Virginia, a southeastern coastal state, hugs the Chesapeake Bay to the east and the Appalachian Mountains to the west. One of the 13 original colonies, Virginia is home to around 8.5 million people, approximately 15% of whom are aged 65 and older. This senior population is expected to double between 2010 and 2030, with around 20% of the population over age 65 by 2030. This means that a significant number of seniors currently need and will continue to need assisted living care.

According to Genworth Financial’s 2019 Cost of Care Survey, assisted living in Virginia costs an average of $4,800 per month. This is around $750 higher than the national average of $4,051. However, there are several resources available to help Virginia seniors with assisted living expenses.

This guide serves as an overview of the costs of assisted living care in Virginia and financial resources that may help pay for care, as well as assisted living facility policies.

The Cost of Senior Living in Virginia

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Several care options are available for senior Virginians. Their choice depends on budget, health care requirements, and preferred lifestyle. Independent living occurs in a community setting, but seniors must require no help with ADLs or medications. This maintenance-free lifestyle allows them time to pursue their interests and passions. When seniors need assistance with two or three activities of daily living (ADLs), such as bathing, grooming, dressing or transportation but are still relatively independent, assisted living is the best option. Memory care, offered by special units in assisted living facilities, is designed for seniors with Alzheimer’s or other forms of dementia. A semiprivate room in a nursing home facility is the best option for seniors who need constant 24-hour skilled nursing.

Estimates taken from the Genworth Cost of Care Survey 2021 show that the cost of independent living in Virginia averages $3,413 per month. Assisted living costs approximately $1,800 a month more, averaging $5,250. Memory care, which includes enhanced assisted living services, averages $6,563 per month. Meanwhile, a semiprivate room in a nursing care facility costs $8,213 a month.

The Cost of Assisted Living in Virginia

According to the Genworth Cost Of Care Survey 2021, Virginia has the highest costs for assisted living among neighboring states. In Virginia, the cost of assisted living is $5,250 a month, which is $750 more expensive than the national average of $4,500. Maryland averages $4,900. West Virginia costs $4,010 a month for assisted living. North Carolina is about $1,250 a month cheaper at $4,010. Kentucky averages $3,448 a month.

The Cost of Nursing Home Care in Virginia

When it comes to nursing homes, Virginia’s cost of $8,213 is approximately $300 a month more expensive than the national average of $7,908. Maryland averages $10,342 per month, or roughly $2,100 a month more expensive than Virginia. West Virginia is approximately $3,400 a month more costly at $11,619. Kentucky is about $1,000 a month cheaper than Virginia at $7,178. North Carolina is about $750 a month less expensive, costing $7,483.

Can You Use Medicaid to Pay for Senior Living in Virginia?

Many older Virginians require long-term care as they age. Long-term care, regardless of which option you select, can be expensive. Fortunately, Virginia offers several different levels of financial assistance for older residents. Medicaid or Medicaid waivers pay for some forms of senior living in Virginia but not all.

Medicaid covers nursing home costs for all qualifying seniors in Virginia who can prove that they require a nursing home level of care and are unable to afford these services. Unfortunately, Medicaid has not covered the cost of assisted living or memory care in Virginia since 2018. Nor does it offer any Medicaid waivers to help seniors with these services. The state of Virginia, however, does offer some assistance.

Independent living is not covered by Medicaid or Medicaid waivers since seniors who reside in an independent living community don’t need assistance with ADLs or medical care.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	NA	N/A
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” participant caps could be in place, and there may be a waiting list. 

Medicaid Coverage of Assisted Living and Memory Care in Virginia

Virginia does not offer any Medicaid plan or waiver to help pay for the costs of assisted living or memory care. Before 2018, a Medicare waiver was available, but the state legislature did not renew it. Instead, Virginia offers two non-Medicaid programs to assist seniors with assisted living and memory care.

The Adult Services Program pays for the cost of the necessary assessment or reassessment for seniors who wish to enter an assisted living facility. The Auxiliary Grant Program provides financial assistance to seniors in assisted living facilities (ALFs), including those receiving memory care. It helps cover the costs of personal care, medical transportation, maintenance and room and board. Residents also receive a personal needs allowance to cover incidentals. Not every ALF accepts the grant, so it’s important to check with the facility.

