Coverage and Services for Adults

Overview

Adults 19-64 years old

Medicaid has health coverage programs for adults in Virginia who qualify. There are no enrollment costs and no monthly premiums for adults between 19-64 years old who qualify. Their income must be within the limits.

• CoverVA | Medicaid expansion
• CoverVA | Former foster care individuals
• CoverVA | Breast and Cervical Cancer Prevention and Treatment Act

Aged, Blind, or Disabled (ABD) individuals

Adults who are 65 or older, disabled, or blind may qualify for full Medicaid. These adults must have income and resources within certain limits. A person with income over the Medicaid  limit who needs long-term care or has high medical costs may still qualify for Medicaid through a Medically Needy spenddown. They must have a certain amount in medical bills before they can be approved for Medicaid. Medicare eligible individuals may also be eligible for a Medicare Savings Program (MSP), where Medicaid will pay their Medicare premiums. The income and resource limits for MSPs are higher than those for full-benefit Medicaid.

• CoverVA | Waiver factsheet
• CoverVA | Medicare Savings Programs
• CoverVA | Medicaid Works

Plan First

Plan First is Virginia’s family planning services program. It is for men and women who do not meet the income rules for full Medicaid. Plan First has limited benefits. It covers yearly family planning exams for men and women, pap tests, sexually transmitted infection testing, family planning education and counseling, tubal ligation and vasectomies. It also covers approved over-the-counter and prescribed contraceptives and transportation to a family planning service.

• CoverVA | Plan First

If you are seeking information for pregnant women or veterans, please visit the relevant sections under "For Members" using the navigation at the top of the site, or linked here: For Pregnant Women, For Veterans.

Visit CoverVA.org for a more detailed explanation of all of our programs.