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VA Medically Needy Income Levels

Some individuals in certain covered groups may meet all Medicaid requirements except that they have Countable Income greater than the limit for their Medicaid Covered Group.

If their income levels are greater than the Medically Needy Income Levels, they are allowed to reduce (spenddown) their excess income by incurring medical expenses. Their income is compared to a limit based on the geographic area in which they reside (Group I, II or III).

The covered groups for which this applies are those involving the Aged, Blind and Disabled (ABD) categories, as well as pregnant women, children under 18, and certain children under 21. (See Medically Needy for more information.)

Calculating the Spenddown

The spenddown is calculated for 6-month periods. Multiply the monthly amounts of your income and the income level by six. If your 6-month income is higher than the 6-month income level, then you are not covered by Medicaid until after you have spent the difference for medical expenses within a 6-month period. Once you have spent that difference, you are covered for the remainder of the 6-month period.

When the 6-month period is over, you start the spenddown all over again.

NOTE: Tables below are listed in reverse chronological order, with current year's tables shown first, followed by previous years.

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2011 - 06/30/2012

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$285.28

$329.17

$427.92

2

$363.24

$405.37

$515.96

3

$427.92

$471.81

$581.54

4

$482.79

$526.68

$636.40

5

$537.65

$581.54

$691.27

6

$592.51

$636.40

$746.13

7

$647.37

$691.27

$800.99

8

$713.21

$757.10

$855.85

9

$786.94

$830.83

$929.58

10

$860.67

$904.56

$1,003.31

Additional

$73.73

$73.73

$73.73

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2010 - 06/30/2011

(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$280.79

$323.99

$421.18

2

$357.52

$399.00

$507.84

3

$421.18

$464.38

$572.38

4

$475.18

$518.38

$626.38

5

$529.18

$572.38

$680.38

6

$583.18

$626.38

$734.38

7

$637.18

$680.38

$788.38

8

$701.98

$745.18

$842.38

9

$774.55

$817.88

$914.95

10

$847.12

$890.45

$987.52

Additional

$72.57

$72.57

$72.57

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2009 - 06/30/2010

(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$280.79

$323.99

$421.18

2

$357.52

$399.00

$507.84

3

$421.18

$464.38

$572.38

4

$475.18

$518.38

$626.38

5

$529.18

$572.38

$680.38

6

$583.18

$626.38

$734.38

7

$637.18

$680.38

$788.38

8

$701.98

$745.18

$842.38

9

$774.55

$817.88

$914.95

10

$847.12

$890.45

$987.52

Additional

$72.57

$72.57

$72.57

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2008 - 06/30/2009

(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$265.39

$306.23

$398.26

2

$337.92

$377.14

$480.00

3

$398.09

$438.93

$541.00

4

$449.13

$489.96

$592.04

5

$500.17

$541.00

$643.08

6

$551.21

$592.04

$694.12

7

$602.25

$643.08

$745.16

8

$663.50

$704.33

$796.20

9

$732.09

$772.92

$864.79

10

$800.68

$841.51

$933.38

Additional

$68.59

$68.59

$68.59

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2007 - 06/30/2008

(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$259.43

$299.34

$389.14

2

$330.34

$368.66

$469.21

3

$389.14

$429.06

$528.84

4

$439.04

$478.95

$578.73

5

$488.93

$528.84

$628.62

6

$538.82

$578.73

$678.51

7

$588.71

$628.62

$728.40

8

$648.58

$688.49

$778.30

9

$708.45

$748.36

$848.14

10

$778.30

$818.21

$908.01

Additional

$67.05

$67.05

$67.05

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2006 - 06/30/2007

(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$251.14

$289.78

$376.71

2

$319.80

$356.88

$454.22

3

$376.61

$415.35

$511.95

4

$425.01

$463.65

$560.24

5

$473.31

$511.95

$608.54

6

$521.61

$560.24

$656.84

7

$569.90

$608.54

$705.14

8

$672.86

$666.50

$753.43

9

$685.82

$724.45

$821.05

10

$753.43

$792.07

$879.01

Additional

$64.91

$64.91

$64.91

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2005 - 06/30/2006
(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$241.25

$278.37

$361.88

2

$307.22

$342.83

$436.33

3

$361.88

$398.99

$491.78

4

$408.27

$445.39

$538.18

5

$454.67

$491.78

$584.57

6

$501.06

$538.18

$630.97

7

$547.46

$584.57

$677.36

8

$603.13

$640.25

$723.76

9

$658.81

$695.92

$788.71

10

$723.76

$760.88

$844.39

Additional

$62.35

$62.35

$62.35

 

Image of horizontal red colored lines, used to seperate topic sections.

