apply.Married, both apply: $1,443Combined couple countable-income reference, not a gross-income ceiling. Countable-income reference from Virginia’s 2026 rounded monthly chart; other protected categories and spenddown may apply. | Single: $2,000Individual countable resources.Married, one applies: Program-specific; see notesThe couple resource reference is 3,000 dollars combined, not an applicant-only allowance.Married, both apply: $3,000Combined countable resources for the two-person assistance unit. | Not inferred for regular coverageCommunity spouse only; program applicability and allocation must be assessed. |
03. Countable & excluded assets
Virginia’s ABD resource chapter distinguishes countable resources from excluded property and provides separate household rules. A qualifying residence or other excluded item should not automatically be added to a cash savings total. For long-term-care payment, the manual also applies a home-equity restriction with specified family and other exceptions. Gather the deed, ownership percentage, mortgage information and occupancy details so the worker can review both tests. The statewide equity figure is not a guarantee that every property below it is excluded, nor does an eligibility exclusion automatically protect the property from later estate recovery.
Keep the ownership question separate from the exclusion question. A bank balance or property value alone does not establish what the agency counts. Document ownership, debt, accessibility and the reason for any proposed exclusion. Do not assume that renaming an account or transferring an asset makes it exempt.
| Often considered countable | Potential exclusions — verify conditions |
|---|---|
| Bank deposits, accessible investments, securities and other real estate may require valuation. | A principal home, a vehicle, personal effects and certain burial or life-insurance arrangements may qualify under specific rules. |
04. Community-spouse protections
The community-spouse resource protection applies through a marital assessment, not by comparing all joint savings with the applicant’s individual resource ceiling. Virginia’s 2026 chart gives the current spousal standards, and the long-term-care chapter explains the assessment and income-allocation rules. A protected resource share is distinct from a monthly maintenance allowance. If both spouses seek institutional care, the community-spouse assumptions may no longer fit. Request a worksheet that identifies each spouse’s role and the effective date, especially after a hospital admission, a change of residence or a spouse’s own application.
A community-spouse allowance is an assessment rule, not a cash payment or an automatic entitlement to the displayed maximum. The income allowance and resource allowance are separate calculations. Federal benchmarks can help identify which questions to ask, but they do not replace the applicable state worksheet or an individual determination.
Federal benchmarks, not automatic state allowances
Minimum MMMNA effective July 1, 2026; maximum and resource standards January 1, 2026. All 20 states in this directory are in the contiguous United States.
CMS standards and effective dates05. Higher income, transfers & recovery
The 300-percent SSI figure is a screening reference, not a promise that everyone above it is excluded from Virginia long-term-care coverage. The manual also contains medically-needy income and spenddown procedures, including community-based care. Its initial 300-percent screen counts income differently from the ordinary ABD calculation, so a general income disregard should not simply be subtracted from every pension. Ask which covered groups were considered, what medical expenses are recognized and which budget period applies. The eventual patient-pay obligation is calculated separately and can remain significant even when financial eligibility is established.
Virginia’s long-term-care chapter reviews transfers within 60 months of the relevant baseline and addresses transfers made afterward as well. The baseline depends on the person being an institutionalized individual under the rules and having applied for Medicaid. Transactions must be evaluated for adequate compensation and applicable exceptions; the result cannot be inferred from one bank balance. Keep agreements, statements and records of services or property involved in questioned payments. A family-care payment can raise documentation questions, so describe the actual arrangement accurately rather than relabeling past transactions to fit a desired outcome.
DMAS guidance explains recovery from the estates of certain Medicaid members who received benefits after age 55. The recovery analysis considers the property interest left at death, applicable surviving-spouse and child protections, and hardship provisions. A residence excluded in the financial application can still be relevant to an estate claim. Recovery of correctly paid benefits after death is different from repayment demanded because of incorrect eligibility information. Keep the benefit notices and seek the specific claim basis. The existence of Medicaid coverage alone does not establish that a home must immediately be sold.
Review transfer history before making financial changes. The look-back interval, a potential penalty period, treatment of the home and estate recovery are different issues. Exemptions, protected relatives and hardship procedures can matter. Ask the agency which rule applies to the service and application date; seek qualified advice before signing an agreement or moving property.
06. Document checklist
Apply through CommonHelp, Cover Virginia or local DSS using the official application options. For long-term services and supports, ask about AppendixD and the screening request rather than submitting only a general health-coverage application. Prepare identity information, income awards, account and property records, existing insurance and relevant medical expenses. A request for additional information should identify what is missing and where to send it. Keep copies and submission dates. Once approved, retain the financial notice, screening outcome and service authorization separately so a delay can be traced to the correct stage.
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07. Frequently asked questions
Does CCC Plus approval replace the financial application?
No. Virginia requires Medicaid eligibility as well as the LTSS screening and waiver approval. Each step addresses a different part of coverage.
Is the 40-dollar allowance an income limit?
No. It is the nursing-facility personal-needs allowance used in post-eligibility budgeting. It is not the 300-percent SSI financial screening standard.
Can I subtract regular ABD disregards from the LTC screen?
Not automatically. The 2026 chart says the 300-percent SSI screen counts all income except items specifically defined as not income. Ask for the category-specific calculation.
Where do I request the CCC Plus screening?
Local Social Services can arrange a community screening. A hospital discharge planner can arrange screening during hospitalization; financial eligibility must still be determined.
Source register
- ChapterM00 income charts, July 2026Consulted: 2026-11-16 · Official source
- ChapterM11 ABD resources, January 2026Consulted: 2026-11-16 · Official source
- ChapterM14 Long-term care, current linked editionConsulted: 2026-11-16 · Official source
- ChapterM13 spenddownConsulted: 2026-11-16 · Official source
- Medical Assistance Handbook, May 2025Consulted: 2026-11-16 · Official search excerpt used; direct-page verification limited.
- CCC Plus Waiver official overviewConsulted: 2026-11-16 · Official source
- Applying for MedicaidConsulted: 2026-11-16 · Official source
- Estate recovery fact sheetConsulted: 2026-11-16 · Official search excerpt used; direct-page verification limited.