To be eligible for either program, seniors must meet financial guidelines. To qualify for the Auxiliary Grant, a senior must be at least 65 or blind or disabled and a U.S. resident or a legal alien who meets specific requirements. The applicant must also be a resident of Virginia for at least 90 days.

Medicaid Coverage of Nursing Home Care in Virginia

When a senior wishes to have Medicaid pay for the cost of nursing care, they, or their caregiver, need to apply for Medicaid through their local Department of Social Services. They also need to undergo a prescreening that authorizes Medicaid to pay for a nursing facility. They need to require a nursing home level of care for at least 30 days. A nurse and a social worker from the local Department of Social Services will visit the senior to determine if they need a nursing home level of care.

If a senior has enough funds to cover the cost of nursing care for a while, they may apply for Medicaid when those funds run out. If a senior is already in a nursing care facility,  they do not need to be prescreened for Medicaid.

Seniors who receive Medicaid long-term coverage need to pay for some of these services if they are able. This is known as Patient Pay. At the time of their admission into a long-term care nursing facility, their Patient Pay will be determined, and they will be notified. If an individual is on Supplemental Security Income (SSI) or has no other income, they do not have to contribute any funds towards their care.

Eligibility for Medicaid in Virginia

Seniors who are aged at least 65, disabled or blind and apply for Medicaid to pay for nursing home care must meet specific financial requirements. An individual cannot earn more than 300% of the Supplemental Security Income (SSI) rate. In Virginia, that comes to $30,276 per year for one person. For a two-person household, that figure is $60,552.

Seniors also have financial limits on their assets. An individual’s assets may not exceed $2,000. In a two-person household where only one person is applying, the nonapplying spouse has an asset limit of $137,400. A home, a vehicle and other items are generally excluded. In a two-person family where both seniors are applying, they may only have $4,000 in assets.

2022 Virginia Medicaid Income Limits

	Income Limits*	Asset Limits
Single Applicant	$30,276	$2,000
Two-Person Household (Only One Person Applying)	$60,552	$2,000 for applicant $137,400 for nonapplicant
Two-Person Household (Both People Applying)	$60,552	$4,000

*per year

There are additional requirements. Seniors applying for Medicaid must:

• Be a resident of Virginia.
• Be U.S. national, a permanent resident or have legal alien status.
• Be aged at least 65, blind or disabled.
• Require a nursing home level of care.

Applying for Medicaid Virginia

Seniors or caregivers may apply for Medicaid online via the CommonHelp website or their local Virginia Department of Social Services office. You can download the VAMedicare Application, complete it and take it to your local Department of Social Services. Call the Cover Virginia Call Center at  (833) 522-5582 to apply over the phone.

Before You Apply

If you wish to expedite the application process, you’ll need to provide:

• Social Security number
• Physical address
• Mailing address (if different)
• Information on any other form of government aid you receive
• Proof of all sources of income, including pay stubs, unemployment and Social Security
• The names and ages of everyone in your household

How to Get Help

If you have questions about eligibility for Medicaid in Virginia, what benefits are available and how you can apply, several agencies can answer your questions.

	Contact	What You Should Know
Ombudsman Program	(800) 552-5019	Best known as advocates for seniors in disputes with long-term care facilities, ombudsmen also act as impartial third parties to assist seniors. They help with billing issues and questions about Medicaid and Medicare and can assist with reapplying when seniors have been denied Medicaid services or medications.
CoverVirginia	1-833-522-5582	CoverVirginia can answer all your questions about Medicaid or any other form of health care available in the state. Staff members can inform you about yearly financial limits, how to determine eligibility, available benefits and how to apply. Medicaid coverage needs to be renewed every year in Virginia, and you can do that on the CoverVirginia website.
Virginia Medicaid	(804) 786-7933	Virginia Medicaid, the state’s official Medicaid site, can provide information on applying for Medicaid, eligibility, enrollment, finding providers and appealing adverse decisions about Medicaid and prescription drug coverage.

