West Virginia Medicaid Income Limits 2024

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The West Virginia Medicaid Program provides a medical card which may be used to receive medical care in the community or in an institutional setting, such as a nursing home. This allows those who may not be able to afford medical care the opportunity to have their health needs addressed. Medicaid is administered on the Federal level by the Center for Medicare and Medicaid Services (CMS) under the Social Security Administration.

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West Virginia Medicaid Income Limits 2023

Who is eligible for West Virginia Medicaid?

To be eligible for West Virginia Medicaid, you must be a resident of the state of West Virginia, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be one of the following:

  • Pregnant, or
  • Be responsible for a child 18 years of age or younger, or
  • Blind, or
  • Have a disability or a family member in your household with a disability, or
  • Be 65 years of age or older.

West Virginia Medicaid Income Limits 2023

Household Size* Maximum Income Level (Per Year)
1 $19,392
2 $26,228
3 $33,064
4 $39,900
5 $46,737
6 $53,573
7 $60,409
8 $67,245

*For households with more than eight people, add $6,836 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

West Virginia Medicaid Income Limits 2023 For Seniors

2023 West Virginia Medicaid Long-Term Care Eligibility for Seniors
Type of Medicaid Single Married (both spouses applying) Married (one spouse applying)
Income Limit Asset Limit Level of Care Required Income Limit Asset Limit Level of Care Required Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $2,742 / month* $2,000 Nursing Home $5,484 / month ($2,742 / month per spouse)* $3,000 Nursing Home $2,742 / month for applicant* $2,000 for applicant & $148,620 for non-applicant Nursing Home
Medicaid Waivers / Home and Community Based Services $2,742 / month $2,000 Nursing Home $5,484 / month ($2,742 / month per spouse) $3,000 Nursing Home $2,742 / month for applicant $2,000 for applicant & $148,620 for non-applicant Nursing Home
Regular Medicaid / Aged, Blind or Disabled $914 / month $2,000 Help with ADLs $1,371 / month $3,000 Help with ADLs $1,371 / month $3,000 Help with ADLs

*All of a beneficiary’s income, with the exception of Medicare premiums, a Personal Needs Allowance of $50 / month, and potentially a spousal income allowance for a non-applicant spouse, must go towards nursing home costs.

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WV Bureau for Medical Services

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The West Virginia Department of Health and Human Resources, Bureau for Medical Services (BMS), is the designated single state agency responsible for the administration of the State’s Medicaid program. BMS provides access to appropriate health care for Medicaid-eligible individuals.

Authorized under Title XIX of the Social Security Act, Medicaid is an entitlement program financed by the state and federal governments and administered by the states. The West Virginia Medicaid program is administered by the Department of Health and Human Resources (DHHR).

Federal financial assistance is provided to states for coverage of medical services for specific groups of citizens.

Mission Statement | West Virginia Medicaid Income Limits 2023

 The Bureau for Medical Services is committed to administering the Medicaid Program, while maintaining accountability for the use of resources, in a way that assures access to appropriate, medically necessary, and quality health care services for all members; provide these services in a user friendly manner to providers and members alike; and focus on the future by providing preventive care programs.

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West Virginia Medicaid Expansion

​On Thursday, May 2, 2013, Governor Earl Ray Tomblin joined by U.S. Sen. Rockefeller, President and CEO of United Health System Tom Jones, and CEO of Thomas Health Systems Steve Dexter, announced the decision to expand Medicaid in West Virginia.

“We anticipate expansion will allow us to provide insurance coverage to approximately 91,500 working West Virginians, significantly reducing the number of uninsured,” Gov. Tomblin said. “A decision to expand today, however, does not end our efforts. We must carefully watch federal efforts. If the program becomes unsustainable, particularly after three years, or the federal government changes its promised funding allocations, we must be prepared to take action to protect our State.

“I appreciate Governor Tomblin’s thorough evaluation of what he believes expanding Medicaid will mean to West Virginia,” Sen. Manchin said. “I respect and support his decision to go ahead with expansion in a way that is tailored to West Virginia. I will do everything I can at the federal level to make sure he has all the flexibility he needs to make this program work in a fiscally responsible way for the benefit of the West Virginians it is intended to help.”

How to Apply for West Virginia Medicaid

Elderly applicants can apply for Medicaid in West Virginia online at WV Path, in person at their local DHHR field office, or by submitting a competed application to their local DHHR field office. There is both an “Application for Health Coverage & Help Paying Costs” and a “Supplement to Application for Health Coverage”. One can also apply for benefits by calling the Customer Service Center at 877-716-1212. One’s local Area Agency on Aging might be helpful in answering Medicaid related questions and / or providing application assistance.

Before applying for long-term care Medicaid in West Virginia, it is vital that applicants be certain they meet all eligibility requirements. Seniors who have income and / or resources in excess of the limit(s) should consider Medicaid planning for the best chance of acceptance into a Medicaid program.

