Virginia Medicaid covers nearly 1.8 million residents, including many immigrants who meet both income and immigration status requirements. Virginia is a Medicaid expansion state, meaning adults with incomes up to 138% of the Federal Poverty Level ($22,025 a year for an individual in 2026) can qualify regardless of age, disability, or family status. For immigrants, however, a second test applies: federal law requires a qualifying immigration status, and not every visa or authorization category counts.
The rules are also changing. H.R.1, the reconciliation law signed in 2025, restricts which immigration statuses qualify for federally funded Medicaid starting October 1, 2026. Adults who previously qualified under certain parolee, asylee, or special visa categories may lose full Medicaid coverage. This guide explains who qualifies, who is affected by the October 2026 changes, how to apply, and what coverage options remain for those who do not qualify for full Virginia Medicaid.
Direct Answer: Who Qualifies for Virginia Medicaid as an Immigrant in 2026
It depends on immigration status. Virginia Medicaid covers adults below 138% FPL ($22,025/yr for one person in 2026), but requires a federally qualifying immigration category. Lawful permanent residents after 5 years, refugees, asylees, Cuban/Haitian entrants, and COFA migrants qualify for full coverage. DACA recipients, TPS holders, and undocumented adults do not qualify for full Virginia Medicaid. Starting October 1, 2026, H.R.1 narrows adult eligibility, removing parolees and certain other previously covered groups. Emergency Medicaid remains available for acute, life-threatening care.
Virginia Medicaid Income Limits by Household Size (2026)
Virginia Medicaid uses MAGI (Modified Adjusted Gross Income) to determine eligibility. MAGI counts taxable wages, self-employment income, alimony received (for agreements before January 1, 2019), and most other income sources. MAGI does not count child support received, Supplemental Security Income (SSI), workers' compensation, or veterans' benefits. Virginia applies a 5% FPL income disregard, which is why the thresholds in the table above are slightly higher than a straight 133% FPL calculation. Family size matters: the income limit rises with each additional household member. For the expansion adult category (ages 19-64), income below 138% FPL qualifies. A family of 4 earning up to $45,540 in 2026 meets the income test.
Virginia's children's programs have separate thresholds. FAMIS Plus (Medicaid for children) covers children at or below 148% FPL, and FAMIS (the separate CHIP program) covers children in families with incomes between 148% and 205% FPL. Pregnant individuals qualify at 148% FPL regardless of immigration status, as Virginia covers pregnancy-related Medicaid for all immigration categories.
Immigration Status Categories: Who Qualifies for Virginia Medicaid
Virginia Medicaid immigration eligibility follows the federal framework established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), modified by H.R.1 effective October 1, 2026. The table below shows current eligibility by status category.
Virginia Medicaid eligibility by immigration status 2026| Immigration Status | Full Medicaid (Adults) | 5-Year Wait? | Notes |
|---|
| Lawful Permanent Resident (green card) | Yes, after 5-year bar | Yes (most cases) | 5-year bar waived for those with 10+ years U.S. work history, military/veterans, and certain survivors |
| Refugee or Asylee | Yes (no waiting period) | No | Refugees and asylees are exempt from the 5-year bar; must still meet income limits |
| Cuban/Haitian Entrant | Yes (no waiting period) | No | Specific legal category created for Cuban and Haitian entrants; federally qualifying |
| COFA Migrant (Marshall Islands, Micronesia, Palau) | Yes (no waiting period) | No | Compact of Free Association migrants are a federally qualifying category as of the 2024 COFA Medicaid restoration |
| Trafficking Victim (T visa, U visa holders with certification) | Yes (no waiting period) | No | Federal law exempts certified trafficking victims from the 5-year bar |
| U.S. Active-Duty Military or Veteran (noncitizen) | Yes (no waiting period) | No | Noncitizen active-duty military and honorably discharged veterans and their families are exempt from the 5-year bar |
| Parolee (humanitarian or other parolee) | Not eligible after Oct 1, 2026 | Was: No | H.R.1 removes parolees from eligible categories for federally funded Medicaid for adults effective October 1, 2026 |
| Temporary Protected Status (TPS) | Not eligible after Oct 1, 2026 | N/A | TPS is not a qualifying immigration status for federal Medicaid; H.R.1 confirms this restriction |
| DACA Recipient | Not eligible | N/A | DACA is not a qualifying immigration status for federal Medicaid. Emergency Medicaid only for life-threatening emergencies. |
| Undocumented (no lawful status) | Not eligible | N/A | Emergency Medicaid only; pregnant individuals qualify for pregnancy-related Medicaid regardless of status |
Children and pregnant individuals follow different rules: lawfully residing children under 19 and pregnant individuals at any immigration status may qualify for Virginia Medicaid or FAMIS regardless of adult eligibility restrictions. H.R.1 changes apply only to non-pregnant adult eligibility.
