Apply for Medicaid in Virginia: Forms and Deadlines

This article is provided for educational and informational purposes only. It does not constitute legal, financial, or tax advice, and no attorney-client relationship is formed by reading it. Laws, regulations, official guidance, and related information vary by jurisdiction, change frequently, and may have changed or become outdated since publication. Always verify current information with authoritative sources and consult a qualified professional about your specific circumstances. The author and publisher assume no liability for actions taken based on this information.

Contents

Choose a way to apply in Virginia
Gather the information and the right appendices
Check the eligibility category before using an income limit
Watch the dates on upcoming eligibility changes
Respond to requests and track the decision deadline
Ask whether Medicaid can cover earlier medical bills
Appeal a denial using the correct deadline
Sources

Key Facts

Virginia application routes: Apply through CommonHelp, call Cover Virginia, mail a paper application, or take it to your local Department of Social Services.
Extra forms depend on your situation: Medicare eligibility, disability, older age, or a request for long-term care can require an application appendix.
Decision timing: The usual maximum is 45 days, or 90 days when applying on the basis of disability, with limited exceptions.
Past bills: Ask about retroactive Medicaid, but do not assume every coverage category pays for the same months.
Denial appeals: Virginia generally gives you 30 calendar days after receiving the notice to request an eligibility appeal.

Applying for Medicaid in Virginia starts with one practical choice: how you will submit the application and keep track of the response. The state uses a Cardinal Care application to collect information for Medicaid and FAMIS, with extra forms for some applicants. Keep a copy of what you submit, the submission confirmation, and any later requests for information.

Choose a way to apply in Virginia

Virginia accepts online applications through CommonHelp and telephone applications through Cover Virginia at 1-855-242-8282, with TTY service at 1-888-221-1590. As of September 2026, Cover Virginia lists call-center hours as Monday through Friday, 8 a.m. to 7 p.m.; Saturday service ended on April 4, 2026.

You can mail the paper application to the Cardinal Care Correspondence Center, Post Office Box 1820, Richmond, VA 23218, or drop it off at your local Department of Social Services. For application help, contact that local office, Cover Virginia, or a local application assister listed by the state.

Virginia’s Insurance Marketplace also makes Medicaid and FAMIS eligibility decisions and automatically enrolls applicants it finds eligible. If you already applied there, check the notice and application status before starting a second application.

Gather the information and the right appendices

Cover Virginia asks for household members’ legal names and birth dates, applicants’ Social Security numbers, immigration document numbers when relevant, income and employer information, and information about other health coverage. A household member who is not applying does not have to supply a Social Security number. That does not mean you should leave the person off the household information the application requests.

Initial Medicaid applications must be signed under penalty of perjury, and federal rules require acceptance of electronic signatures, including recorded telephone signatures. Complete the signature step for the method you use and save evidence that the application was submitted.

Use the main Cardinal Care application with any required supplements; the appendices are not standalone applications.

Appendix D: Include this when someone applying is 65 or older, Medicare eligible, or has a disability; it also applies to long-term care applicants who are 65 or older or Medicare eligible.
Appendix F: Include this for a long-term services and supports applicant ages 19 through 64 who is not yet Medicare eligible.
Appendix E: The state may request this for medically needy spenddown consideration when someone does not qualify for full-benefit Medicaid and appears to meet that program’s criteria.
Additional Person Supplement: Use the extra household page if there are more than two people in your household.

Check the eligibility category before using an income limit

Virginia covers the Medicaid expansion adult group, generally ages 19 through 64, with an effective income ceiling of 138% of the federal poverty level after the applicable disregard. The expansion category excludes pregnant applicants and people entitled to or enrolled in Medicare Part A or B, but another Medicaid category may apply.

For most family and expansion categories, financial eligibility uses modified adjusted gross income, or MAGI, and there is no asset test under that method. A new applicant’s MAGI calculation generally uses current monthly household income and family size, not simply last year’s tax return. Tax relationships and family relationships determine whose income belongs in the calculation; everyone living at the same address is not automatically one Medicaid household.

