West Virginia Medicaid
Last verified: June 2026
Informational resource — not affiliated with West Virginia
New community engagement requirements are coming to West Virginia Medicaid
What is West Virginia Medicaid?
West Virginia Medicaid is administered by the Bureau for Medical Services (BMS), a division of the West Virginia Department of Human Services (DoHS). BMS oversees both the Medicaid program and the West Virginia Children's Health Insurance Program (WVCHIP). West Virginia expanded Medicaid under the ACA, and as of 2025, approximately 650,000 West Virginians are enrolled — roughly 36% of the state's population, one of the highest enrollment rates in the country relative to population size.
That high enrollment figure reflects West Virginia's demographics: an older population, elevated rates of disability, persistent poverty in rural and coalfield counties, and limited employer-sponsored insurance coverage among the working population. West Virginia also covers a relatively broad set of optional benefits, including adult dental, which many states have cut.
Most West Virginia Medicaid members receive care through Mountain Health Trust — the state's managed care program. The managed care contractor operating Mountain Health Trust is called The Mountain Health Promise. BMS manages eligibility determination and program oversight; Mountain Health Promise coordinates day-to-day medical care for enrolled members.
How West Virginia Medicaid is organized
West Virginia Medicaid operates through two primary delivery systems:
Mountain Health Trust (managed care)
The primary delivery model for most West Virginia Medicaid members. Mountain Health Promise (the managed care organization) coordinates medical, behavioral health, and pharmacy benefits. Members select a primary care provider through their plan.
Traditional fee-for-service Medicaid
Some members — including certain elderly, blind, and disabled individuals — receive services through fee-for-service rather than Mountain Health Trust. Long-term care and home and community-based waiver services also operate under fee-for-service. Members can compare benefits through BMS's Alternative Benefit Plan Comparison at bms.wv.gov.
Manage your West Virginia Medicaid benefits, report changes, and handle renewals through the WVPATH portal at wvpath.wv.gov. For assistance, call BMS at 1-877-716-1212 or visit a local DoHS field office.
Who qualifies for West Virginia Medicaid?
West Virginia Medicaid covers multiple eligibility groups. Income limits are based on the Federal Poverty Level for most categories. Approximate thresholds are shown below — verify current figures at bms.wv.gov or by calling 1-877-716-1212.
- Adults ages 19–64 (ACA expansion): at or below 138% FPL — approximately $1,732/month for a single person (2025 FPL)
- Children under 19: up to 212% FPL through Medicaid and WVCHIP
- Pregnant women: up to 150% FPL during pregnancy and for 60 days postpartum
- Parents and caretaker relatives living with children
- Individuals receiving SSI (Supplemental Security Income)
- Elderly individuals ages 65+ with limited income and assets
- Individuals with disabilities meeting financial and medical criteria
- Former foster care youth up to age 26
Source: West Virginia Bureau for Medical Services; CMS Medicaid expansion data. Income figures are approximate — verify current thresholds at bms.wv.gov.
West Virginia Medicaid topics
How to apply
Income limits
Dental coverage
Seniors and long-term care
Medicaid renewal
CHIP
What does West Virginia Medicaid cover?
Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.
The national benefits overview lists required and commonly optional services. Check the West Virginia Medicaid website for the current state-specific benefit package.
How to apply
Most people can apply online through West Virginia's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.
Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). West Virginia must follow that federal timeline.