An Agency of the Commonwealth of Virginia
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Medicaid Forms/Applications

People Who May Be Eligible For Medical Assistance

  • Adults Aged 19 - 64
  • Children Under Age 19
  • Parents & Caretakers of Dependent Children
  • Pregnant Women
  • Supplemental Security Income (SSI) Recipients
  • Adults Aged 65 or Older, Blind or Disabled (not receiving SSI)
  • Children or Adults Who Need Long-term Care in a Facility/Home & Community-based Care (Waiver) Services
  • Medicare Beneficiaries
  • someone interested in Family Planning Services (Plan First)
How To Apply

Forms - All Other

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