Different financial methods apply when eligibility is based on age 65 or older, blindness, disability, Medicare cost-sharing assistance, medically needy coverage, or certain long-term care categories. Tell the eligibility worker about those circumstances instead of treating the expansion income limit as the answer for every family member. If the programs are easy to mix up, our Medicare and Medicaid comparison explains the basic distinction.

Watch the dates on upcoming eligibility changes

Virginia says new immigration eligibility rules for nonpregnant adults take effect October 1, 2026, so they are not the rules for every September application. Under the new rules, the listed eligible citizenship or immigration categories are U.S. citizens and nationals, lawful permanent residents, Cuban and Haitian entrants, and qualifying Compact of Free Association migrants. Income requirements and any applicable waiting periods still matter.

Virginia says this change does not alter its eligibility rules for noncitizen children or pregnant individuals. Emergency Medicaid may remain available to a person who meets the other eligibility requirements, but it is limited to qualifying emergency treatment and does not cover organ transplant procedures under that federal exception. If you receive a notice about your immigration category, check whether the state has your current status and follow the response instructions.

Virginia also says work and community engagement requirements for Medicaid expansion begin in January 2027. Federal law excludes several groups, including certain caregivers, medically frail individuals, and people who are pregnant or entitled to postpartum coverage. Do not assume that being unemployed in September 2026 means you cannot apply now.

Respond to requests and track the decision deadline

If the state needs more information, it sends a letter identifying what is missing, and failing to respond can lead to denial. Cover Virginia lists CommonHelp, mail, fax, email, and in-person delivery as ways to provide requested documents. Use the instructions in your own request, note its deadline, and retain proof of delivery.

Federal rules, which Virginia incorporates for application processing, generally require a decision within 45 days, or 90 days for an application based on disability. The clock generally runs from application or transfer from another insurance affordability program through the decision notice. Unusual circumstances, such as a required action delayed by the applicant or examining physician, or an emergency beyond the agency’s control, can justify additional time. The agency must document the reason for a delay and cannot use the maximum period as a waiting period or deny eligibility just because it missed the deadline.

If there is no decision, contact the office handling the case with your application date and submission proof. Virginia allows an appeal when the agency fails to act with reasonable promptness; you can file that delay appeal while the agency has not acted.

Ask whether Medicaid can cover earlier medical bills

Under Virginia’s current rule, retroactive Medicaid generally reaches the three months before the application month if you were eligible when the services were provided, subject to coverage-category exceptions. Qualified Medicare Beneficiary coverage, which helps with Medicare costs, follows a different start rule and is not covered by that general retroactive provision. Ask the worker to review the dates and bills rather than assuming that an application guarantees payment.

For applications made on or after January 1, 2027, federal law reduces the general retroactive window to one month before the application month for expansion adults and two months for other Medicaid groups. Eligibility at the time of care and the program’s coverage rules still apply.

Appeal a denial using the correct deadline

For a Virginia eligibility denial, generally file the appeal within 30 calendar days after you receive the notice. The state presumes receipt five days after mailing unless you show that the notice arrived later. Virginia also permits a good-cause extension, including when serious illness or failure to receive the notice prevented a timely appeal.

Send the request to the DMAS Appeals Division using the notice’s instructions, explain which decision you challenge, and include relevant records. Mail filing uses the postmark date; other delivery methods use the date DMAS receives the request. When the last day falls on a weekend or state or federal holiday, Virginia extends the deadline to the next regular business day.

If the notice instead reduces or ends existing benefits, continuation during an appeal has a shorter trigger: under Virginia’s 10-day advance-notice rule, file before the action takes effect. An exception permits termination or reduction pending the final decision when the hearing determines that the sole issue is law or policy and you receive prompt written notice. If the agency wins, it may seek repayment for services provided solely because of that continuation. That protection concerns existing coverage; appealing an initial denial does not itself start Medicaid.