West Virginia Medicaid

West Virginia Medicaid offers health coverage to eligible residents, including those with limited income, high medical expenses, the elderly, and individuals with disabilities.

It provides comprehensive coverage, including doctor visits, hospital services, prescription drugs, nursing home care and mental health services.

Members typically receive medical services through one of four approved Managed Care Organizations (MCOs):

Aetna Better Health
The Health Plan
Wellpoint
Highmark Health Options

Aetna is the exclusive MCO for Mountain Health Promise (MHP), a specialized program for children in foster care, kinship care, and adoptive care.

FAQ

What is the income limit for Medicaid in West Virginia?

As West Virginia is expanding Medicaid coverage, nearly all uninsured adults age 19–64 with income up to 138% of the federal poverty level may now gain coverage under the Affordable Care Act (ACA).

Children ages 6–18 are covered up to 138% of the FPL. Coverage is also available for pregnant women with family income at or below 305% of the FPL.

WV Medicaid income limits by household size
WV MedicaidHousehold Size	146% Child 1–5	305% Pregnant Women	138% Adults 19—64
1	$1,942	$4,057	$1,835
2	$2,633	$5,500	$2,489
3	$3,324	$6,944	$3,142
4	$4,015	$8,388	$3,795
5	$4,706	$9,831	$4,448
6	$5,397	$11,275	$5,101
7	$6,088	$12,719	$5,755
8	$6,779	$14,162	$6,408

A 5% disregard based on the federal poverty level (FPL) for the household size may be applied and is reflected in the amounts shown above. Source: Kaiser Family Foundation (KFF).

Medicaid Work Incentive (M-WIN) is for working individuals between ages 16 and 65 who have a disability. There is a $50 enrollment fee and a monthly premium based on income.

How do I apply for Medicaid in WV?

You can apply for Medicaid in person at a local DoHS office or through WV PATH , which serves as the state’s unified system for family assistance programs.

West Virginia Department of Human Services
Customer Service Center
(877) 716-1212