Can You Use Medicare to Pay for Senior Living in Virginia?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support and Resources in Virginia

Seniors and caregivers often have important questions about Medicare. How long do I have to apply? Do I need to apply for Medicaid right away if I already have a health care plan? Should I apply for long-term care? Fortunately, several agencies in Virginia can help seniors and caregivers answer these questions.

Resource	Contact	What You Should Know
Virginia Insurance Counseling & Assistance Program (VICAP)	(800) 552-3402	Experienced VICAP counselors can answer all your questions about Medicare. They provide free, unbiased and confidential advice on selecting a Medicare plan that best suits your needs. Counselors can answer questions about Original Medicare, Medicare Advantage Plans, prescription drug coverage, long-term care and Medigap. Counselors can also help you appeal service denials and identify low-income subsidies. You or your caregiver can meet with the counselor in person or over the phone. Contact your Area Agency on Aging to set up an appointment.
Medicare.gov	(800) 633-4227	Medicare.gov provides details on all forms of Medicare, how to apply for them and if you can receive financial assistance from Virginia to help cover the cost of Medicare. Experts are available to talk 24 hours a day and can put you in touch with a local expert if needed.
SeniorNavigator	(804) 525-7728	The Virginia SeniorNavigator helps you find local resources and services in the state. You’ll find information on Medicare, benefits and different Medicare Advantage Plans that are available depending upon your county. You can also find physicians and medical facilities in your area that accept Medicare.

Are There Other Financial Assistance Options for Senior Living in Virginia?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Virginia. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in Virginia

Regardless of the senior living option you’ve chosen in Virginia, there are free or low-cost resources available to help you in many areas, including legal advice, memory care, financial assistance for Medicare and many others.

	Contact	What You Should Know
Virginia Association of Area Agencies on Aging	(804) 545-1644	The 27 Area Agency on Aging offices located throughout Virginia work with local organizations to coordinate services and resources for seniors. When they discover gaps, they partner with these organizations to bridge them. The AAA’s services include wellness programs, nutrition, elder justice, advance care planning, transportation and help finding appropriate assisted living, memory care or nursing care facilities as well as respite care for caregivers.
Virginia VeteransNavigator	(804) 525-7728	The VeteransNavigator provides information specifically designed to help senior veterans in Virginia. Information includes government benefits, assisted living, independent living, mental health care, housing issues and rehabilitation. The VeteransNavigator can also help you find resources to help pay for respite care.
Senior Legal Aid Helpline	(844) 802-5910	Virginia seniors can call this hotline for help with civil legal issues, such as alleged abuse in LTC facilities, end-of-life documents, allegations of age discrimination, powers of attorney, guardianship, guardianship alternatives, advanced medical directives and financial exploitation. Seniors need to be at least 60 to use the hotline. Although Senior Legal Aid staffers cannot help with criminal law matters. Its site covers other topics and includes a do-it-yourself guide to divorces.
Dementia Services-Office for Aging Services, Division of Community Living	(804) 662-9154	The Dementia Services Coordinator monitors and coordinates Virginia’s Dementia State Plan. The coordinator also supports the Alzheimer’s Disease and Related Disorders Commission. The commission’s website at AlzPossible provides links to training for caregivers, information on where to find memory assessment centers in Virginia and a guide on recognizing and reporting elder abuse.
Extra Help	(800) 772-1213	Medicare beneficiaries who need assistance paying for their monthly premiums, annual deductibles and prescription drug copays can apply for Extra Help through the Social Security Administration. Participants in the program can save as much as $5,100 per year. To qualify for Extra Help, you must receive Medicare and meet financial and asset guidelines. You must also be a resident of the United States.

COVID-19 Rules and Restrictions for Virginia Senior Living Facilities

The following information is based on research done on several government websites, including vdh.virginia.gov/coronavirus and cdc.gov/coronavirus. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in Virginia

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

Assisted living programs provide valuable care for seniors that extends into many areas, such as minor medical assistance and medication management. To ensure residents are as safe as possible, the Department of Social Services has implemented extensive rules and regulations pertaining to operating an assisted living facility.

