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VA Medicaid Resource Limits

See VA Medicaid Resources Defined for more information about assets that do and do not count as resources.

NOTE: The following resource limits are valid as of March 2010. Most resource limits do not change annually, and are likely to remain the same for the foreseeable future (except QMB, SLMB, and QI). To check that the following limits are still in effect, see Department of Social Services (DSS) Medicaid Manual, Sections M0610.002, M1110.003.B.2, and M2040.200B.

ABD (Aged, Blind and Disabled) Covered Groups

For recipients of Supplemental Security Income (SSI) and other ABD Covered Groups except for Medicare Related Covered Groups and Medicaid Waiver groups (see below), the dollar amount of the resource limits are the same as the Federal SSI limits, $2,000 for individuals and $3,000 for couples. Note, however, that Virginia's definition for the resources that are counted is more restrictive than the Federal definition. (See More Restrictive Resource Limits - SSI & Medicaid.)

Medicare Related Covered Groups

NOTE: Beginning January 1, 2010 the resource limit for QMBs, SLMBs and QIs is the limit that is used by the Medicare Part D Low Income Subsidy program, referred to as the Extra Help program. See section M2040.200B of the Department of Social Services (DSS) Medicaid Manual for the most recent information.

For those in Medicare Related Covered Groups, there are several different limits. Qualified Disabled and Working Individuals (QDWIs) must have resource limits at or below $4,000 for individuals and $6,000 for individuals (twice the maximum amount of resources that an individual or couple may have and be eligible for SSI). Qualified Medicare Beneficiaries (QMB), Special Low-Income Medicare Beneficiaries (SLMB), and Qualified Individuals (QI) must have resources (effective 1/1/2010) of not more than $6,600 for a single person and $9,910 for a couple. For all of these groups, the more restrictive definition of resources does not apply. (See VA Medicaid Resources Defined and Medicaid Resource Exclusions.)

Medicaid Waivers

All individuals receiving waiver services must meet the financial and non-financial Medicaid eligibility criteria and be Medicaid eligible in a medical institution. The resource and income rules are applied to waiver eligible individuals as if the individuals were residing in a medical institution.

For all aged, blind, and disabled (ABD) groups, the resource limit is $2,000 per individual.

For individuals receiving Medicaid Waiver services, the real property resource limit is $5,000. Note, however, that none of the real property exclusions in sections M1130.100, M1130.140, S1130.150, or M1130.160 of the Department of Social Services (DSS) Medicaid Manual apply to the property. (See VA Medicaid Resources Defined and Medicaid Resource Exclusions.)

Medically Needy

For those who are categorized as Medically Needy, the resource limits are based on the size of the family or budget unit. (Since the Assistance Unit for those who are Aged, Blind or Disabled (ABD) is always either 1 or 2, the limits are the same as for ABD Covered Groups, above.):

Low Income Families with Children

The resource limit for a family/budget unit for Low Income Families with Children (LIFC) (previously $1,000) has been eliminated. There are no resource limits for this group.

Children under 19, Pregnant Women and Infants

For children aged 1-6, children aged 6-19, and pregnant women and infants (who are in categorically needy groups related to the Federal Poverty Level) there are no resource limits.

See Also:

VA Medicaid Resources Defined

VA Medicaid Resource Exclusions

Back to:

VA Medicaid Eligibility

Source:

Information for this topic was drawn from Chapters M06, S11, M1460.500, and M20 of the Department of Social Services (DSS) Medicaid Manual.

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