West Virginia CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of West Virginia CHIP

For current eligibility thresholds and enrollment, visit https://dhhr.wv.gov/bms. CHIP and Medicaid applications are processed together in most states — apply once and both programs are considered.

West Virginia's CHIP program is called WVCHIP — it covers children up to 212% FPL

WVCHIP (West Virginia Children's Health Insurance Program) covers uninsured children under 19 whose family income is above the Medicaid limit but at or below 212% FPL. WVCHIP is administered by the Bureau for Medical Services (BMS) alongside West Virginia Medicaid. Apply through WVPATH at wvpath.wv.gov or call 1-877-716-1212.

Who qualifies for WVCHIP

WVCHIP covers children under 19 who live in West Virginia, are not currently covered by Medicaid, and whose household income is at or below 212% of the Federal Poverty Level. The program uses the same application and renewal process as West Virginia Medicaid — one application through WVPATH determines whether a child qualifies for Medicaid or WVCHIP.

Child must be under age 19
Household income at or below 212% FPL (approximately $2,661/month for a household of 1 under 2025 guidelines)
Child must be a West Virginia resident
Child must be a U.S. citizen, national, or qualified non-citizen
Child must not be eligible for West Virginia Medicaid
Child must not have other creditable health coverage

Source: West Virginia BMS WVCHIP program information; 2025 HHS Federal Poverty Level guidelines.

WVCHIP premiums and cost-sharing

WVCHIP charges monthly premiums based on family income. Premiums are calculated at enrollment and vary by income level. Federal CHIP rules limit total out-of-pocket costs to 5% of household income per year.

Small co-pays apply to certain services such as non-emergency hospital visits. Preventive care, immunizations, and well-child visits are generally exempt from co-pays. Emergency care co-pays are typically waived if the child is admitted to the hospital.

What WVCHIP covers

WVCHIP provides comprehensive children's health coverage through Mountain Health Trust managed care — the same delivery system as West Virginia Medicaid.

Well-child visits and immunizations
Primary care doctor visits and specialist referrals
Prescription drugs
Emergency and urgent care
Inpatient hospital care
Mental health services
Substance use disorder treatment
Dental care (comprehensive under EPSDT)
Vision care and eyeglasses
Physical, occupational, and speech therapy
West Virginia HealthCheck (EPSDT) screenings

How to apply for WVCHIP

Apply for WVCHIP through WVPATH at wvpath.wv.gov. The single application covers both West Virginia Medicaid and WVCHIP — DHHS determines the applicable program based on household income. You can also apply by calling 1-877-716-1212 or visiting a local DoHS field office.

Apply even if a parent is uninsured or undocumented

Children may qualify for WVCHIP regardless of their parents' immigration status. Parents applying only on behalf of a child are not required to provide their own Social Security numbers or immigration documents. This is standard policy under federal Medicaid and CHIP rules nationwide.

What CHIP is

CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.

CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families.

Nationally, CHIP covers approximately 7 million children, according to CMS data. In most states, it is a seamless part of the broader children's health coverage system alongside Medicaid.

What CHIP covers

Federal law requires CHIP to cover certain core benefits. States may add to the list. Standard CHIP coverage includes:

Doctor visits, including well-child checkups and sick visits
Hospital care — inpatient and outpatient
Emergency room and urgent care services
Prescription drug coverage
Mental health and substance use disorder services
Dental care — preventive and restorative
Vision care, including eye exams and glasses
Laboratory and imaging services
Physical, occupational, and speech therapy
Medical equipment, such as wheelchairs or hearing aids when medically necessary

How to apply for West Virginia CHIP

Apply through West Virginia Medicaid — the same application covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.

See the how to apply page for the complete application process, required documents, and what to expect during review.

CHIP and Medicaid income ranges overlap — apply regardless

If you're not sure whether your child qualifies for Medicaid or CHIP, apply anyway. The eligibility system determines which program applies based on your income. A child who earns out of Medicaid may qualify for CHIP, and vice versa. Don't let uncertainty about which program applies prevent you from applying.