West Virginia Medicaid helps low-income residents get health care. It covers costs for doctor visits, hospital stays, and more. The program is vital for families facing high medical bills.
Income limits matter in 2025. They set who can join. Limits rose with federal poverty guidelines to match living costs. This makes coverage easier for some.
The program covers children, adults, pregnant women, seniors, and people with disabilities. This article explains West Virginia Medicaid income limits 2025, WV Medicaid eligibility 2025, income chart West Virginia Medicaid, coverage, and how to apply.
What Is West Virginia Medicaid?
West Virginia Medicaid is a health program for low-income people. It provides free or low-cost care. The goal is to keep residents healthy.
The program serves those who can’t afford insurance. It includes doctor care, prescriptions, and hospital services.
The West Virginia Department of Health and Human Resources (DHHR) runs it. They handle applications and benefits.
West Virginia Medicaid Income Limits 2025 (Overview)
Income limits are based on the Federal Poverty Level (FPL). FPL for 2025 is $15,060 yearly for one person. Add $5,380 for each extra member.
Limits vary by household size and category. Use modified adjusted gross income from taxes. This includes wages and benefits.
Seniors and disabled use SSI levels. Limits help decide WV Medicaid eligibility 2025.
West Virginia Medicaid Income Limits 2025; Full Chart
This income chart West Virginia Medicaid shows monthly and annual limits. Add $448 monthly ($5,376 annual) for each extra person beyond 8.
| Category | % FPL or Level | Household 1 (Monthly/Annual) | Household 2 (Monthly/Annual) | Household 3 (Monthly/Annual) | Household 4 (Monthly/Annual) |
| Adults (19–64) | 138% | $1,732 / $20,784 | $2,343 / $28,116 | $2,953 / $35,436 | $3,564 / $42,768 |
| Children (0–18) | 158% | $1,984 / $23,808 | $2,684 / $32,208 | $3,384 / $40,608 | $4,084 / $49,008 |
| Pregnant Women | 185% | $2,322 / $27,864 | $3,142 / $37,704 | $3,961 / $47,532 | $4,781 / $57,372 |
| Parents/Caretakers | 138% | $1,732 / $20,784 | $2,343 / $28,116 | $2,953 / $35,436 | $3,564 / $42,768 |
| Seniors (65+) | SSI | $967 / $11,604 | $1,450 / $17,400 | N/A | N/A |
| Disabled Individuals | SSI | $967 / $11,604 | $1,450 / $17,400 | N/A | N/A |
| Long-Term Care | 300% SSI | $2,901 / $34,812 | N/A | N/A | N/A |
Income Limits Explained by Category
Adults (Ages 19–64)
Adults qualify up to 138% FPL. No kids needed due to expansion.
Key requirements: Resident, citizen or qualified immigrant, income under limit.
Covers doctor visits, mental health, prescriptions.
Children (0–18)
Children qualify up to 158% FPL. Higher for CHIP up to 317%.
Key requirements: Under 19, meet income, residency.
Covers check-ups, dental, vision, hospital.
Pregnant Women
Pregnant women qualify up to 185% FPL. Coverage lasts 12 months postpartum.
Key requirements: Prove pregnancy, meet income.
Covers prenatal care, delivery, postpartum visits.
Parents & Caretaker Relatives
Parents qualify up to 138% FPL with kids under 19.
Key requirements: Care for dependent child, meet income.
Covers basic health, preventive care.
Seniors (65+)
Seniors qualify up to $967 monthly single.
Key requirements: Age 65+, meet income/assets $2,000 single.
Covers long-term care, prescriptions.
People With Disabilities (SSI, Medicaid Disability)
Disabled qualify up to $967 monthly. Assets $2,000 single.
Key requirements: Prove disability, meet income.
Covers therapy, equipment, mental health.
Long-Term Care / Nursing Home Medicaid
Long-term care up to $2,901 monthly. Assets $2,000.
Key requirements: Need nursing level care, meet income.
Covers nursing homes, home aides.
Who Is Eligible for WV Medicaid in 2025?
- Income test: Under limit for your group.
- Residency: Live in West Virginia.
- Citizenship/immigration status: U.S. citizen or qualified.
- Household size: You, spouse, dependents.
- Age or disability status: Fits category.
- Pregnancy: Higher limits with proof.
Required Documents
- ID (driver’s license, birth certificate).
- SSN.
- Proof of income (pay stubs, tax returns).
- Residency proof (utility bill).
- Medical documents (for disability or pregnancy).
How to Apply for Medicaid in West Virginia
- Go online to WV PATH portal.
- Call 1-877-716-1212 for phone help.
- Visit in person at local DHHR office.
- Mail forms to your county office.
- Approval takes 45 days; faster for pregnancy.
What WV Medicaid Covers in 2025
- Doctor visits.
- Pharmacy.
- Hospital services.
- Dental.
- Vision.
- Mental health.
- Pregnancy care.
- Children’s preventive services.
- Long-term care (if applicable).
Common Reasons for Denial (and Fixes)
Too much income: Reapply if income drops or use spend-down.
Missing documents: Gather all before submitting.
Incorrect information: Double-check forms.
Not meeting residency rules: Provide proof like bills.
Non-response during process: Reply fast to requests.
FAQs
What are the West Virginia Medicaid income limits for 2025?
Limits vary: Adults $1,732 monthly for one, kids $1,984, pregnant $2,322, ABD $967.
What is the income limit for a family of 3 in West Virginia in 2025?
Adults/parents: $2,953 monthly, kids $3,384, pregnant $3,961.
Does West Virginia Medicaid cover dental in 2025?
Yes, full for kids; limited for adults.
How do I qualify for WV Medicaid in 2025?
Meet residency, citizenship, and income rules for your gro
Can adults without children get Medicaid in West Virginia in 2025?
Yes, up to 138% FPL via expansion.
What are the WV pregnancy Medicaid income limits for 2025?
Up to 185% FPL, $2,322 monthly for one.
Conclusion
Income limits rose for 2025 in West Virginia Medicaid. This helps more people qualify. Many WV families fit the rules.
Check eligibility now. Apply as soon as possible if you meet the income limits. Contact DHHR for help.
Optional: Quick Summary Table
| Group | Monthly Limit (1 Person) | % FPL/Level |
| Adults | $1,732 | 138% |
| Children | $1,984 | 158% |
| Pregnant | $2,322 | 185% |
| ABD | $967 | SSI |
