This page provides a plain-English summary of key elder care and estate planning information specific to Virginia residents. It covers Virginia Medicaid limits, estate tax rules, advance directive information, and links to important Virginia agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
Virginia Medicaid — 2026 Eligibility Limits for Long Term Care
Virginia’s Medicaid program is called Cardinal Care and is administered by the Virginia Department of Medical Assistance Services — DMAS. Virginia expanded Medicaid under the Affordable Care Act in 2019 providing coverage to adults aged 19 to 64 with incomes up to 138 percent of the federal poverty level.
Income limit — single applicant The income limit for a single Virginia nursing home Medicaid applicant is $2,982 per month in 2026. Virginia uses a medically needy spend-down pathway — not Qualified Income Trusts — for applicants whose income exceeds this limit. This means applicants apply their excess income toward qualifying medical expenses each month to reach the eligibility threshold.
Asset limit — single applicant A single applicant must have $2,000 or less in countable assets. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, and irrevocable burial trusts. Note that IRAs are counted as countable assets in Virginia.
Virginia’s unique annual gifting exception Virginia has an unusual rule that allows Medicaid applicants to gift up to $4,000 per year without penalty — but only if they can document a pattern of such gifting for at least three years prior to the Medicaid application. This is different from most states where any gift above the federal annual exclusion during the look-back period triggers a penalty. Virginia families who have a documented history of regular annual gifting for birthdays holidays or other purposes may be able to continue those gifts without penalty.
Home and community based care — CCC Plus Waiver Virginia’s primary HCBS program for seniors is the Commonwealth Coordinated Care Plus — CCC Plus — Waiver which provides home and community based services for people who need nursing facility level care but want to remain at home or in community settings. The asset limit is $2,000 for a single applicant and the income limit is $2,982 per month. Note that CCC Plus is not an entitlement program and when enrollment slots fill a waitlist may form.
Consumer-directed services within CCC Plus CCC Plus offers a consumer-directed services option where the member acts as the employer of their own attendant — handling hiring training managing and if necessary terminating the caregiver. A services facilitator assists with employer responsibilities. This option gives participants significant control over their care.
Married couples — one spouse applying When only one spouse applies for Virginia Medicaid the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined countable assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $2,000.
Monthly Maintenance Needs Allowance The minimum Monthly Maintenance Needs Allowance for the community spouse is $2,644 per month in 2026. The maximum is $4,066.50 per month for community spouses with high housing costs.
Personal needs allowance — among the lowest in the country Virginia nursing home Medicaid recipients are allowed to keep only $40 per month as a personal needs allowance — one of the lowest in the country. The remainder of income is applied toward the cost of care.
Look-back period Virginia has a 60-month — five year — look-back period for nursing home Medicaid and CCC Plus Waiver applications. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. The documented annual gifting exception described above is the only significant carve-out to this rule in Virginia.
Estate recovery Virginia requires Medicaid estate recovery. After a Cardinal Care recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney can help protect assets from estate recovery.
How to apply for Virginia Cardinal Care Medicaid Applications can be submitted online through CommonHelp at commonhelp.virginia.gov or CoverVA at coverva.dmas.virginia.gov, by phone at 1-855-242-8282, or in person at your local Department of Social Services — DSS — office.
Virginia Medicaid administering agency Virginia Department of Medical Assistance Services — dmas.virginia.gov
Virginia Estate Tax — 2026
No Virginia state estate tax Virginia does not impose a state estate tax. Virginia’s estate tax was tied to the federal state death tax credit which was eliminated by federal law. Virginia’s estate tax was effectively repealed prior to July 1 2007. No Virginia estate tax applies to any estate regardless of size.
No Virginia inheritance tax Virginia does not impose an inheritance tax. Beneficiaries who receive assets from a Virginia decedent owe no Virginia inheritance tax regardless of the size of the inheritance or their relationship to the deceased.
Virginia compared to its neighbors Virginia’s lack of both estate and inheritance taxes gives it a significant advantage over its immediate neighbors. Maryland imposes both a state estate tax — on estates over $5 million — and an inheritance tax on non-exempt beneficiaries. The District of Columbia imposes an estate tax on estates over $4 million. This makes Virginia particularly attractive for estate planning especially for residents in the Northern Virginia region who live close to the Maryland and DC borders.
Federal estate tax Virginia residents may be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses meaning a married couple can protect up to $30,000,000 from federal estate tax with proper planning. The top federal estate tax rate is 40 percent on amounts above the exemption.
No Virginia gift tax Virginia does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026.
Step-up in basis — important for Northern Virginia real estate Inherited assets in Virginia receive a stepped-up tax basis to fair market value at the date of the original owner’s death. Given the extraordinary appreciation in Northern Virginia real estate particularly in Fairfax Arlington Loudoun and Prince William counties this step-up in basis can eliminate very large capital gains tax obligations for heirs who inherit Northern Virginia real estate.