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West Virginia Medicaid Income Limits 2023: Eligibility Based on Household Size

Medicaid, the joint federal and state program that provides healthcare coverage to low-income individuals and families, plays a crucial role in ensuring access to medical services for those who may not otherwise afford it. Each year, states update their Medicaid income limits to reflect changes in the cost of living and other economic factors. In 2023, West Virginia has set its Medicaid income limits based on the number of household members, making it essential for individuals and families to understand these limits to determine their eligibility for this vital healthcare program.

West Virginia Medicaid Income Limits by Household Size

The West Virginia Medicaid income limits for 2023 are categorized by household size. It’s important to note that these limits are subject to change based on federal and state regulations, but as of 2023, they are as follows:

  • Household Size: 1
    • Maximum Income Per Year: $19,392
  • Household Size: 2
    • Maximum Income Per Year: $26,228
  • Household Size: 3
    • Maximum Income Per Year: $33,064
  • Household Size: 4
    • Maximum Income Per Year: $39,900
  • Household Size: 5
    • Maximum Income Per Year: $46,737
  • Household Size: 6
    • Maximum Income Per Year: $53,573
  • Household Size: 7
    • Maximum Income Per Year: $60,409
  • Household Size: 8
    • Maximum Income Per Year: $67,245

West Virginia Medicaid Eligibility 2023

To determine your eligibility for Medicaid in West Virginia, you must first assess your household size and annual income. Your household size includes all individuals for whom you are financially responsible. This may include yourself, your spouse, children, and other dependents.

Next, calculate your total annual income, taking into account all sources of income for all household members. This includes wages, salaries, self-employment income, rental income, and any other forms of financial support you receive. If your total annual income falls below the income limits specified for your household size, you may be eligible for Medicaid coverage.

It’s important to remember that these income limits are just one part of the eligibility criteria. Other factors, such as your immigration status, disability status, and age, can also affect your eligibility. Therefore, it’s advisable to contact the West Virginia Department of Health and Human Resources or a certified Medicaid application assistor for a comprehensive assessment of your eligibility.

The Benefits of West Virginia Medicaid Coverage

Medicaid provides a wide range of healthcare services to eligible individuals and families. These services can include doctor visits, hospital stays, prescription medications, preventive care, dental and vision services, and more. Medicaid is a vital safety net program that ensures that low-income individuals and families have access to essential healthcare services when they need them the most.

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Applying for West Virginia Medicaid Programs

If you believe you meet the income and other eligibility criteria for West Virginia Medicaid, you can apply through several methods. These include:

  • Online Application: You can apply for Medicaid online through the West Virginia Department of Health and Human Resources website.
  • In-Person Application: You can visit your local Department of Health and Human Resources office to apply in person. They can provide you with assistance and answer any questions you may have about the application process.
  • Mail or Fax Application: You can download a paper application from the department’s website, complete it, and then mail or fax it to the provided address or fax number.
  • Phone Application: You can also apply by phone by calling the West Virginia Department of Health and Human Resources and speaking to a representative who can guide you through the application process.

FAQ’s-West Virginia Medicaid Income Limits 2023

1. What is the maximum income limit for a household with 3 members in West Virginia under Medicaid in 2023?

  • The maximum income limit for a household with 3 members in West Virginia under Medicaid in 2023 is $33,064 per year.

2. If a family of 5 in West Virginia has an annual income of $45,000, are they eligible for Medicaid in 2023?

  • Yes, a family of 5 in West Virginia with an annual income of $45,000 is eligible for Medicaid in 2023. The income limit for a household of 5 is $46,737, and their income falls below this threshold.

3. How much can a single individual earn annually in West Virginia and still qualify for Medicaid in 2023?

  • A single individual in West Virginia can earn up to $19,392 annually and still qualify for Medicaid in 2023.

4. What is the income limit for a family of 8 in West Virginia to be eligible for Medicaid in 2023?

  • The income limit for a family of 8 in West Virginia to be eligible for Medicaid in 2023 is $67,245 per year.

5. Are the Medicaid income limits the same for all counties in West Virginia?

  • Medicaid income limits are typically the same for all counties within the state of West Virginia. These income limits are set at the state level and apply uniformly throughout the state. However, it’s always a good idea to check with your local Department of Health and Human Resources or Medicaid office for any regional or county-specific variations or updates.

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Conclusion | West Virginia Medicaid Eligibility 2023

Access to healthcare is a fundamental right, and Medicaid serves as a critical lifeline for many low-income individuals and families in West Virginia. Understanding the Medicaid income limits based on household size is the first step in determining your eligibility for this essential program. If you find that you meet the income criteria, it’s important to apply promptly to ensure you receive the healthcare coverage you need. Medicaid is here to help ensure that healthcare remains accessible for those who need it most, providing peace of mind and improved well-being for countless West Virginians.

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