West Virginia Medicaid for Seniors & Long-Term Care

Updated August 2026

West Virginia Medicaid covers nursing facility care for eligible seniors and disabled individuals who require that level of support. The state also funds an extensive network of home and community-based services through its waiver programs — designed to allow people to remain in their homes and communities rather than enter nursing facilities.

$2,000

Individual resource (asset) limit

~$2,982/mo

Nursing facility income limit (300% FBR, 2026)

Aged and Disabled Waiver

Key HCBS waiver for seniors

WV long-term care Medicaid is separate from Mountain Health Trust managed care

Long-term care services — including nursing facility care and HCBS waivers — are covered under traditional West Virginia Medicaid fee-for-service, not through Mountain Health Promise managed care. A separate financial eligibility determination is required. Call West Virginia BMS at 1-877-716-1212 or contact the Bureau for Family Assistance (BFA) at bfa.wv.gov to begin the process.

What West Virginia Medicaid covers for long-term care

Skilled nursing facility (nursing home) care
Personal care attendant services at home
Home health aide visits
Adult day health services
Assisted living through HCBS waiver
Respite care for family caregivers
Home modifications (ramps, grab bars, widened doorways)
Assistive technology and medical equipment
Transportation to medical appointments
Behavioral health and substance use disorder services

Financial eligibility for West Virginia long-term care Medicaid (2026)

West Virginia long-term care Medicaid uses income and asset tests separate from MAGI-based expansion coverage. The income standard for nursing facility care is 300% of the Social Security Federal Benefit Rate. Asset limits and spousal impoverishment protections apply under federal law (42 U.S.C. § 1396r-5).

Financial figure	2026 amount
Income limit (300% FBR)	~$2,982/mo
Individual resource (asset) limit	$2,000
Community spouse minimum CSRA	$32,532
Community spouse maximum CSRA	$162,660

Income limit (300% FBR)

2026 amount: ~$2,982/mo

Individual resource (asset) limit

2026 amount: $2,000

Community spouse minimum CSRA

2026 amount: $32,532

Community spouse maximum CSRA

2026 amount: $162,660

HCBS waivers: staying at home instead of a nursing facility

West Virginia's Bureau for Medical Services (BMS) operates four Home and Community-Based Services (HCBS) waivers under Section 1915(c) of the Social Security Act: the Aged and Disabled Waiver (ADW), which is the primary waiver for seniors; the Intellectual/Developmental Disabilities Waiver (IDDW); the Traumatic Brain Injury Waiver (TBIW), for members age 3 and older; and the Children with Serious Emotional Disorder Waiver (CSEDW). These waivers allow Medicaid-eligible individuals who meet nursing facility level of care (or the program's specific level-of-care standard) to receive long-term services in their home or community setting instead of an institution.

West Virginia also has a Substance Use Disorder (SUD) Waiver — a distinct program announced by BMS to address the state's ongoing opioid crisis. West Virginia has one of the highest overdose mortality rates in the nation, and the SUD Waiver expands access to residential and outpatient treatment services for Medicaid members with substance use disorders. HCBS waiver slots may be limited and wait lists can exist — contact BMS to learn about current waiver availability.

West Virginia Medicaid estate recovery

West Virginia operates a Medicaid estate recovery program. The state may seek reimbursement from the estate of a member who received nursing facility care or certain long-term services at age 55 or older. West Virginia's 60-month look-back period applies to asset transfers before a long-term care Medicaid application. Consult a licensed West Virginia elder law attorney before making asset transfers if a family member may need long-term care Medicaid.

Spousal protections

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).