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This represents approximately one third of the state's total population in 2017. West Virginia chose to expand Medicaid eligibility under the Affordable Care Act in 2014. From 2013 to 2014, Medicaid enrollment increased by more than 50%, and has remained relatively stable since then.
This Medicaid coverage group is for individuals who are disabled and are between ages 16 and 65. Individuals who meet the Social Security disability requirement and who are employed may qualify when total gross income is at or below 250% FPL and when unearned income is at or below the current SSI Payment Level.
West Virginia Medicaid covers family planning and counseling, pregnancy tests, STI tests, sterilization, and gynecologist services such as pap smears, birth control visits, and lab tests. Maternity care including prenatal, delivery and postpartum care (including newborn doctor services) are all included as well.
Call the Customer Service Center at 1-877-716-1212 to apply over the phone.
Who is eligible for West Virginia Medicaid? Household Size*Maximum Income Level (Per Year)1$18,0752$24,3533$30,6304$36,9084 more rows
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Federal Poverty Level thresholds to qualify for Medicaid The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. For example, in 2022 it is $13,590 for a single adult person, $27,750 for a family of four and $46,630 for a family of eight.
Under the expanded eligibility guidelines, adults age 19-64 are eligible for Medicaid with a household income up to 138% of the poverty level. For a single adult in 2022, that amounts to $18,754 in total annual income.
You may call Provider Services at (888)-483-0793 or (304) 348-3360 to check if a claim has been received. Please have your ten-digit WV Medicaid provider number, the patient's eleven digit Medicaid number, the date/s of service and the billed amount when calling Provider Services to check claim status.

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