Source: Virginia DMAS, DMAS H.R.1 Eligibility Changes Fact Sheet December 2025; Health Reform Beyond the Basics Immigrant Eligibility Guide; KFF Key Facts on Health Coverage of Immigrants 2026
Is Virginia a Medicaid Expansion State?
Virginia expanded Medicaid under the ACA on January 1, 2019, covering adults ages 19-64 with incomes up to 138% of the Federal Poverty Level. Before expansion, adults without children or disability had extremely limited Medicaid access in Virginia. Expansion added more than 600,000 Virginia residents to the program and removed the prior categorical restrictions that kept most working-age adults without children ineligible.
Virginia is not in the group of 10 non-expansion states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming). Residents in those states who earn between 100% and 138% FPL fall into the ACA coverage gap because they earn too much for traditional Medicaid and too little for ACA marketplace subsidies. Virginia residents in that income range qualify for Virginia Medicaid expansion, which is a significant benefit for eligible immigrants who meet income requirements.
H.R.1 Changes Starting October 1, 2026: What Immigrants Need to Know
H.R.1, the One Big Beautiful Bill Act signed into law in 2025, makes the most significant changes to immigrant Medicaid eligibility since PRWORA in 1996. Effective October 1, 2026, federal matching funds for Medicaid and CHIP are restricted to: U.S. citizens and nationals, Lawful permanent residents (after the 5-year bar where applicable), Cuban/Haitian entrants, and COFA migrants. Adults in previously qualifying categories such as certain parolees, Iraqi and Afghan special immigrants, and similar groups may lose full Medicaid coverage as of October 1, 2026 if Virginia follows the federal funding restriction.
Virginia DMAS has published guidance that these changes apply only to non-pregnant adults. Children under 19 who are lawfully residing and pregnant individuals regardless of immigration status continue to qualify for Virginia Medicaid or FAMIS under the states' existing coverage options. The Congressional Budget Office estimated H.R.1 will result in approximately 1.3 to 1.4 million immigrants losing coverage nationally by 2034. Individuals who lose full Medicaid coverage due to H.R.1 may be eligible for Emergency Medicaid for life-threatening acute care, or may explore ACA marketplace plans at marketplace.virginia.gov if their immigration status makes them eligible for marketplace enrollment.
Emergency Medicaid: What It Covers for Ineligible Immigrants in Virginia
Virginia provides Emergency Medicaid coverage to immigrants who meet all other Medicaid eligibility rules (income, residency, household composition) but do not have a qualifying immigration status. Emergency Medicaid covers emergency medical conditions, which under federal law means a condition that requires immediate medical intervention to prevent serious jeopardy to health, impairment of bodily functions, or dysfunction of a body organ or part. Emergency Medicaid in Virginia covers emergency room stabilization, labor and delivery, emergency surgery, and other acute interventions.
Emergency Medicaid does not cover: preventive care, outpatient doctor visits, prescription drugs, mental health counseling, dental or vision services, chemotherapy or other non-emergency treatments for chronic conditions, or long-term care. DACA recipients, TPS holders, and undocumented immigrants in Virginia who meet income requirements can apply for Emergency Medicaid through the same application process, checking the emergency services option. Pregnant individuals who are undocumented qualify for pregnancy-related full Medicaid in Virginia, which covers prenatal, delivery, and postpartum care.
How to Apply for Virginia Medicaid as an Immigrant
Virginia processes Medicaid applications year-round with no enrollment window. The fastest application method is online at commonhelp.virginia.gov, which automatically checks eligibility for Medicaid, FAMIS, and ACA marketplace plans in a single submission. Virginia allows applicants to submit an application and provide documentation afterward, but faster processing results from submitting immigration documents at the time of application. For language assistance, Cover Virginia offers interpretation in over 100 languages at 1-855-242-8282.
Virginia Medicaid uses a household composition definition based on tax filing relationships, not just who lives in the home. For immigrants whose household includes non-applying family members (for example, a parent who is undocumented and not applying), Virginia allows those household members to be excluded from the application. The income of non-applying household members is still counted in the MAGI household income calculation for the applying members, but only the applying members' immigration status is evaluated for Medicaid eligibility.
Appealing a Virginia Medicaid Denial
Virginia Medicaid applicants who are denied have the right to a state fair hearing. Denials must come in writing with a specific reason. For immigrants, the most common denial reason is an immigration status determination. If you believe your status was misclassified or that the eligibility worker made a legal error, you can request a fair hearing within 90 days of the denial notice. Contact Cover Virginia at 1-855-242-8282 to request a hearing or write to Virginia Department of Social Services, Appeals and Fair Hearings, P.O. Box 1203, Richmond, VA 23218.
