Virginia expanded Medicaid in January 2019, opening coverage to roughly 400,000 working-age adults below 138% of the federal poverty level. That changed the picture for free clinics in Virginia, but it did not replace them — the state still has one of the strongest charitable clinic networks in the South, alongside a large FQHC system and robust nonprofit hospital charity care. In fact, Virginia’s free and charitable clinics reported unprecedented demand in recent years, so the safety net remains essential. This guide walks through every layer of that net so you can find primary care, dental, prescriptions, and specialty referrals without paying out of pocket. Because hours, services, and eligibility change frequently, always call a clinic to confirm current details before you go.
Types of free and low-cost clinics in Virginia
Virginians typically access affordable care through four channels: FQHCs and FQHC look-alikes (sliding-scale, federally funded), charitable free clinics affiliated with the Virginia Association of Free and Charitable Clinics (VAFCC) and the National Association of Free & Charitable Clinics (NAFC), hospital charity care under ACA Section 501(r), and Virginia Medicaid (Cardinal Care) plus FAMIS CHIP. Many residents use more than one — for example, an FQHC primary care visit plus a Sentara or UVA Health charity care application for downstream care.
The healthcare costs guide compares these public options with cash-pay primary care and direct primary care models.
FQHCs in Virginia
Virginia has roughly 30 HRSA-funded FQHC organizations operating well over 150 delivery sites — large networks include Central Virginia Health Services and other community health center systems statewide. The Virginia Community Healthcare Association (VCHA) is the state’s primary care association. Federal rules require every FQHC to charge on a sliding scale tied to the HHS Poverty Guidelines. Under the 2025 guidelines (used for 2026 coverage), 100% of the federal poverty level is about $15,650 for a single person and $32,150 for a family of four. The simplest national locator is HRSA’s findahealthcenter.hrsa.gov. Call the specific site to confirm which services it offers and whether it is accepting new patients.
Virginia FQHCs offer primary care, prenatal care, pediatrics, behavioral health, dental, and 340B-discounted pharmacy. Visit fees in the lowest income tier are often modest — commonly in the $0 to $35 range, though the exact schedule varies by center and should be confirmed when you call.
NAFC and free volunteer-staffed clinics in Virginia
Virginia has one of the strongest free clinic networks in the country. The Virginia Association of Free and Charitable Clinics (VAFCC) represents roughly 60 or more member clinics across the state. These clinics typically serve uninsured adults below about 200% FPL at no charge or for a token donation, though each clinic sets its own eligibility, so confirm the current thresholds directly. NAFC’s national directory is at nafcclinics.org, and Virginia’s clinic finder is at vafreeclinics.org.
Service mix varies widely. Many VAFCC clinics specialize in chronic disease management, dental, women’s health, vision, mental health, or volunteer specialty care. Hours are often limited because of the volunteer model, so calling ahead to confirm current hours, services, and eligibility is especially important with these clinics.
Hospital charity care under ACA Section 501(r)
Every nonprofit hospital in Virginia — Inova, Sentara, Carilion Clinic, UVA Health, VCU Health, Bon Secours, and others — must publish a financial assistance policy under Section 501(r). Most Virginia nonprofit hospitals offer free care up to around 200% FPL and discounted care up to roughly 300 to 400% FPL, with UVA and VCU policies among the more generous in the state; exact thresholds differ by system and change over time, so request each hospital’s current policy. The IRS rules are on the 501(r) page.
Always request the financial assistance application before paying a hospital bill. Under federal rules, hospitals must accept applications for at least 240 days after the first post-discharge billing statement.
Cardinal Care (Virginia Medicaid) and FAMIS
Cardinal Care is Virginia’s unified Medicaid managed care program. It covers adults up to 138% FPL (expansion effective January 2019), children through FAMIS, pregnant women, seniors, and people with disabilities. In 2025-guideline terms, 138% FPL is approximately $21,600 for a single person and about $44,400 for a family of four, though the exact income limits are updated annually and vary by household and category. Apply at commonhelp.virginia.gov, through Cover Virginia, or by calling the Cover Virginia call center. Confirm current income limits when you apply, since thresholds shift each year.
Above the Medicaid limit, the federal Marketplace at healthcare.gov offers subsidized plans, with very low-premium silver plans common for lower-income enrollees. Note that the size of Marketplace subsidies can change year to year with federal policy, so check the current numbers during open enrollment.
