West Virginia Health Insurance

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Health Insurance for the Well Informed

In West Virginia, medical underwriting is allowed without restriction. There is a 12 month look back and 24 month exclusionary period limit for preexisting conditions.

In West Virginia, there is a high risk pool called Access WV. You may be eligible for Access WV due to your HIPAA rights or if you have been a West Virginia resident for at least 30 days, you have been denied coverage in the past six months, you have been offered coverage but at a much higher rate than the pool offers, you have one of the medical conditions listed on the application, or you qualify under the Health Care Tax Credit Program.

Coverage under the high risk pool includes physician services, inpatient hospital services, hospital outpatient services, mental health and substance abuse services, emergency care, durable medical equipment, and home health services.

In West Virginia, medical underwriting is allowed with rates varying plus or minus 30% of the indexed rate based on the health status of the group. There is a 6 month look back and 12 month exclusionary period limit for preexisting conditions for those without prior health coverage.

West Virginia offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce.

Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.

Children (ages 1-5)-133% of the Federal Poverty Level
Children (Ages 6-19)-100% of the Federal Poverty Level

Pregnant Women and Infants

Pregnant Women-150% of the Federal Poverty Level
Infants (ages 0-1)-150% of the Federal Poverty Level

Non Working Parents- 19% of the Federal Poverty Level

Working Parents- 38% of the Federal Poverty Level

Medically Needy Individual- 28% of the Federal Poverty Level

Medically Needy Couple- 28% of the Federal Poverty Level

Supplemental Security Income Recipients- 74% of the Federal

Physician's services, wherever provided, hospital inpatient care, outpatient hospital services, emergency room services, x-ray and laboratory services prescribed by an authorized practitioner, routine dental care for children and with approval some medically necessary special care such as braces. Adult dental coverage is limited to removal of cysts or tumors, biopsies, treatment of fractures of the jaw bones and some emergency services, and prescribed drugs. Most of the drugs that are prescribed by your doctor are covered by the Medicaid Program. Drugs sold over-the-counter must be prescribed by your doctor to be covered. Some drugs have limits and some may require prior approval.

Co-payments vary. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

West Virginia offers WVCHIP for children under the age of 18 whose family income is up to 200% of the Federal Poverty Level and who do not qualify for Medicaid. The children must be residents of West Virginia and U.S. citizens, have not had health insurance in the past six months, and are not eligible for state employee health insurance. Please visit the WVCHIP website for more detailed information at http://www.wvchip.org/.

West Virginia Health Insurance Quotes

West Virginia Health Insurance Companies

All About West Virginia Individual Health Insurance

West Virginia Group Health Insurance (Small Business: 2-50 employees)

West Virginia COBRA Individual Health Coverage

Medicaid in West Virginia

Other West Virginia Health Insurance Programs

More West Virginia Health Insurance Information