Virginia income tax Virginia has a progressive income tax with rates from 2 percent to 5.75 percent. Social Security benefits are not taxed in Virginia. Military retirement pay is fully exempt from Virginia income tax. Other retirement income is partially taxed. Virginia allows an age deduction for residents aged 65 and older.
Transfer on death deeds Virginia allows transfer on death deeds — also called TOD deeds — for real estate. A TOD deed allows real estate to pass directly to named beneficiaries at death without going through probate. This is a useful and relatively simple tool for Virginia homeowners who want to avoid probate on their primary residence.
Virginia Advance Directives
Virginia law recognizes the following advance directive documents:
Virginia Advance Medical Directive Virginia uses a single combined Advance Medical Directive that includes both the appointment of a healthcare agent and treatment instructions. Must be signed and witnessed by two adults who are not the healthcare agent.
Virginia POLST — Physician Orders for Life-Sustaining Treatment Virginia uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or nurse practitioner.
Virginia Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. Virginia has standardized out-of-hospital DNR protocols.
Virginia Advance Directive Registry Virginia maintains a statewide advance directive registry through the Virginia Department of Health. Virginia residents can register their advance directives to ensure healthcare providers can access them. Website: vdh.virginia.gov — search Advance Directive Registry Phone: 1-888-533-5678
Free Virginia advance directive forms Free Virginia-specific advance directive forms are available at caringinfo.org and from the Virginia Department of Health at vdh.virginia.gov.
Virginia Key Agencies and Resources
Virginia Department of Medical Assistance Services — DMAS Administers Cardinal Care — Virginia Medicaid — including the CCC Plus long term care waiver program. Website: dmas.virginia.gov CommonHelp Portal: commonhelp.virginia.gov CoverVA Portal: coverva.dmas.virginia.gov Phone: 1-855-242-8282
Virginia Department for Aging and Rehabilitative Services — DARS Coordinates programs and services for older Virginians including home care nutrition programs caregiver support and the Virginia SHIP program for free Medicare counseling. Website: vadars.org Phone: 1-800-552-3402 Virginia SHIP — free Medicare counseling: 1-800-552-3402
Virginia Area Agencies on Aging Virginia is served by 25 Area Agencies on Aging that coordinate local services for older adults and caregivers. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
Virginia Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: vadars.org/ltco Phone: 1-800-552-3402
Virginia State Bar Lawyer Referral Service Connects Virginians with attorneys including those who specialize in elder law and estate planning. Website: vsb.org Phone: 1-800-552-7977
Virginia Legal Aid Provides free civil legal services to low income Virginians including seniors on issues related to Medicaid benefits housing and elder law. Website: valegalaid.org Phone: 1-866-534-5243
Virginia Veterans Resources
Virginia Department of Veterans Services — DVS Provides services and benefits to Virginia veterans and their families including free VA claims assistance and connections to Virginia veterans resources. Website: dvs.virginia.gov Phone: 1-804-786-0286
Virginia Veterans Care Center Virginia operates veterans care centers providing long term care to eligible veterans and their spouses. Facilities are located in Roanoke and Virginia Beach. Website: dvs.virginia.gov/virginia-veterans-care-center
Virginia National Guard and Reserve Support Virginia has one of the largest concentrations of active duty military and veterans in the country particularly in Hampton Roads and Northern Virginia. The DVS can connect veterans with state and federal benefits.
Virginia Senior Property Tax Benefits
Real Property Tax Relief for Elderly and Disabled Virginia localities — counties and cities — are required to offer property tax exemption or deferral programs for qualifying homeowners aged 65 and older or permanently and totally disabled who meet income and net worth requirements. The specific exemption amounts income limits and net worth limits vary significantly by locality. Contact your local commissioner of the revenue or assessor for information about the program available in your jurisdiction.
Land Use Assessment Virginia farmers and landowners who qualify for land use taxation may see significant reductions in property tax assessments. This can be relevant for rural Virginia seniors with agricultural land.
Disabled Veterans Property Tax Exemption Virginia veterans with a 100 percent permanent and total service-connected disability rating are exempt from property taxes on their primary residence. The exemption also applies to surviving spouses of qualifying veterans who have not remarried.
Finding Elder Law and Estate Planning Attorneys in Virginia
The following resources can help you find a qualified elder law or estate planning attorney in Virginia:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- Virginia State Bar Lawyer Referral Service — vsb.org — 1-800-552-7977
- Virginia Chapter of NAELA — Virginia has an active NAELA chapter with members throughout the state
- Virginia Legal Aid — valegalaid.org — free legal assistance for income-qualifying seniors — 1-866-534-5243
The information on this page is for general informational purposes only and does not constitute legal or financial advice. Virginia Cardinal Care Medicaid rules and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: April 2026