Medicaid Eligibility
Many Virginians qualify for high-quality, no-cost health coverage through Medicaid. Do you? Find out if Virginia Medicaid is an option for you by viewing eligibility for adults, children, and pregnant women. Use the Screening Tool on the Cover Virginia website to check.
Medicaid Eligibility for Children
Your child may be eligible for benefits if they:
- live in Virginia
- are under age 19
- are United States citizens or lawfully residing immigrants
- live in a family meeting FAMIS income guidelines
Medicaid Eligibility for Adults
Adults may be eligible if you:
- are a Virginia resident, age 19 to 64
- are a United States citizen or lawfully-residing immigrant
- are not eligible or covered by Medicare
- you are medically complex
- meet the income requirements based on your household size.
You are eligible for the Commonwealth Coordinated Care Plus (CCC Plus) program when you have full Medicaid benefits and meet one of the following conditions:
- you are a Virginia resident, age 65 and older
- you are an adult or child with a disability
- you reside in a nursing facility
- you receive services through the CCC Plus home and community-based services waiver
- or you receive services through any of the three waivers serving people with developmental disabilities (Building Independence, Family & Individual Supports, and Community Living Waivers), also known as the DD Waivers
Medicaid Eligibility for Pregnant Women
You may be eligible for pregnancy coverage if you:
- live in Virginia
- are currently pregnant or within the 60-day period after your pregnancy ends
- are a United States citizen or a legally-residing immigrant
- meet the income requirements based on your household size
You can Apply For Medicaid at Any Time
If you are new to Medicaid, you can apply to enroll anytime of the year. You may apply on the Common Help website for health insurance and other benefits you may be eligible to receive.
Not Eligible for Medicaid?
Optima Health also offers affordable health plans for individuals and families. Shop and compare plans to determine if you are eligible for tax credits (financial assistance) to help pay for your health insurance plan. Optima Health offers a variety of health insurance plans both on and off the Health Insurance Marketplace.