Know How to Navigate Medicaid Eligibility for Nursing Home Care in Virginia

Many seniors could benefit from long-term care and support, especially if they’re living alone. However, many people are concerned about how they will pay for care. Oftentimes, seniors are eligible for Medicaid support but don’t realize it. They may worry that seeking out care could create additional burdens for their family, but this isn’t true. Understanding how to navigate Medicaid in Virginia can alleviate some of these concerns and help people get the long-term care they need in a nursing home setting.

Understanding Medicaid

Medicaid is a government program that provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Each state has its own eligibility requirements, and the benefits can also vary from state to state.

Medicaid offers support to many seniors who need long-term care. Because many people think of Medicaid as a benefit only for those who live in poverty, they may not realize that they’re eligible for help. As long as an individual meets certain income and asset limits, they can access Medicaid’s benefits and receive the compassionate long-term care they need.

Medicaid Eligibility for Nursing Home Care

In Virginia, as of 2023, there are income limits and asset limits for Medicaid eligibility. Assets include money in bank accounts, non-excluded vehicles, non-excluded IRAs and annuities, non-excludable property and whole life insurance cash values, etc. Assets are reviewed by the state to determine asset eligibility. Depending on whether a nursing home resident is married or single, the state can have different/additional eligibility guidelines. In many cases, the state allows for a spouse to be able to retain assets. To find the asset limits for your household size, click here.

  • For single individuals, there is an income limit of $2,742/month and an asset limit of $2,000.
  • For married individuals, the asset limit is $2,000. However, any assets in the resident’s name that would put them above this amount (as part of the Community Spouse Resource Allowance minimum of $29,724 and maximum of $148,620 as of 2023) are often able to be part of a spousal transfer (that follows the state guidelines and rules) in order to become asset eligible.

For more details on Medicaid income and asset limits in Virginia, visit the American Council on Aging.

Medicaid Spenddown

For seniors who meet the non-financial eligibility requirements but whose income exceeds the Medicaid limit, they can explore the option of a “spenddown,” which means that they spend or owe the amount above the Medicaid income limit in medical bills. When an individual applies for Medicaid, they will receive a letter that tells them their “spenddown liability” if it applies. The types of bills that count toward a spenddown liability are:

  • Doctor or hospital bills
  • Dentist bills
  • Cost of prescription drugs and certain medical supplies
  • Health insurance premiums

Get Support

Trio Healthcare facilities are dedicated to supporting our community and helping individuals thrive. If you know someone who is struggling to live independently at home, we can help. Reach out to us, and we’ll provide guidance and assistance to those who could benefit from long-term skilled care.

How we can help:

  • Offer navigation for the Medicaid application process
  • Provide 24-hour support and supervision for those who need more assistance than can be provided by part-time in-home care
  • Deliver therapy services to regain strength, function and mobility
  • Provide access to physicians and nurse practitioners

For more information or help navigating the Medicaid process, contact us today.