Federal Work Requirements

A new federal law will change some Medicaid eligibility requirements beginning January 1, 2027.

Under the new law, some adults enrolled in Virginia Medicaid Expansion will need to meet a work requirement to qualify for and maintain Medicaid coverage. These same adults will also have their coverage reviewed every 6 months, instead of every 12 months.

These requirements do not apply to everyone who has Medicaid.

Who this affects

This probably affects you if all of these are true:

• you are ages 19 through 64, and
• you do not have a disability, and
• you are not pregnant or eligible for postpartum coverage (12 months after a pregnancy ends), and
• you are not a parent, guardian, caretaker relative or family caregiver of a dependent child under age 14 or a person with a disability and
• you do not qualify for an exception or exclusion*

*Some exceptions and exclusions apply, and they are listed later in this page.

How to meet the requirement

There are two ways to meet the new requirement. You or your household can earn at least $580 a month, or you can do 80 hours of approved activities a month. You only need to do one.

1. You or your household earn at least $580 a month.
   
   If you earn at least $580 in a month, you meet the rule. Virginia Medicaid may also include income from people in your household, like your spouse. It may also include some income that is not from a job, like unemployment benefits.
   
   If you are a seasonal worker, meaning your job is only available during certain months of the year, you can meet the rule if your income during the last six months is an average of $580 a month or more.
    
2. Or, you do 80 hours of activities a month. Activities can be a combination of:
• Work at a job or for yourself
• Be in a work training program
• Do unpaid work, like an internship
• Go to school at least half-time (this is usually 6 credit hours)
• Volunteer or perform community service

You can mix these activities.

When this requirement is checked

Virginia Medicaid will check every 6 months, when your Medicaid is renewed (“renewal”). You must meet the requirement for 1 out of 6 months leading up to each renewal. If you do not, you will lose your Medicaid coverage.

If you do not have Medicaid and are applying for it, you must meet this rule for 1 month before you apply. If you do not, you may not be able to get Medicaid. But you can apply again at any time.

Certain people will be exempt from the requirements: You do not have to do these activities, or earn a minimum amount, if any of the below describe you:

• Certain people will be exempt from the requirements:
  • Children who are 18 or younger and adults who are 65 or older 
• People who are pregnant or within 12 months of the end of a pregnancy
• People who left foster care at age 18 and are currently 25 or younger
• Parents and caregivers of: a child age 13 and younger, or a person of any age with a disability
• Members of federally recognized tribes
• Veterans with a 100% disability rating
• People who are incarcerated (jail or prison), or were released from incarceration in last 3 months
• People who qualify for Medicare Part A or are enrolled in Medicare Part A or Part B
• People with a disabling condition or who have special medical needs (also referred to as medically frail), such as:  
  • A disability as defined by the Social Security Administration, including Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) recipients.
  • Disabling behavioral health disorders
  • Substance use disorders
  • A physical, intellectual, or developmental disability that significantly impairs a person’s ability to perform 1 or more activity of daily living (such as bathing, dressing, feeding themselves or using the bathroom)