West Virginia Medicaid income limits
Last verified: June 2026
Verify current limits with West Virginia Medicaid
West Virginia uses MAGI-based income for most Medicaid eligibility groups
West Virginia Medicaid income limits by coverage group (2025)
West Virginia expanded Medicaid under the ACA. The expansion added coverage for adults ages 19–64 who were previously ineligible, and it has driven West Virginia's high enrollment rate — nearly 36% of the state's population. Income limits vary by coverage group.
| Coverage group | FPL % | Approx. monthly limit (household of 1) | Approx. monthly limit (household of 4) |
|---|---|---|---|
| Adults 19–64 (ACA expansion) | 138% FPL | ~$1,732/mo | ~$3,576/mo |
| Children under 19 (Medicaid + WVCHIP) | Up to 212% FPL | ~$2,661/mo | ~$5,493/mo |
| Pregnant women | 150% FPL | ~$1,883/mo | ~$3,887/mo |
| Parents and caretaker relatives | Varies | Varies | — |
| Individuals with SSI / aged, blind, disabled | SSI-linked or medically needy | Varies | — |
Source: West Virginia Bureau for Medical Services; 2025 HHS Federal Poverty Level guidelines. Monthly income figures are approximate. West Virginia uses MAGI for most categories — verify current dollar amounts at bms.wv.gov.
No asset test for MAGI-based West Virginia Medicaid
MAGI-based West Virginia Medicaid — covering adults under the expansion, children, and pregnant women — has no asset test. Savings, vehicles, and home equity are not counted. This applies to all ACA expansion coverage.
Long-term care Medicaid programs (nursing facility care and HCBS waivers for elderly and disabled individuals) operate under a different standard. These programs have an asset limit and use spousal impoverishment protections from federal law (42 U.S.C. § 1396r-5) when one spouse enters a nursing facility.
West Virginia operates a Medicaid estate recovery program. The state may seek reimbursement from the estates of members who received nursing facility or certain long-term care services at age 55 or older. West Virginia's 60-month look-back period for asset transfers applies to long-term care applications. Consult a West Virginia-licensed elder law attorney before making asset transfers.
West Virginia's pregnant women coverage — lower threshold than many expansion states
West Virginia covers pregnant women at 150% FPL. This is notably lower than many other expansion states — Arizona covers pregnant women at 156% FPL, New York at 223%, and Massachusetts at 200%. A pregnant woman in West Virginia with income between 138% and 150% FPL qualifies through the pregnancy-specific threshold rather than the adult expansion category. If income exceeds 150% FPL, marketplace coverage with premium tax credits may be the next option. West Virginia DHHS can help screen for eligibility at 1-877-716-1212.
How Medicaid income limits work
Medicaid eligibility is tied to the Federal Poverty Level (FPL), a measure the Department of Health and Human Services updates each January. States set their income limits as a percentage of FPL — so when FPL increases, the dollar thresholds for Medicaid also shift.
The Affordable Care Act established a standard income methodology called Modified Adjusted Gross Income (MAGI) for most Medicaid applicants. Under MAGI, the agency counts wages, salaries, self-employment income, Social Security benefits, and most other taxable income. Assets — a savings account, vehicle, home — are not counted for MAGI-based programs. That changed with the ACA and applies in all states.
States that expanded Medicaid under the ACA cover most adults at or below 138% FPL. In non-expansion states, income limits for adults without dependent children are far lower — sometimes as low as a few hundred dollars per month — or eligibility for that category simply doesn't exist.
These are federal guidelines — state limits may differ
What counts as income under MAGI
MAGI (Modified Adjusted Gross Income) is the income standard for most Medicaid applicants — children, adults under 65, pregnant women, and parents. It includes wages, salary, tips, self-employment income, unemployment benefits, Social Security retirement and disability benefits (SSDI), and most other taxable income.
It does not count child support received, gifts, loans, inheritances that are not generating income, or Supplemental Security Income (SSI) payments. One key MAGI rule: the ACA added a 5% FPL income disregard for most adults, which effectively raises the usable threshold by that amount. So a state with a 133% FPL limit effectively covers adults to about 138% FPL after the disregard.
Assets — a bank account, car, or home — are not counted for MAGI-based programs. That's a major difference from old-law Medicaid, where asset tests were common. If you previously didn't qualify because of assets, your eligibility may have changed after the ACA.
Asset limits and long-term care Medicaid
MAGI-based programs have no asset test. But Medicaid programs that cover long-term care — nursing home care, home and community-based services for seniors — use the old income and asset methodology, which does include asset limits.
Asset limits for long-term care Medicaid vary by state and are updated periodically. Generally, countable assets above the limit must be spent down before an applicant qualifies. Exempt assets — the primary home (in most circumstances), one vehicle, and certain personal property — are not counted.
Specific asset limits for West Virginia's long-term care programs are on the seniors and long-term care page. The thresholds change, so verify current figures with West Virginia Medicaid directly.