West Virginia State Guide

Written By Jerdon Johnston

Citizen Guide for West Virginia

Understanding Your Healthcare Options in West Virginia

Navigating healthcare coverage can feel overwhelming, but West Virginia provides several programs to help residents access quality care. Whether you are uninsured, underinsured, or seeking financial assistance for medical costs, this guide introduces key options available to you.

Who Needs This Guide?

  • You are uninsured or struggling to afford health insurance.

  • You want to explore your healthcare coverage options in West Virginia.

  • You need financial assistance for medical costs.

  • You want to maximize the benefits of your current healthcare plan.

Key Healthcare Programs in West Virginia

1. Medicaid & CHIP

  • Who Qualifies? Low-income individuals, families, pregnant women, children, and people with disabilities.

  • What It Covers? Doctor visits, hospital care, prescriptions, preventive services, and more.

  • How to Apply? Visit West Virginia’s Medicaid website or apply through the federal marketplace at HealthCare.gov.

2. Affordable Care Act (ACA) Plans

  • Who Qualifies? Anyone who doesn’t receive insurance through an employer, Medicare, or Medicaid.

  • What It Covers? Comprehensive health coverage, including preventive care, emergency services, and mental health care.

  • How to Apply? Visit HealthCare.gov or West Virginia’s health exchange website.

3. Medicare

  • Who Qualifies? Individuals 65+ or those with certain disabilities.

  • What It Covers?

    • Part A (Hospital Insurance)

    • Part B (Medical Insurance)

    • Optional Part D (Prescription Drug Coverage)

  • How to Apply? Visit Medicare.gov.

4. Employer-Sponsored Health Insurance

Many West Virginia employers offer group health insurance plans, often covering part of the premium. If you are employed, check with your employer about available health benefits. If you’ve recently lost job-based insurance, COBRA or alternative options may be available.

5. Short-Term & Supplemental Health Plans

For those needing temporary coverage or additional financial protection, options include:

  • Short-term health plans for transitional periods.

  • Accident or critical illness insurance to help cover unexpected medical expenses.

Financial Assistance Programs

  • Premium Tax Credits – Reduce the cost of ACA marketplace plans.

  • Cost-Sharing Reductions – Lower out-of-pocket costs for qualifying individuals.

  • State-Specific Assistance Programs – West Virginia offers additional subsidies and healthcare resources.

Where to Get Help

  • West Virginia Health Insurance Marketplace – Compare and enroll in ACA plans.

  • West Virginia Medicaid Office – Apply for Medicaid or CHIP.

  • Local Community Health Centers – Get low-cost or free healthcare services.

  • Tsunami Advisors – Personalized guidance to find the best plan for your needs.

➡ Need Help? Schedule a free consultation with a Tsunami Advisor today at TsunamiHealth.com/app.

Jerdon Johnston