People Who May Be Eligible For Medical Assistance
- Adults Aged 19 - 64
- Children Under Age 19
- Parents & Caretakers of Dependent Children
- Pregnant Women
- Supplemental Security Income (SSI) Recipients
- Adults Aged 65 or Older, Blind or Disabled (not receiving SSI)
- Children or Adults Who Need Long-term Care in a Facility/Home & Community-based Care (Waiver) Services
- Medicare Beneficiaries
- someone interested in Family Planning Services (Plan First)
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How To Apply
Forms - All Other
- 2023 Income Limits & LTC Spousal Impoverishment Standard Changes Eff. 01-10-2023 (DOC)
- 2021 Income Limits & LTC Spousal Impoverishment Standard Changes Eff. 01-13-2021 (PDF)
- 2020 Income Limits & LTC Spousal Impoverishment Standard Changes Eff. 01-17-2020 (PDF)
- Affidavit of Identity for Medicaid Applicants/Recipients Residing in an Institution (PDF)
- Appendix D: ABD, LTC Application (PDF) (PDF)
- Appendix D: ABD, LTC Application (Spanish) (PDF) (PDF)
- Appendix E: Medically Needy Spenddown (Spanish) (PDF)
- Appendix E: Medically Needy Spenddown (English) (PDF)
- Appendix F (English) (PDF)
- Appendix F (Spanish) (PDF)
- Application for Birth Certificate (English) (PDF)
- Application for Birth Certificate (Spanish) (PDF)
- Application for Health Coverage & Help Paying Costs (English) (PDF)
- Application for Health Coverage & Help Paying Costs (Spanish) (PDF)
- Asset Transfer Undue Hardship Claim (PDF)
- Benefit Programs Brochure (PDF)
- Burial Fund Designation (PDF)
- Commonwealth of Virginia Voter Registration Agency Certification (PDF)
- Cover Virginia Additional Person Supplement (English) (PDF)
- Cover Virginia Additional Person Supplement (Spanish) (PDF) (PDF)
- Medicaid Funded Long-term Care Service Authorization (PDF)
- Notification of Change (PDF)