Virginia residents facing complex immigration and Medicaid issues can seek free assistance from legal aid organizations including Legal Aid Justice Center (justice4all.org), which operates in Virginia and has experience with immigrant benefits cases. Many Virginia local DSS offices also partner with community health workers who can assist with documentation and appeals at no cost.
Common Denial Reasons and How to Avoid Them
Virginia Medicaid applications from immigrants are most frequently delayed or denied for five reasons. First, immigration status does not qualify after October 1, 2026 under H.R.1 rules. Second, the 5-year bar has not been met for LPRs who received their green card less than 5 years ago. Third, income documentation is incomplete or income exceeds 138% FPL ($22,025 for an individual in 2026). Fourth, Virginia residency cannot be established because only a P.O. box or an out-of-state address is provided. Fifth, required immigration documents were not submitted with the application.
Frequently Asked Questions
Can a green card holder get Medicaid in Virginia in 2026?
Yes, if the 5-year bar has been met. Lawful permanent residents (green card holders) who have held their status for at least 5 years can qualify for Virginia Medicaid if their income is below 138% FPL ($22,025/yr for an individual in 2026). LPRs who received their green card less than 5 years ago are generally not eligible unless they are refugees, asylees, COFA migrants, trafficking victims, or active-duty military or veterans.
Can DACA recipients get Medicaid in Virginia?
No, not full Medicaid. DACA (Deferred Action for Childhood Arrivals) is not a federally qualifying immigration status for Medicaid. DACA recipients in Virginia who meet income and residency requirements may access Emergency Medicaid, which covers life-threatening acute conditions only. For preventive care, DACA recipients may explore ACA marketplace plans, though the 2025 reconciliation law (H.R.1) also restricts DACA access to marketplace subsidies.
Do refugees and asylees qualify for Virginia Medicaid?
Yes. Refugees and asylees are exempt from the 5-year bar and qualify for full Virginia Medicaid immediately upon resettlement, provided they meet income requirements (138% FPL or below). Importantly, H.R.1 effective October 1, 2026 removes federal matching funds for refugees and asylees who do not hold LPR status (a green card). Virginia DMAS has published guidance that H.R.1 affects only adult non-pregnant eligibility. Contact Cover Virginia at 1-855-242-8282 for the latest status on refugee and asylee eligibility post-October 2026.
Can undocumented immigrants get Medicaid in Virginia?
Only Emergency Medicaid. Undocumented immigrants do not qualify for full Virginia Medicaid. However, they may receive Emergency Medicaid for life-threatening acute conditions if they meet income and residency requirements. Pregnant undocumented individuals have broader access: Virginia covers prenatal, delivery, and postpartum care under pregnancy-related Medicaid regardless of immigration status.
What is the income limit for an immigrant family of 4 to qualify for Virginia Medicaid in 2026?
A family of 4 must earn below $45,540 per year (about $3,795 per month) to qualify for the Virginia Medicaid expansion category in 2026. This threshold is based on 138% of the 2026 Federal Poverty Level including the 5% disregard. The income test is the same for citizens and qualifying immigrants. Children may qualify at higher thresholds: FAMIS Plus covers children at up to 148% FPL and FAMIS covers 148% to 205% FPL.
What counts as income for Virginia Medicaid (MAGI definition)?
Virginia Medicaid uses MAGI (Modified Adjusted Gross Income), which includes wages and salaries, self-employment income, rental income, taxable interest and dividends, alimony received (for agreements made before January 1, 2019), and Social Security benefits if the amount is taxable. MAGI does not count: child support received, Supplemental Security Income (SSI), workers' compensation, veterans' benefits, or income of household members who are not included in the application household.
What documents do I need to apply for Virginia Medicaid as an immigrant?
You need proof of identity (driver's license, passport, or state ID), proof of immigration status (Permanent Resident Card I-551, I-94, EAD, or USCIS approval notice), Social Security numbers for all household members applying, proof of Virginia residency (utility bill, lease, or bank statement), and proof of income for all household members (pay stubs, tax return, or employer letter). Submit immigration documents with your application to avoid delays. Apply at commonhelp.virginia.gov or call Cover Virginia at 1-855-242-8282.
How long does the Virginia Medicaid application take for immigrants?
Virginia has up to 45 days to process a standard Medicaid application and up to 90 days for disability-based applications. In practice, many online applications are processed faster, especially if all documents are submitted upfront. Immigration status verification may add time if DMAS needs to confirm status with federal immigration databases. You can check your application status online at commonhelp.virginia.gov or call Cover Virginia. You do not need to wait for a decision before receiving care if you submit a complete application.
