A state in the mid-Atlantic region of the country, Virginia has approximately 8.6 million people, of whom 15.9% are seniors aged 65 and older. In Virginia, the cost of living is only three points above the national average. Virginia scores 7.4/10 on the Best Places Comfort Index, making it one of the most pleasant places to live in the state. In the Caring 2022 Senior Living Report, Virginia ranked 37th overall but only 44th in health care and 42nd in senior living and housing. However, it ranked 22nd in quality of life.

Virginia is home to several high-quality hospitals, including the Inova Fairfax hospital in Falls Church, Virginia. The no. 1 hospital in the state, it’s nationally ranked in one adult specialty and highly rated in several other adult specialties. According to the Genworth Cost of Care Survey 2021, the overall cost of assisted living in Virginia is $5,250 a month.

This guide covers the cost of assisted living in cities throughout Virginia and nearby states. It also considers Medicaid and Medicare coverage of costs of assisted living in Virginia, and it presents a list of free resources for Virginia seniors.

The Cost of Assisted Living in Virginia

According to the Genworth Cost of Care Survey 2021, Virginia’s monthly assisted living cost of $5,250 is higher than other states in the region. North Carolina, to the south, averages $4,010 a month. West Virginia costs $150 a month more at $4,160. Maryland is the next highest neighboring state, averaging $4,900 a month. Kentucky has the highest costs in the region at $3,448 a month.

$5250

Virginia

$4500

The United States

$5375

North Carolina

$5045

West Virginia

$3750

Maryland

$4000

Kentucky

The cost of assisted living in cities in Virginia has a considerable range. The closer you live to Washington D.C., the more expensive the prices tend to be. Across the Potomac River from Washington, Arlington shares its costs with the nation’s capital at $5,948 a month. Richmond, the capital of Virginia, averages $4,901 a month in assisted living costs.

On the Atlantic coast in the southern part of the state, Virginia Beach averages $4,690 a month. Winchester, closer to Washington, costs $5,015 a month for assisted living. Locations close to universities also have high average assisted living costs. Charlottesville, home of the University of Virginia, costs $5,700 a month, while Blacksburg, home to Virginia Tech averages $5,595 a month. Roanoke, the largest metro area in western Virginia, costs $5,925 a month. Prices fall again in Staunton, which averages $4,708 a month.

$5948

Arlington

$5015

Winchester

$4690

Virginia Beach

$4901

Richmond

$5595

Blacksburg

$5925

Roanoke

$5700

Charlottesville

$4708

Staunton

Assisted living is not the only form of care available for seniors in Virginia. Home care, used by seniors who need assistance with activities of daily living (ADLs) but who wish to remain in their homes, costs $4,767 a month. Home health care, like home health but with additional medical services, is $4,954 a month. Adult daycare has the lowest cost state, of $1,690 per month. A semiprivate room in a nursing home facility has the highest costs of $8,213 a month.

$4767

Home Care

$4954

Home Health Care

$1690

Adult Day Health Care

$5250

Assisted Living Facility

$8213

Nursing Home, semiprivate room

Does Medicaid Cover Assisted Living in Virginia?

Currently, no Medicaid program helps to pay for assisted living in Virginia. Virginia does have one relevant waiver program for the elderly, the Commonwealth Coordinated Care Plus Medicaid Waiver (CCC+). Virginia’s Program of All-inclusive Care for the Elderly (PACE) is not a waiver program but is available to seniors on Medicaid.

What Assisted Living Services Are Covered by Medicaid in Virginia?

The CCC+ Waiver  provides services for seniors who require a nursing home level of care but want to remain living in their homes or their communities. Benefits can include durable medical equipment, assistive technology, skilled nursing and respite care. Program participants can hire their caregiver of choice, including friends and some relatives.

The PACE program is for adults aged 55 and older who are living with chronic health care needs and who meet a functional nursing home level of care. It helps them remain in their communities for an extended period. PACE uses federal Medicare and Medicaid funds to cover many assisted living costs, including medical expenses such as emergency room care and hospital admissions, dentistry, some prescription drugs, nutrition counseling and occupational and physical therapy.

Assisted Living Waiver Programs in Virginia 

Commonwealth Coordinated Care Plus Medicaid Waiver (CCC+).

