How to get Medicaid or low-cost care in West Virginia

West Virginia Medicaid in plain words

Medicaid is a program that pays for health care for people with low incomes. In West Virginia the program is run by the Bureau for Medical Services, which is part of the state Department of Human Services, or DoHS. People can get help applying and keeping their coverage at local DoHS offices.

KFF, a health policy research group, reports that West Virginia began covering low-income adults on January 1, 2014. The state's Medicaid help website says the adult expansion group covers people ages 19 to 64 with a low income. It gives about $22,025 a year for one person and $45,540 for a family of four. Those amounts come from the federal poverty level, a dollar amount the government sets each year to measure poverty.

Children and people with disabilities can qualify under other rules. Our guide on who qualifies for Medicaid explains each group.

How to apply with WV PATH

WV PATH is the state's website for applying for benefits and finishing reviews. The DoHS Customer Service Reporting Center answers questions at 1-877-716-1212. You can find your local office on the DoHS website under field offices.

The state's Medicaid program office has a separate line at 304-558-1700. To get your papers ready, use our guide to how to apply for Medicaid. Medicaid has no sign-up season, so any month works.

Please keep your phone number and address current in your WV PATH account. The state has been mailing renewal papers, and it warns that people can lose coverage when that mail does not reach them.

What the 2027 work rule means in West Virginia

The state calls its work rule community engagement, and it starts on January 1, 2027. It applies to adults ages 19 to 64 in the expansion group. Applicants may need to meet it for the month before they apply. For example, someone who applies for January 2027 may need to show activity in December 2026.

Current members are affected at their regular renewal, beginning with March 2027. Some members will also renew every six months instead of every 12, starting in January 2027.

The rule asks for at least 80 hours a month of work or approved activities. The state counts paid, unpaid or in-kind work, and it also accepts income of at least $580 a month. A work training program, school at least half time and volunteering count too. Seasonal workers can qualify if their average income over six months is at least $580 a month.

The state excludes some people from the rule. It lists pregnancy, and caring for a child 13 or younger or a disabled person. Young adults ages 19 to 25 who left the child welfare system are also on the list. People who already follow SNAP or TANF work rules are excluded too. So are veterans with a 100 percent disability rating and people with a medically frail condition, which means a serious health problem.

The state first reviews the information it already has. If it needs more, it will write to you or message you in your WV PATH account, and you must respond within 30 days. If you are not contacted, you do not need to send anything. For the latest details, the state keeps a website called wvmedicaidhelp.org. Our Medicaid work requirement guide explains the national rule.

If your income is above the Medicaid limit

People in West Virginia go to HealthCare.gov to apply for tax credits that lower the cost of a private plan. The state insurance office says trained local helpers can help with enrollment, and its Consumer Services Division can be reached at 1-800-435-7381. Sign-up for 2027 plans opens on November 1, 2026, and you must choose a plan by December 15 for coverage that starts January 1.

If you lost a job, our guide on what to do after losing insurance explains the special sign-up window.

Health centers and low-cost clinics

Federally funded community health centers charge by income and family size, and they serve everyone. To find one, enter your zip code in the free Find a Health Center tool from the Health Resources and Services Administration. West Virginia has many rural areas, so ask each center how far its offices are from you.

At the center, ask about the sliding fee, which is a price scale based on what you earn. Then ask what proof of income to bring. Our guides on community health centers and sliding-scale clinics can help you compare.

Checking a West Virginia doctor

The West Virginia Board of Medicine has a Licensee Search tool for medical doctors and podiatrists, and for the physician assistants who work with them. It does not list osteopathic doctors, who hold a DO degree. Those doctors are checked on the website of the West Virginia Board of Osteopathic Medicine. The Board of Medicine's phone number is 304-558-2921.

Flat-fee doctors and emergencies

Some West Virginia doctors charge a flat monthly fee for primary care. They do not bill insurance for those visits, and this is called direct primary care. Our directory lists cash-pay doctors you can search.

In an emergency, call 911 or go to the nearest emergency room. Federal law says a hospital with an emergency room must examine you whether or not you have coverage. If a bill comes later, our guide to hospital financial assistance shows how to ask for help.