How to Apply for Medicaid in West Virginia: Eligibility and Renewal

To apply for Medicaid in West Virginia, submit an application online through the WV PATH portal at wvpath.wv.gov, by phone at 1-877-716-1212, by mail, or in person at your local Department of Human Services (DoHS) county office.¹ All four methods reach the same eligibility workers, and the state must give you a decision within 45 days (90 if your application is based on disability).²

The Four Ways to Apply

Pick whichever method fits your situation. The online portal is the fastest for most people, and it handles SNAP and WVCHIP in the same account if you need more than one program.¹

Online: Create an account at wvpath.wv.gov, fill out the application, and upload your documents.
In person: Go to your local DoHS county office, generally open Monday through Friday, 8:30 a.m. to 5:00 p.m., except state holidays. Staff can help you complete the forms.³
By mail: Print the application from the Bureau for Medical Services website or request one from your county office. Send it with copies, not originals, of your supporting documents.
By phone: Call 1-877-716-1212 to apply for some types of Medicaid and WVCHIP, ask questions, or report changes.

Double-check every field before you submit. Missing information is the most common reason an application stalls.

What to Have Ready Before You Start

Gathering your paperwork first saves time and avoids the back-and-forth that delays a decision. For every person on the application, you’ll need:

Social Security numbers and dates of birth⁴
Income documentation such as recent pay stubs or W-2s, covering all sources³
Proof of identity: a driver’s license, birth certificate, or U.S. passport
Proof of West Virginia residency, like a utility bill or lease
Policy numbers for any current health insurance
Tax filing details, including who you claim as dependents or who claims you

Non-citizen applicants must provide an immigration document and identification number.³ If you’re applying for long-term care Medicaid, you’ll also need statements for bank accounts, vehicle titles, property deeds, life insurance, and retirement accounts, because asset rules apply (see below).

Who Qualifies

Eligibility turns on income, household size, residency, and citizenship or immigration status. For adults, children, and pregnant applicants, the state uses Modified Adjusted Gross Income (MAGI), which looks at taxable income and the people you claim on your federal tax return.³

Income Limits

West Virginia expanded Medicaid under the Affordable Care Act, so adults aged 19 to 64 qualify with household income up to 138% of the Federal Poverty Level.⁵ For 2026, that works out to roughly $22,025 a year for a single person and about $37,702 for a family of three.⁶

Pregnant applicants qualify at higher income levels, with the state’s poverty-level pregnant women category set at 150% FPL.⁷ Children qualify at thresholds above the adult limit, with infants generally having the highest ceiling.

Seniors, Blind, and Disabled Applicants

If you receive Supplemental Security Income (SSI), you’re automatically eligible for Medicaid, and your SSI application counts as a Medicaid application.⁸ Seniors and people with disabilities who don’t receive SSI can still qualify under different rules than the MAGI categories.

Residency and Citizenship

You must live in West Virginia for a reason other than vacation. The state cannot require a minimum length of residence, and you don’t need a permanent address.⁹ U.S. citizens and lawfully present non-citizens can apply, though some lawfully present non-citizens face a five-year waiting period before they can receive full benefits.

What Happens After You Apply

Federal law gives DoHS 45 days to decide most applications, and 90 days for disability-based applications because of the extra medical review.² During that period, you may be contacted for more documents. Respond quickly. A missed document can produce a denial for “failure to provide information” instead of a decision on the merits. You can track your application status through WV PATH or by calling 1-877-716-1212.

The decision arrives by mail. An approval notice explains your coverage type and effective date, and a medical ID card follows separately. A denial notice explains the reason and your appeal rights.

Retroactive Coverage

If you’re approved, Medicaid can cover medical bills you incurred up to three months before the month you applied, provided you would have been eligible during that earlier period.¹⁰ Keep records of any hospital or clinic bills from that window and ask about retroactive coverage when you’re approved.