Medicaid manages CCC+, the long-term services and support program that helps over 250,000 residents of Virginia. It uses an integrated delivery model to cover a wide range of health services for members with complex health care needs. The waiver is designed for Medicaid recipients who are at least 65 years old, receive Medicare benefits and full Medicare benefits (dual eligibility), receive Medicaid long-term supports and services (LTSS) and live in a facility or who have a medical or behavioral health condition and functional impairment.

To apply for CCC+ Waiver, contact your local Department of Social Services. It will complete a screening to determine eligibility.

How to Know If You’re Eligible for Medicaid in Virginia

Virginia Medicaid determines eligibility for Medicaid. The Department of Medical Assistance Services operates Virginia Medicaid. You can apply for Virginia Medicaid if you meet the program’s financial limits. An individual cannot earn more than $17,131 a year, and a couple must earn no more than $23,169. An individual cannot have assets worth more than $2,000 and a couple $4,000.

2022 Medicaid Financial Limits for Seniors in Virginia

 .

Annual Income limits

Asset limits

Single applicant

$17,131

$2,000

Two-person household (only one person applying)

$23,169

$137,400

Two-person household (both people applying)

$23,169

$4,000

Medicaid does not count certain assets, including numerous household effects, prepaid burial arrangements, family heirlooms and one car. Applicants may not have more than $603,000 in home equity.

Other eligibility requirements include:

  • A resident of Virginia
  • A U.S. national, a permanent resident illegal alien who needs help with health care insurance
  • An individual aged 18-64 whose finances fall below Medicaid’s financial limits

You may also be eligible if you:

  • Are pregnant or responsible for a child younger than 18 years of age
  • Are blind
  • Have a disability or a family member in your household who has a disability
  • Are at least 65 years of age

How Do I Apply For Medicaid?

You or your family can apply for Medicaid in two ways:

You can mail your paper application, or you can take it to your local Social Services department

Information You Will Need 

When you apply for Medicaid, you need to have the following information available: 

  • Proof of age 
  • Proof of residency in Virginia and of your US citizenship or your permanent resident status
  • Proof of all income sources, including tax returns, Social Security, Supplemental Security Income and veterans’ benefits 
  • Proof of assets, including bank accounts, retirement accounts and trusts 
  • Social Security number 
  • Policy numbers for any current health insurance, including Medicare 

How to Get Help Applying for Medicaid

If you want to learn more about how to determine eligibility for Medicaid and how to apply, you have several options:

Resource

Contact

Description

(833)522-5582

Operated through the Department of Medical Assistance Services, this organization provides any information that you require about enrollment or available options at the Virginia Medicaid site

(804)726-7000

You can learn more about Medicaid by visiting your local Social Security office. They can tell you how to determine your eligibility, how to apply, and the information you'll need to provide during the application process.

(804) 565-1600

While the ombudsman's office may best be known for helping seniors prevent abuse in long-term care facilities, it can also provide seniors with information on their health care choices, including Medicaid. If a senior is denied Medicaid, an ombudsman, acting as an independent third-party, can help them reapply.

Does Medicare Cover Assisted Living in Virginia?

The short answer is that no, Medicare does not cover the cost of assisted living in Virginia. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Virginia.

Other Financial Assistance Options for Assisted Living in Virginia

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Virginia

Seniors who reside in assisted living are always looking to reduce costs. The following resources help seniors reduce costs, connect with other resources in the community, and learn more about their health care choices.

RESOURCE
CONTACT
SERVICE

(804) 786-0286

The department helps veterans and their dependents with health care, suicide prevention, mental health issues, homelessness and employment. The department also determines eligibility for senior veterans, their spouses and their survivors looking for assisted living in one of the four Veterans Homes in the state.

(804) 545-1644

The agency operates 27 different offices in Virginia that work with other organizations to coordinate services to ensure seniors have the resources they need. Services include nutrition, transportation, wellness programs, elder justice, advance care planning and helping seniors find appropriate assisted-living facilities and caregiver support.

(844) 802-5910

Seniors aged at least 60 can use the helpline for help with legal issues in civil law areas such as Medicaid issues, alleged abuse in long-term care facilities, alleged age discrimination, power of attorney directives, guardianship, advanced medical directives, financial exploitation and other consumer issues. Legal Aid attorneys cannot help with matters of criminal law, divorce proceedings or lawsuits

The trained volunteer consultants who work for VACAP provide seniors or their families with information on all aspects of Medicare and help with some issues involving Medicaid. They can provide details of Original Medicare, Medicare Advantage programs, long-term care Insurance, Medigap insurance and Medicare Part D prescription drug plans. Counselors can also help seniors protect themselves against Medicare fraud and assist with billing issues. Counselors don't work for any commercial health care company, and their consultations are free, unbiased and confidential.

