Virginia Long-Term Care Planning

Last updated: August 21, 2026 Jurisdiction: Virginia

Virginia planning starts with the correct income route

Virginia's 2026 manual lists a $2,982 monthly 300%-of-SSI amount for the institutional and waiver eligibility group, but Virginia also publishes medically needy income standards and a spend-down route. The long-term-care manual specifically describes certain HCBS, PACE, and hospice penalty cases in which the person must meet a spend-down, qualify in another full-benefit group, or enter a nursing facility before the penalty may be imposed. This published structure is why a family should not assume a Qualified Income Trust is the automatic Virginia solution for income over $2,982 (DMAS 2026 income charts; DMAS Chapter M14).

Resource planning has separate rules. Virginia's current policy uses $2,000 for one person and $3,000 for the basic two-person ABD resource standards, while a community spouse may receive a protected-resource amount between the $32,532 floor and $162,660 maximum in 2026. The home-equity limit is $752,000, subject to the policy's spouse and child occupancy exceptions. Those rules make it important to perform the resource assessment before moving money or changing title (DMAS 2026 resource policy; DMAS Chapter M14).

Transfers, deeds, and trusts need a five-year view

Virginia reviews 60 months of transfers and determines an LTSS penalty from the uncompensated value and the private-pay nursing-facility cost for the relevant locality and application date. That timing applies to gifts, sales below value, some retained-interest arrangements, and other transactions that can be transfers for less than fair market value. A later hardship request is tightly limited; it is not a substitute for planning before the transaction (DMAS Chapter M14).

Virginia's transfer-on-death deed is a probate-planning tool with a particular lifetime rule: it does not affect public-assistance eligibility while the transferor is alive and does not create a beneficiary interest during life. It does not settle the post-death recovery question, because Virginia defines the recoverable estate to include assets in which the deceased retained a legal title or interest at death. Revocable trusts, life estates, and deeds should therefore be reviewed for both transfer and recovery consequences (Virginia Code § 64.2-631; Virginia estate-recovery regulation).

A Virginia-specific family-support rule

Virginia retains a filial-support statute. An adult child with sufficient earning capacity or income, after reasonable provision for the child's immediate family, may have a joint-and-several duty to assist a parent in necessitous circumstances; the statute has exceptions and public-assistance limits, and a court determines any amount. The statute also limits child responsibility for institutionalization costs to no more than 60 months. This is a legal planning issue, not an automatic nursing-home bill (Virginia Code § 20-88).

Virginia planning sequence: identify the care setting, verify the correct income pathway, complete any community-spouse assessment, preserve five years of transfer records, and get advice before changing title or making gifts (DMAS Chapter M14).

For planning framework, see Advance Medicaid Planning. The details are too consequential for a generic form or an out-of-state internet answer.

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Virginia planning starts with the correct income route

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