Admissions and Scope of Care

Due to the division between nursing homes and assisted living communities, seniors seeking admission in an assisted living facility must have staff certify that:

• A treatment plan has been written and submitted
• A primary care physician has determined that assisted living offers an appropriate level of care
• A mental health screening has indicated that assisted living is appropriate
• A designed contact person is available in case of emergencies and incapacity

In Virginia, assisted living communities are restricted to activities within the approved scope of care, including prescribed amounts of nonmedical assistance. This includes offering a clean and safe living environment, emergency assistance for injuries and falls, meal services and regular help with activities of daily living. True medical care is extremely limited in assisted living facilities.

Senior Living Service Plans

All seniors in assisted living require a service plan that relates to their individual needs while living in the facility. Plans are created by facility staff members, with the input of family members, caregivers and the resident’s doctors. These plans are divided into four general categories, such as activities of daily living, instrumental activities of daily living, ambulation and hygiene and grooming.

For the purpose of residence in an assisted living facility, activities of daily living include bathing, toileting, dressing, transferring and eating. Instrumental activities of daily living include housekeeping, preparing meals, money management and doing laundry. Ambulation refers to whether a resident needs assistance moving around, such as with a walker or wheelchair. Hygiene and grooming includes shampooing hair, shaving, trimming fingernails and toenails and skin care. Some care plans may also address transportation, shopping and correspondence.

Service plans must be updated at least once a year.

Staffing and Training Requirements

In Virginia, at least two staff members must be on-site and awake at all times when residents are present during daytime hours. This staffing level is suitable for 20 or fewer residents; an additional staff member must be present for every 10 additional residents. During night hours, two care team members must be on duty for facilities with less than 22 residents, three with under 32 residents, four care members with less than 40 residents and at least four care members for facilities with over four residents, with another team member for every 10 additional residents. An appropriate number of staff members must be available when accompanying residents on trips outside of the community.

Training is required for all staff members. Administrators in assisted living care communities must undergo at least six hours of training in memory impairment, and staff members must complete at least four.

Background checks are standard for employees in an assisted living facility. Those with felony records and whose who have been convicted of domestic violence and sex crimes are not permitted to be hired.

Medication Management

Staff members at assisted living facilities in Virginia can help residents with medication management in a limited fashion. This includes supporting self-administered medication, such as reminding residents to take their medication, helping with the application of topical medication, offering OTC medication permitted by a resident’s doctor and emergency medication use, such as the use of a rescue inhaler. Residents may also be able to request help crushing up pills and mixing them with food or drink if requested or permitted.

Frequently Asked Questions

How much does assisted living cost in Virginia?

The cost of assisted living in Virginia averages $4,800 per month, which is approximately $750 more than the national average of $4,051. Virginia is more expensive on average than the surrounding states, including Kentucky, West Virginia and North Carolina.

Are there financial assistance programs for assisted living in Virginia?

Yes. Financial assistance programs are available to seniors living in Virginia. This includes the state Medicaid program and the Commonwealth Coordinated Care Plus (CCC+) Medicaid Waiver. Military veterans living in Virginia can also take advantage of the VA Aid and Attendance Benefit to supplement the cost of care.

What are Activities of Daily Living?

Activities of daily living (ADLs) refer to tasks required to live a normal life on a daily basis. This includes getting out of bed, using the bathroom, getting dressed, eating and doing laundry. Assisted living facilities primarily provide support with activities of daily living.

What is the difference between assisted living and nursing homes?

The caliber of medical care is the primary difference between assisted living facilities and nursing homes. In assisted living facilities, care is usually limited to support with activities of daily living, medication management and basic first aid. More serious medical problems are more appropriate for a nursing home, in which 24-hour medical care is available.

Who should consider assisted living?

Assisted living should be considered by seniors who could comfortably live at home with the support of a caregiver to help with ADLs but would prefer to live in a community. An assisted living facility allows seniors to live with some semblance of independence while still getting the support necessary.

Learn More About Senior Living in Virginia

For more information about specific types of senior living in Virginia read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Virginia

Learn more about the cost of senior living in the top Virginia cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.