West Virginia Medicaid

Updated August 2026

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. As of 2026, approximately 487,000 West Virginians are enrolled — roughly 27% of the state's population, still one of the higher enrollment rates in the country relative to population size, though down from a pandemic-era peak of over 650,000 as continuous coverage protections have unwound nationally.

New community engagement requirements are coming to West Virginia Medicaid

The Bureau for Medical Services (BMS), part of the West Virginia Department of Human Services (DoHS), is implementing new federal community engagement (work) requirements required by H.R. 1 (signed July 4, 2025). New applicants must meet the requirement starting January 1, 2027; current members are not affected until their regularly scheduled renewal, beginning with renewals due in March 2027. Visit bms.wv.gov for current information on upcoming eligibility changes and how they may affect your coverage.

What is West Virginia Medicaid?

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.