How to find a clinic near you
Three searches cover most cases: HRSA’s findahealthcenter.hrsa.gov for FQHCs, the VAFCC directory and NAFC list for charitable clinics, and 211 (which covers nearly all US ZIP codes) by dialing 2-1-1 or visiting 211.org. Virginia 211 handles prescription help, dental programs, and social-services referrals along with healthcare. Whichever tool you use, call the individual clinic to confirm it is open, accepting patients, and offering the service you need.
For predictable primary care outside the safety net, some Virginians use direct primary care memberships — flat monthly fees that include unlimited visits and discounted labs.
What to bring to a visit
Bring photo ID, proof of Virginia residency (a utility bill or lease), proof of household income (pay stubs, a Social Security or unemployment letter, or a self-attestation if you have no documentation), a list of medications, and any prior records. At an FQHC, ask for the sliding-fee schedule and a Cardinal Care application — many clinics have certified application counselors on site. Requirements can differ by clinic, so it is worth asking what to bring when you call to make the appointment.
When to seek emergency care: Free clinics, FQHCs, and sliding-scale clinics are not equipped to handle medical emergencies. Call 911 or go to the nearest emergency room if you experience chest pain, signs of stroke, severe difficulty breathing, severe bleeding, a head injury with loss of consciousness, or a mental health crisis (call or text 988). Federal law (EMTALA) requires emergency rooms to stabilize you regardless of your ability to pay, and ACA Section 501(r) charity care can apply to ER bills at nonprofit hospitals.
Frequently asked questions
Are free clinics in Virginia really free?
VAFCC and NAFC member clinics typically charge nothing for qualifying uninsured, low-income patients. FQHCs use a sliding scale with the lowest tier often as low as $0 to $35, and no one is turned away for inability to pay. Because policies differ by site, call ahead to confirm what a specific clinic charges and whether you qualify.
What is Cardinal Care?
Cardinal Care is the unified brand for Virginia Medicaid managed care, launched in 2023 to combine the previous Medallion 4.0 and CCC Plus programs. It serves adults, children (FAMIS), pregnant women, seniors, and people with disabilities.
What if I live near North Carolina, Tennessee, Kentucky, West Virginia, Maryland, or DC?
FQHCs serve patients across state lines, though Medicaid is state-specific. See the North Carolina free clinics guide, Tennessee free clinics guide, Kentucky free clinics guide, West Virginia free clinics guide, or Maryland free clinics guide.
Does Cardinal Care cover dental?
Yes. Cardinal Care covers comprehensive adult dental (added in 2021) and pediatric dental through the Smiles for Children program. FQHCs and free clinics often supplement these services.
Can undocumented residents get care in Virginia?
FQHCs and free clinics serve patients regardless of immigration status. Cardinal Care has citizenship and residency requirements, but emergency Medicaid covers emergency services for income-eligible residents regardless of immigration status. Eligibility rules can change, so confirm current details with the clinic or Cover Virginia.
Getting care you can afford in Virginia
Virginia’s safety net is dense and well organized, but it rewards persistence. If you might qualify for Cardinal Care (under 138% FPL), apply through commonhelp.virginia.gov or Cover Virginia first. If you are above the limit or in transition, walk into the nearest FQHC for a sliding-scale visit and check whether a VAFCC clinic in your county can take you. For hospital bills, always request the Section 501(r) charity care application before paying. With the right combination of FQHC, free clinic, and hospital charity care, most Virginians can avoid skipping needed care because of cost — just remember to call ahead to confirm current hours, services, and eligibility at any clinic on your list.
Please note: This guide is general educational information, not medical, legal, or financial advice. Clinic hours, services, eligibility rules, income limits, and program details change frequently and vary by location. Call any clinic, hospital, or Cover Virginia to confirm current hours, services, and eligibility before relying on the information here. In a medical emergency, call 911 or go to the nearest emergency room.
Sources
- HRSA — Find a Health Center (FQHC locator)
- Virginia Association of Free & Charitable Clinics — vafreeclinics.org
- National Association of Free & Charitable Clinics — nafcclinics.org
- HHS ASPE — 2025 Federal Poverty Guidelines
- Cover Virginia / DMAS — Cardinal Care and FAMIS enrollment
- IRS — Charitable hospitals: Section 501(r) requirements