Updated September 5, 2026. Quick answer: Virginia runs three separate regional medically-needy income limits rather than one statewide figure. For a household of one, Virginia’s own administrative code sets Group I at $2,691.00 a month, Group II at $3,105.00, and Group III at $4,036.50, depending on where in the state the applicant lives, a genuinely unusual structure compared to the single flat figure most states use.
Three regions, three numbers
Virginia’s administrative code sets a medically needy income level, family size 1, at “$2,691.00” for Group I localities, with separate, higher figures of $3,105.00 for Group II and $4,036.50 for Group III. Virginia is unusual among the states in this family in tying the applicable medically-needy income figure to a geographic group rather than applying one number statewide.
A separate 300% formula also exists
Virginia’s code separately states, in a different chapter: “The income level used for 42 CFR 435.211, 42 CFR 435.217, and 42 CFR 435.230 shall be 300% of the current supplemental security income (SSI) payment standard for one person.” That is the ordinary federal-style cap. This session located that provision in a chapter covering developmental-disability waivers and could not, within this session, independently confirm its direct applicability to plain nursing-facility Medicaid specifically, so this page does not assert that connection as settled.
A citation worth double-checking before relying on it
The regional medically-needy figures come from a code section whose page metadata shows current text as of this session but whose last substantive amendment is dated 2017. This page states the figures exactly as Virginia’s own current code presents them, while flagging that a code section unamended since 2017 is worth confirming has not been superseded elsewhere before relying on it for a real application.
| Citation | Virginia Administrative Code, 12 VAC 30-40-220 (medically needy income levels) and 12 VAC 30-122-60 (special income level formula), Virginia Law site |
| What it says | “$2,691.00 (Group I, family size 1) … The income level used for 42 CFR 435.211, 42 CFR 435.217, and 42 CFR 435.230 shall be 300% of the current supplemental security income (SSI) payment standard for one person.” |
This page covers the income eligibility figure itself. How a state handles income above that figure (a Qualified Income Trust, a medically needy spend-down, or something else) is covered on Virginia’s excess income mechanism page.
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a county or state caseworker has the final say on any individual application.