Where to start your Medicaid application in West Virginia

In West Virginia, you apply for Medicaid through the Department of Health and Human Resources (DHHR), Division of Welfare. You can start your application in three ways: online through the DHHR website, by mail, or in person at your county office. The online portal is the fastest route — you create an account, fill out the form, and upload documents without waiting for an appointment.

If you prefer to apply by mail, download the application from the DHHR website or call your county office to request one. Mail it to your county DHHR office with supporting documents. In-person applications at your county office take longer because offices have limited hours and staff, but you can ask questions as you fill out the form and submit documents on the spot.

Your county office location depends on where you live. The DHHR website has a county office finder that shows the address, phone number, and hours for your area. Call ahead if you plan to go in person — some offices require appointments or have specific days for Medicaid applications.

Key Takeaways

  • Apply online through the DHHR website, by mail to your county office, or in person — online is usually fastest.
  • You will need proof of income, residency, citizenship or immigration status, and Social Security numbers for everyone in your household.
  • West Virginia uses modified adjusted gross income (MAGI) to determine income limits, which includes most types of income but excludes certain benefits.
  • The DHHR will contact you within 30 days if they need more information, and you have 10 days to respond or your application may be denied.
  • If you are denied, you can request a fair hearing within 30 days of the denial letter.

Documents you need before you apply

Gather these documents before you start your application. You will need proof of income for the past 30 days — pay stubs, tax returns, Social Security statements, unemployment letters, or child support papers. If you are self-employed, bring your most recent tax return and profit-and-loss statement. If you have no income, bring a statement from your employer or a letter explaining why you are not working.

You also need proof of residency in West Virginia — a utility bill, lease, mortgage statement, or government mail with your current address. Bring your Social Security card or a document showing your Social Security number for each person in your household. For citizenship or immigration status, bring a birth certificate, passport, green card, or other immigration document. If you are applying for a child, bring their birth certificate.

If you are pregnant or have a newborn, bring medical records or hospital discharge papers showing the birth date. If you are disabled, bring medical records or a letter from your doctor describing your condition. Keep copies of everything you submit — the DHHR may lose documents, and you will need them if you appeal a denial.

Income limits and how West Virginia counts your money

West Virginia uses modified adjusted gross income (MAGI) to calculate whether your household income is low enough for Medicaid. MAGI includes wages, self-employment income, Social Security, unemployment, and most other income. It does not include Supplemental Security Income (SSI), certain veteran benefits, or child support you receive.

The income limit changes each year and depends on your household size. For 2024, a single adult can earn up to roughly 138% of the federal poverty level, and a family of four can earn up to the same percentage. The exact dollar amount varies — you can find the current limits on the DHHR website or ask your county office. If your income is above the limit, you may still be able to get coverage through the health insurance marketplace instead.

When you apply, list all income sources for everyone in your household, including children. If your income changes after you are approved, you must report it within 30 days. If you earn more money, your coverage may end or your cost-sharing may increase. If you earn less, your coverage may improve.

What happens after you submit your application

After you submit your application, the DHHR has 30 days to make a decision. If they need more information, they will contact you by mail or phone. You have 10 days to send the missing documents or information. If you do not respond within 10 days, the DHHR will deny your application, but you can reapply later.

If you are approved, you will receive a letter in the mail with your Medicaid number and the date your coverage starts. Coverage usually starts on the first day of the month after you are approved, but in some cases it can start earlier. You will also receive information about which doctors and hospitals accept your Medicaid coverage in your area.

If you are denied, the letter will explain why. Common reasons include income above the limit, not providing proof of citizenship or residency, or not responding to a request for more information. You have 30 days from the date of the denial letter to request a fair hearing, which is a chance to present your case to an independent reviewer.

Renewing your Medicaid coverage each year

Your Medicaid coverage lasts for 12 months. Before your coverage ends, the DHHR will send you a renewal form in the mail. You must complete it and return it within the deadline shown on the form, usually 30 days. If you do not renew on time, your coverage will end and you will have to reapply.

You can renew online, by mail, or in person using the same methods as your original application. When you renew, report any changes in income, household size, or address. If your income has increased, your coverage may end. If your income has decreased, your coverage may continue or improve.

If you move out of West Virginia, your Medicaid coverage ends. If you move to another state, you must apply for Medicaid in that state. The new state will not transfer your West Virginia coverage.

What to do if your application is denied

If the DHHR denies your application, read the denial letter carefully to understand the reason. Common reasons include income above the limit, missing documents, not meeting residency requirements, or not providing proof of citizenship. Some reasons can be fixed by submitting more information or correcting an error on your application.

You have 30 days from the date of the denial letter to request a fair hearing. To request a hearing, contact your county DHHR office or call the DHHR central office. At the hearing, you can present documents, explain your situation, and answer questions from a hearing officer. The hearing officer will make a new decision based on the evidence you provide.

If you are still denied after the hearing, you can appeal to the West Virginia Supreme Court, but this is rare and requires a lawyer. Before you appeal, ask your county office whether you might be covered under a different program, such as the health insurance marketplace or a state-specific program for pregnant women or children.

Special situations: pregnancy, disability, and children

West Virginia covers pregnant women and new mothers under Medicaid even if their income is slightly above the regular limit. If you are pregnant, apply as soon as you know — coverage can start retroactively to the first day of the month you became pregnant. Bring medical records or a letter from your doctor confirming the pregnancy and due date.

Children under 19 have a higher income limit than adults in West Virginia. A child can be covered even if their parents earn too much, as long as the child's own income is below the limit. If you have a child, apply for them separately — do not assume they will be denied just because you were.

If you are disabled or blind, you may be covered under a different program with different income and asset limits. Ask your county office whether you should apply for Medicaid as a disabled person or under the regular program. If you receive Supplemental Security Income (SSI), you are automatically covered by Medicaid in West Virginia — you do not need to apply separately.

Frequently Asked Questions

How long does it take to get approved for Medicaid in West Virginia?

The DHHR has 30 days to make a decision from the date you submit your application. If they need more information, the clock pauses while you gather documents. In practice, approval usually takes two to four weeks if you submit all documents at once, or longer if you have to send documents back and forth.

Can I apply for Medicaid if I am not a U.S. citizen?

It depends on your immigration status. U.S. citizens and may have access to immigrants (green card holders and some other statuses) can apply. Undocumented immigrants are not covered by regular Medicaid, but West Virginia covers emergency services for anyone regardless of status. Bring whatever immigration documents you have — the DHHR will tell you whether you may have access to.

What if my income is too high for Medicaid?

If your income exceeds the Medicaid limit, you may be able to buy health insurance through the federal marketplace at healthcare.gov. Depending on your income, you might be able to get a tax credit that lowers your monthly premium. You can also ask your county DHHR office whether you may have access to for any other state programs.

Do I have to report changes in income while I have Medicaid?

Yes. If your income changes, you must report it to your county DHHR office within 30 days. If you earn more money, your coverage may end or your cost-sharing may increase. If you earn less, your coverage may improve. Failing to report changes can result in overpayment, which the state may ask you to repay.

Can I apply for Medicaid online if I do not have a computer?

Yes. You can apply by mail or in person at your county DHHR office. You can also use a computer at a public library, community center, or your county office to apply online. Call your county office for hours and locations.