Medically Needy Monthly Income Levels
Effective 07/01/2004 - 06/30/2005
(NOTE: This table provided for archival purposes only)

 

Family Size

Net Income Level by Area

 

Group I

Group II

Group III

1

$234.91

$271.05

$352.36

2

$299.15

$333.81

$424.86

3

$352.36

$388.50

$478.85

4

$397.54

$433.68

$524.03

5

$442.71

$478.85

$569.21

6

$487.89

$524.03

$614.38

7

$533.06

$569.21

$659.56

8

$587.28

$623.42

$704.73

9

$641.49

$677.63

$767.98

10

$704.73

$740.87

$822.19

Additional

$60.71

$60.71

$60.71

 

Image of horizontal red colored lines, used to seperate topic sections.

Virginia Geographic Areas

 

County or City

Group

Accomack

Group I

Albemarle

Group II

Alexandria

Group III

Alleghany

Group I

Amelia

Group I

Amherst

Group I

Appomattox

Group I

Arlington

Group III

Augusta

Group II

Bath

Group I

Bedford

Group I

Bland

Group I

Botetourt

Group I

Bristol

Group I

Brunswick

Group I

Buchanan

Group I

Buckingham

Group I

Buena Vista

Group I

Campbell

Group I

Caroline

Group I

Carroll

Group I

Charles City

Group I

Charlotte

Group I

Charlottesville

Group III

Chesapeake

Group II

Chesterfield

Group II

Clarke

Group I

Colonial Heights

Group III

Covington

Group II

Craig

Group I

Culpeper

Group I

Cumberland

Group I

Danville

Group I

Dickenson

Group I

Dinwiddie

Group I

Emporia

Group I

Essex

Group I

Fairfax

Group III

Falls Church

Group III

Fauquier

Group I

Floyd

Group I

Fluvanna

Group I

Franklin

Group I

Franklin

Group I

Frederick

Group I

Fredericksburg

Group III

Galax

Group I

Giles

Group I

Gloucester

Group I

Goochland

Group I

Grayson

Group I

Greene

Group I

Greensville

Group I

Halifax

Group I

Hampton

Group III

Hanover

Group I

Harrisonburg

Group II

Henrico

Group II

Henry

Group I

Highland

Group I

Hopewell

Group II

Isle of Wight

Group I

James City

Group I

King & Queen

Group I

King George

Group I

King William

Group I

Lancaster

Group I

Lee

Group I

Lexington

Group II

Loudoun

Group II

Louisa

Group I

Lunenburg

Group I

Lynchburg

Group II

Madison

Group I

Manassas

Group III

Manassas Park

Group III

Martinsville

Group II

Mathews

Group I

Mecklenburg

Group I

Middlesex

Group I

Montgomery

Group III

Nelson

Group I

New Kent

Group I

Newport News

Group II

Norfolk

Group II

Northampton

Group I

Northumberland

Group I

Norton

Group I

Nottoway

Group I

Orange

Group I

Page

Group I

Patrick

Group I

Petersburg

Group II

Pittsylvania

Group I

Portsmouth

Group II

Powhatan

Group I

Prince Edward

Group I

Prince George

Group I

Prince William

Group III

Pulaski

Group I

Radford

Group II

Rappahannock

Group I

Richmond

Group II

Richmond County

Group I

Roanoke

Group II

Roanoke

Group II

Rockbridge

Group I

Rockingham

Group II

Russell

Group I

Scott

Group I

Shenandoah

Group I

Smyth

Group I

Southampton

Group I

Spotsylvania

Group I

Stafford

Group I

Staunton

Group II

Suffolk

Group I

Surry

Group I

Sussex

Group I

Tazewell

Group I

Virginia Beach

Group II

Warren

Group II

Washington

Group I

Waynesboro

Group III

Westmoreland

Group I

Williamsburg

Group II

Winchester

Group II

Wise

Group I

Wythe

Group I

York

Group I

 

Image of horizontal red colored lines, used to seperate topic sections.

Back to:

VA Medicaid Eligibility

VA Medicaid Covered Groups

VA Medicaid Overview

VA Benefit Information System Welcome and Introduction

Source:

Information for this topic was drawn from Chapter M0710, Appendices 2 & 5 and M0810.002 of the Department of Social Services (DSS) Medicaid Manual.

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