West Virginia Medicaid

Medicaid, funded by both the federal and state governments, is an important health program for people with lower incomes, elderly people, some families with children, and people with disabilities.

The state Department of Health and Human Resources (DHHR) administers Medicaid programs throughout West Virginia, and recipients must be American citizens or legal permanent residents living in West Virginia who fall into certain qualifying categories.

Qualifying categories for Medicaid eligibility include:

  • the elderly
  • the physically disabled
  • the mentally disabled
  • severely disabled children
  • pregnant women
  • low income adults
  • low income children

By 2014, most adults across the country who are under age 65 and have incomes under $15,000 will qualify for Medicaid. Although income limits for various West Virginia Medicaid programs vary substantially, all limits are tied to the Federal Poverty Level (FPL).

For older West Virginians, the income threshold for required services such as nursing home care and in-home care is set at $2,094 annually through 2013. Asset limits for these services are set at $2,000 for a single person and $3,000 for a couple. Some assets are protected, and people whose income exceeds the threshold are eligible for Medicaid if cost of their care exceeds the Medicare income threshold.

For help determining income and asset limits under various qualifying categories, consult the DHHR Medicaid information page.

Medicaid in West Virginia covers a wide range of medical services including:

  • Laboratory and X-ray services
  • Inpatient and outpatient hospital services
  • Health screenings for children and treatment of detected medical problems
  • Comprehensive dental services for children
  • Adult medical and surgical dental services
  • Nursing facility services for adults
  • Health clinic services
  • Prescription drugs
  • Physical, occupational, or speech therapy for children
  • Eye doctor visits and eyeglasses for children
  • Medically-necessary transportation services

Dual Eligibility

Some people are eligible for both Medicare and Medicaid. In such cases, Medicare is the primary payer.

West Virginia Medicaid offers assistance to Qualified Medicare Beneficiaries (QBM). Medicare recipients with incomes below 100% of the FPL and assets not exceeding $6,940 for a single person and $10,410 for a couple qualify for payment of Medicare Part B premiums and Medicare copayments and deductibles. If you are eligible for both Medicare and West Virginia Medicaid, looking into Medicare Advantage plans may be a wise move. Medicare Advantage can offer increased coverage and

security to dual eligible individuals, and some Medicare Advantage plans are available premium-free.

Call MedicareMall toll-free at 1-877-413-1556 for help determining whether Medicare Advantage is right for you.

For more information about Medicaid in West Virginia, contact the West Virginia Bureau for Medical Services at 1-304-558-1700. To apply for any of the various West Virginia Medicaid programs and services, visit the DHHR inROADS page, where you can also self-screen to help determine whether you are eligible for benefits. If you have any further questions about senior healthcare including Original Medicare Part A and Part B, Medicare Advantage, or Medicare supplement plans, contact a licensed, bonded MedicareMall representative and let us lead you with confidence through the Medicare maze!

© 2013 MedicareMall.com

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