Official Form & Source
Procedures › This procedure
Apply for Virginia Medicaid
Apply for Virginia's Medicaid health coverage program.
Complex — read carefully
We are not a government agency. We help you understand and prepare. Apply to Virginia Medicaid online at CommonHelp (commonhelp.virginia.gov), by phone through Cover Virginia, or by mail or in person at your local Department of Social Services.
This is the official form.
Application for Health Coverage & Help Paying Costs
Virginia Department of Medical Assistance Services (DMAS) — Cover Virginia
- Agency
- Virginia Department of Medical Assistance Services (DMAS) — Cover Virginia
- Form
- MAGI Standard
- Version
- rev. 09/26/2025
- Boxes to fill
- 539
TNT checked
coverva.dmas.virginia.gov ↗Aged, Blind or Disabled / Long-Term Care Supplement
Virginia Department of Medical Assistance Services (DMAS) — Cover Virginia
- Agency
- Virginia Department of Medical Assistance Services (DMAS) — Cover Virginia
- Form
- Appendix D
- Version
- rev. 09/26/2025
- Boxes to fill
- 250
TNT checked
coverva.dmas.virginia.gov ↗Where this goes
Apply to Virginia Medicaid online at CommonHelp (commonhelp.virginia.gov), by phone through Cover Virginia, or by mail or in person at your local Department of Social Services.
What happens next
The agency reviews your application and decides eligibility. You receive a written notice of the decision, and may be asked for more documents first.
TNT does not determine eligibility. Eligibility is decided by the agency after you submit your application.
FreshnessVerification pending
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