12VAC30-40-220: Income eligibility levels
Where this section sits in the code
- Title 12. Health
- Agency 30. Department of Medical Assistance Services
- Chapter 40. Eligibility Conditions and Requirements
- Part IV. Eligibility Requirements
A. 1. Groups I, II, and III income limits are set forth in this subdivision 1.
Group I
Size of assistance unit
Monthly
Yearly
1
$239
$2,868
2
364
4,368
3
464
5,568
4
563
6,756
5
663
7,956
6
748
8,976
7
844
10,128
8
945
11,340
Each additional person
98
1,176
Group II
Size of assistance unit
Monthly
Yearly
1
$313
$3,756
2
449
5,388
3
565
6,780
4
675
8,100
5
794
9,528
6
895
10,740
7
1,002
12,024
8
1,119
13,428
Each additional person
111
1,332
Group III
Size of assistance unit
Monthly
Yearly
1
$472
5,664
2
633
7,596
3
774
9,288
4
909
10,908
5
1,074
12,888
6
1,195
14,340
7
1,330
15,960
8
1,471
17,652
Each additional person
135
1,620
2. Pregnant women and infants under § 1902(a)(10)(i)(IV) of the Act. Effective January 1, 2014, based on 143% of the official federal income poverty level.
3. Children under § 1902(a)(10)(i)(VI) of the Act (children who have attained age one year but have not attained age six years), the income eligibility level is 143% of the federal poverty level (as revised annually in the Federal Register) for the size family involved.
4. For children under § 1902(a)(10)(i)(VII) of the Act (children who were born after September 30, 1983, and have attained age six years but have not attained age years), the income eligibility level is 143% of the federal poverty level (as revised annually in the Federal Register) for the size family involved.
B. Treatment of cost of living adjustment (COLA) for groups with income related to federal poverty level.
1. If an individual receives a Title II benefit, any amount attributable to the most recent increase in the monthly insurance benefit as a result of a Title II COLA is not counted as income during a "transition period" beginning with January, when the Title II benefit for December is received, and ending with the last day of the month following the month of publication of the revised annual federal poverty level.
2. For individuals with Title II income, the revised poverty levels are not effective until the first day of the month following the end of the transition period.
3. For individuals not receiving Title II income, the revised poverty levels are effective no later than the beginning of the month following the date of publication.
C. Qualified Medicare beneficiaries with incomes related to federal poverty level. The levels for determining income eligibility for groups of qualified Medicare beneficiaries under the provisions of § 1905(p)(2)(A) of the Act are as follows:
Section 1902(f) states, which as of January 1, 1987, used income standards more restrictive than SSI, Virginia did not apply a more restrictive income standard as of January 1, 1987.
Based on the following percentage of the official federal income poverty level:
Effective January 1, 1989: 85%
Effective January 1, 1990: 90% (no more than 100)
Effective January 1, 1991: 100% (no more than 100)
Effective January 1, 1992: 100%
D. Aged and disabled individuals described in § 1902(m)(1) of the Act; Level for determining income eligibility for aged and disabled persons described in § 1902(m)(1) of the Act is 80% of the official federal income poverty level (as revised annually in the Federal Register) for the size family involved.
E. Income levels - for medically needy. (Increased annually the increase in the Consumer Price Index but no higher than the level permitted to claim federal financial participation.
1. The following income levels are applicable to all groups, urban and rural.
2. The agency has methods for excluding from its claim for federal financial participation payments made on behalf of individuals whose income exceeds these limits.
(1)
(2)
(3)
Family Size
Net income level protected for maintenance for 12 months
Amount by which Column 2 exceeds limits specified in 42 CFR 435.10071
Group I
Group II
Group III
1
$2,691.00
$3,105.00
$4,036.50
$0
2
$3,519.00
$3,824.00
$4,867.00
$0
3
$4,036.50
$4,450.50
$5,485.50
$0
4
$4,554.00
$4,968.00
$6,003.00
$0
5
$5,071.50
$5,485.50
$6,520.50
$0
6
$5,589.00
$6,003.00
$7,038.00
$0
7
$6,106.50
$6,520.50
$7,555.50
$0
8
$6,727.50
$7,141.50
$8,073.00
$0
9
$7,348.50
$7,762.50
$8,797.50
$0
10
$8,073.00
$8,487.00
$9,418.50
$0
For each additional person, add:
$695.52
$695.52
$695.52
$0
1As authorized in § 4718 of OBRA '90.
GROUPING OF LOCALITIES
GROUP I: Counties
Accomack
King and Queen
Alleghany
King William
Amelia
Lancaster
Amherst
Lee
Appomattox
Louisa
Bath
Lunenburg
Bedford
Madison
Bland
Matthews
Botetourt
Mecklenburg
Brunswick
Middlesex
Buchanan
Nelson
Buckingham
New Kent
Campbell
Northampton
Caroline
Northumberland
Carroll
Nottoway
Charles City
Orange
Charlotte
Page
Clarke
Patrick
Craig
Pittsylvania
Culpeper
Powhatan
Cumberland
Prince Edward
Dickenson
Prince George
Dinwiddie
Pulaski
Essex
Rappahannock
Fauquier
Richmond
Floyd
Rockbridge
Fluvanna
Russell
Franklin
Scott
Frederick
Shenandoah
Giles
Smyth
Gloucester
Southampton
Goochland
Spotsylvania
Grayson
Stafford
Greene
Surry
Greensville
Sussex
Halifax
Tazewell
Hanover
Washington
Henry
Westmoreland
Highland
Wise
Isle of Wight
Wythe
James City
York
King George
GROUP I: Cities
Bristol
Franklin
Buena Vista
Galax
Danville
Norton
Emporia
Suffolk
GROUP II: Counties
Albemarle
Loudoun
Augusta
Roanoke
Chesterfield
Rockingham
Henrico
Warren
GROUP II: Cities
Chesapeake
Petersburg
Covington
Portsmouth
Harrisonburg
Radford
Hopewell
Richmond
Lexington
Roanoke
Lynchburg
Staunton
Martinsville
Virginia Beach
Newport News
Williamsburg
Norfolk
Winchester
GROUP III: Counties
Arlington
Montgomery
Fairfax
Prince William
GROUP III: Cities
Alexandria
Fredericksburg
Charlottesville
Hampton
Colonial Heights
Manassas
Fairfax
Manassas Park
Falls Church
Waynesboro
Collected 2026-09-14T04:50:54Z. Source file · JSON