(804) 545-1644

Seniors who live in assisted living or in adult foster care can receive direct financial assistance under the Auxiliary Grant Program from the Virginia Department Of Social Services. Financial aid helps adults maintain a standard of living that meets a basic level of need. Seniors who apply for the program need to live in an approved facility and meet other criteria. Applicants need to be at least 65 and be a resident of Virginia for at least 90 days. Applicants must also need help with 1-2 ADLs. Seniors should contact their local Social Security office to learn more.

COVID-19 Rules for Assisted Living in Virginia

The following information is based on research done on several government websites, including The Virginia Department of Health and The CDC. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/11/2022, 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.

Visitation Policies

Rules for Virginia Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) 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 checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Virginia Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Virginia Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Virginia

The Virginia Department of Social Services, Division of Licensing Programs regulates assisted-living facilities, known as ALFs, in the state. Virginia has a set of rules and regulations more complex than many other states, but the result is a set of requirements that hold ALFs to high standards.

VIRGINIA LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

Assisted living staff are required to create an individual service plan for each resident. Usually, this is accomplished when the resident moves into the facility. Facility staff, the resident, the resident's doctor, the resident's family or caregiver and other concerned parties create the care plan, which must be updated at least once a year

Assisted Living Admission Requirements

Before a senior can move into an assisted living facility, staff must certify that they meet specific requirements for admission. Staff must certify that an individual treatment plan has been completed and submitted, that the senior's physician has agreed that assisted living is the right choice, that the senior has had a mental health screening, and that a person who can act as a contact in the case of emergency or incapacity has met with the staff.

Assisted Living Scope of Care

Virginia licenses ALFs to house and provide measured amounts of nonmedical assistance. These communities must stay within this designated scope of care. At a minimum, ALF's must provide safe, clean and comfortable living conditions, regular meal service, assistance with ADLs and emergency assistance if the resident has a fall or other injury. 

Assisted Living Medicaid Policy

Some, but not all, ALFs in Virginia accept Medicaid as a form of payment for residents who qualify for benefits under PACE. Seniors who receive SSI/SSDI may use this to cover housing costs.

Assisted Living Facility Requirements

Virginia ALS must meet facility requirements that ensure accessibility and safety for residents and visitors. These requirements must meet or exceed the Virginia Uniform Statewide Building Code standards. 

Medication Management Regulations

ALF staff may be required to assist some residents with medication management. Therefore, all staff must be trained in the appropriate procedures and scope of care for assisted living in Virginia. Staff can assist seniors with largely self-administered medication. Staff may remind residents to take medication on time, help them apply topical medications and provide them with over-the-counter medications. 

Staffing Requirements

Virginia law requires at least two staff members to be awake and on duty at all times, one of whom should be trained in CPR. The larger the facility, the more staff required. In most cases, enough staff must be on hand to operate the facility without leaving any resident who needs immediate assistance in need. 

Staff Training Requirements

Administrators at an ALF in Virginia who are not licensed must undergo at least 20 hours of training within 12 months of their hire. At least six hours of that training involves working with residents who have memory care issues. If an administrator has not received this training previously, they need to complete it within two months of their hire. Direct care staff must either have a certificate as a nurse's aide or successfully complete the approved 40-hour direct care staff training program provided by a registered nurse or licensed practical nurse. 

Background checks for assisted living

All employees who work at a Virginia ALF must undergo a background check before hiring. Any individual with a felony or domestic violence conviction or offenses related to moral turpitude, such as sex crimes, is permanently barred from employment in a Virginia ALF.

Requirements for Reporting Abuse

Any allegation of elder abuse, including physical, sexual or emotional, financial abuse or caregiver neglect, must be reported under Virginia state law. Managers of ALF's must notify the authorities about the alleged abuse, regardless of their opinions about the allegation's credibility or the evidence. Staff members must be trained to recognize and report abuse and neglect cases. 

Assisted Living Facilities in Virginia (81)