Managed Care Assignment

Starting in July 2025, West Virginia began enrolling Medicaid and WVCHIP members into managed care organizations. After approval, you’ll be assigned to one of four MCOs: Aetna Better Health, Highmark Health Options, The Health Plan, or Wellpoint West Virginia. Each MCO will assign a primary care provider, and you can usually request a different MCO or provider if your preferred doctor participates in a different plan.

If You’re Denied

You have up to 90 days from the date the denial notice was mailed to request a fair hearing.¹¹ The notice itself includes instructions, and your county office or the 1-877-716-1212 line can walk you through the process.

At the hearing you can present evidence, bring witnesses, and explain why the decision was wrong. Common reversible errors include miscalculated income, miscounted household members, and documentation lost in processing. If the hearing officer rules against you, you have 10 days to appeal to the state agency.¹¹

Keeping Your Coverage: Annual Renewal

Approval lasts 12 months. After that, the state must redetermine whether you still qualify.¹² First it tries to verify eligibility using data it already has, like tax and wage records. If that works, your coverage renews automatically.

If the state can’t confirm on its own, it mails you a prepopulated renewal form showing what it has on file. You get at least 30 days to correct anything and return it with any requested documentation.¹² Not returning the form is the single biggest reason people lose coverage they still qualify for. Watch your mail during renewal season and respond even if nothing has changed. Before any termination, the state must check whether you qualify under a different Medicaid category and give you at least 10 days’ notice plus a right to a hearing.

Applying for Long-Term Care Medicaid

If you or a family member needs nursing home care or home-and-community-based waiver services, the rules shift. The monthly income limit is 300% of the maximum SSI payment ($2,901 as of the most recent published figure), and countable assets cannot exceed $2,000 for an individual or $3,000 for a couple.¹³ Exempt items include your primary home, one vehicle, household belongings, life insurance with a face value under $1,500, and up to $1,500 set aside for burial.¹⁴ Checking and savings accounts, stocks, bonds, extra vehicles, and real property beyond your home all count.

If your assets exceed the limit, you may need to “spend down” the excess on medical expenses before qualifying. Keep every receipt. And know that when you apply for nursing home Medicaid, the state reviews every financial transaction from the 60 months before your application to find any assets you gave away or sold for less than fair market value.¹⁵ Transfers found during that look-back trigger a penalty period during which Medicaid won’t pay for your care. Planning around this rule is possible, but families who wait until a nursing home admission is imminent have few options left.

1
Bureau for Medical Services. Applying for Healthcare: Medicaid, West Virginia Childrens Health Insurance Program or Private Insurance at the Health Insurance Marketplace
2
eCFR. 42 CFR 435.912 – Timely Determination and Redetermination of Eligibility
3
Bureau for Medical Services. Your Guide to Medicaid 2025
4
West Virginia Department of Health and Human Resources. Application for Adult/Family Medicaid
5
KFF. Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level
6
ASPE. 2026 Poverty Guidelines: 48 Contiguous States
7
West Virginia Department of Health and Human Resources. Income – Medicaid For Poverty-Level Pregnant Women
8
Social Security Administration. Supplemental Security Income (SSI) and Eligibility for Other Government and State Programs – 2025 Edition
9
West Virginia Department of Health and Human Resources. WV Income Maintenance Manual – Chapter 8 Section 8.2 Residence
10
Office of the Law Revision Counsel. 42 USC 1396a – State Plans for Medical Assistance
11
eCFR. 42 CFR Part 431 Subpart E – Fair Hearings for Applicants and Beneficiaries
12
Centers for Medicare and Medicaid Services. Implementation of Eligibility Redeterminations, Section 71107 of the Working Families Tax Cut Legislation
13
Bureau for Family Assistance. Medicaid for Long Term Care Eligibility and Requirements
14
Administration for Community Living. Medicaid Eligibility
15
CMS. Transfer of Assets in the Medicaid Program Important Facts for State Policymakers Deficit Reund Act