West Virginia Medicaid Eligibility Requirements

This page provides general guidelines for the West Virginia Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is West Virginia Department of Health and Human Resources. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the West Virginia Medicaid office.


West Virginia Medicaid Overview

Medicaid provides coverage for working families with low incomes.


West Virginia Medicaid Eligibility Requirements - Non Income

The enrollee must be West Virginia resident and U.S. citizen or legal aliens.


Documents Needed For West Virginia Medicaid Application

  • Proof of U.S. citizen or legal alien status
  • Proof of residency in Virginia
  • Proof of identity and/or age
  • Social Security numbers and birthdays of everyone applying
  • Proof of income
  • If applicable, proof of pregnancy
  • If applicable, proof of disability
  • Information about paid expenses for children or adult care
  • Information about current health insurance or health insurance that has been lost in the past 6 months

West Virginia Medicaid Benefits

Services include but are not limited to inpatient and outpatient hospital care, nursing home care, physician services, laboratory and x-rays, immunizations and other early and periodic screening, diagnostic, and treatment (EPSDT) services for children, family planning, health centers and rural health clinics.


West Virginia Medicaid & CHIP Eligibility Levels

Below is the modified adjusted gross income (MAGI) eligibility levels for West Virginia Medicaid and Children's Health Insurance Program (CHIP).

Eligibility Levels - By Percentage Of Federal Poverty Level (FPL)

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: 158%
Age 1-5: 141%
Age 6-18: 133%
 300% Medicaid: 158%
CHIP: N/A		 133% 133%

Eligibility Levels - Individual By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $1,537
Age 1-5: $1,371
Age 6-18: $1,293
 $2,918 Medicaid: N/A
CHIP: N/A		 $1,293 $1,293

Eligibility Levels - Family Of Two By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $2,071
Age 1-5: $1,848
Age 6-18: $1,743
 $3,933 Medicaid: $2,071
CHIP: N/A		 $1,743 $1,743

Eligibility Levels - Family Of Three By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $2,606
Age 1-5: $2,325
Age 6-18: $2,193
 $4,948 Medicaid: $2,606
CHIP: N/A		 $2,193 $2,193

Eligibility Levels - Family Of Four By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $3,140
Age 1-5: $2,802
Age 6-18: $2,643
 $5,963 Medicaid: $3,140
CHIP: N/A		 $2,643 $2,643

Medicaid Eligibility

State Medicaid Office

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