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West Virginia Health Insurance

West Virginians now have new health insurance options, thanks to the Affordable Care Act. According to an October 2013 report by the Kaiser Family Foundation, Gov. Earl Ray Tomblin decided not to pursue a state-run marketplace.

However, West Virginia is one of 27 states including Washington, D.C., that chose to expand Medicaid benefits in 2014.

West Virginians can sign up with the national health insurance marketplace at HealthCare.gov. The application process consists of answering questions about family members and anticipated 2014 income.

After you apply during open enrollment, you can find out if you and your family members qualify for tax credits (subsidies) to help offset the cost of marketplace plans, Medicaid, or the Children’s Health Insurance Program, called CHIP.

Do you qualify for a West Virginia health insurance subsidy?

According to a January 2014 Kaiser Family Foundation profile of the uninsured in West Virginia, about 76 percent of formerly uninsured state residents now qualify for some kind of financial assistance.

Eligibility for assistance is usually determined by your family size and income, but if you get affordable health insurance from your employer or other public programs, you may not qualify.

If you qualify for tax credits, you can immediately apply your subsidy to premiums for plans purchased in the marketplace.

Here are some ways West Virginians can get public assistance to pay for health insurance:

Typically, eligibility for Medicaid and CHIP is determined using 2014 poverty level guidelines, and eligibility for subsidies is determined using 2013 limits.
People with income between 100 and 400 percent of the poverty level may qualify for a subsidy. This would be between $23,550 and $94,200 for a family of four and between $11,490 and $45,960 for an individual.
Because West Virginia expanded Medicaid in 2014, adults with an income less than 138 percent of the federal poverty level, or about $32,913 for a family of four, might qualify for Medicaid.
Children of West Virginia families with income less than 305 percent of the poverty level, or about $72,740 for a family of four, might qualify for CHIP.

If you earn too much to qualify for assistance or have access to other health plans, you may still choose to purchase a marketplace plan. These plans must provide minimum mandated benefits, and insurers cannot deny your application based on pre-existing health issues.

Health insurance companies with marketplace plans in West Virginia

Highmark Blue Cross Blue Shield offers marketplace plans for West Virginia residents.

West Virginia health and coverage statistics

West Virginia population (2013): 1,854,304
Population 65 and older (2012): 16.8 percent
Life expectancy (2010): 75.4 years
Number of Medicaid beneficiaries (2012): 310,000
Number of Medicare beneficiaries (2012): 310,200
Estimated number of uninsured residents (2012): 268,600

Overall state health ranking (2014): 46

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.