Virginia's nursing home personal spending allowance is one of the lowest in the country — but there's genuinely good news on the income-planning side. Here's the real picture.
Virginia-specific — figures don't apply nationallyOnce a Virginia nursing home resident's income goes toward the cost of care, they keep a Personal Needs Allowance of just $40/month for their own spending — the second-lowest figure in the entire country, ahead of only South Dakota's $30. This isn't a reason to avoid nursing home Medicaid if it's needed, but it's worth planning around, especially for small personal expenses that add up.
Virginia consolidated its HCBS options into a single program: Commonwealth Coordinated Care Plus (CCC Plus), operating under the state's Cardinal Care managed care system. It covers adult day care, personal care assistance, home modifications, and personal emergency response systems — but it's not an entitlement, so waitlists can exist, with priority typically based on application date.
| CCC Plus (HCBS) | Nursing Home Medicaid | |
|---|---|---|
| 2026 income limit | $2,982/month | Excess goes toward care; $40/month PNA retained |
| 2026 asset limit | $2,000 (single) | $2,000 (single) |
| Guaranteed if eligible? | No — waitlist possible | Yes — an entitlement |
Source: Virginia Department of Medical Assistance Services (DMAS); figures effective 2026.
CCC Plus offers a Consumer-Directed option that goes further than many states' family-hiring rules: you become the actual employer of your own attendant, responsible for hiring, training, and managing them — and, if needed, terminating the arrangement. A Services Facilitator assists with the employer-side responsibilities, so you're not navigating this entirely alone.
Virginia's average nursing home costs run about 6.5% below the national average — a modest but real difference if you're comparing costs against other states in the region.
$40/month — the second-lowest in the country, ahead of only South Dakota's $30.
No — Virginia uses Medically Needy spend-down instead, deducting medical expenses rather than requiring a trust.
Yes, through Consumer-Directed services within CCC Plus, where you act as the actual employer of your attendant.
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