West Virginia Health Insurance

Residents of West Virginia have a wide choice of health insurance plans and insurance companies to choose from. They will be able to find plans that suit a range of individual and family health care needs.

When looking for the right health insurance plan for your needs you’ll find a lot of helpful information at GoHealthInsurance. You can read about the various important rules, regulations, and laws concerning West Virginia health plans as well as learn about the state’s top health insurance carriers.

Search health insurance by state here if you don’t live in West Virginia.

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Resources on this page

West Virginia Health Insurance Laws and Regulations

Public Health Insurance Programs for West Virginia Residents

West Virginia Health Insurance High Risk Pools

West Virginia Health Insurance Companies

Contact Info for the West Virginia Offices of the Insurance Commissioner and Department of Health & Human Resources

West Virginia Health Insurance Stats

West Virginia Residents: 1,820,500
Median Annual Household Income: $42,801
West Virginia Health Care Expenditures (in millions): $13,964
Households with at least 1 full time worker: 816,000
West Virginia Health Insurance Coverage based on Total Population (%):

• Employer: 48%
• Individual: 2%
• Medicaid: 17%
• Medicare: 17%
• Uninsured: 14%

Avg. Annual Employee Premium in West Virginia employer-sponsored plan (after employer contrib.): $990
Avg. Monthly West Virginia Individual Premiums: $333
Total West Virginia HMO Enrollment: 292,933

West Virginia Health Insurance Laws and Regulations

When a resident applies for a West Virginia health insurance plan, health companies will consider that applicant's health status before they accept him or her into coverage and set monthly premiums.

But the West Virginia health insurance market is regulated by state and federal law to provide certain protections for consumers.

Some HMO health plans in West Virginia have open enrollment periods where insurers must accept every applicant into coverage regardless of health status.

Residents who recently left a group West Virginia health insurance plan with an employer and meet other eligibility requirements may be HIPAA-eligible. Under the federal law, HIPAA, health insurers are not allowed to deny coverage or permanently restrict benefits.

If an applicant is turned down for coverage for any reason, they can purchase a health plan through the West Virginia health insurance pool, called AccessWV.

West Virginia health insurance law also requires that all health plans cover certain medical services. They include:

• Medical costs of certain clinical trials
• Screening for cervical, colorectal, breast, and HPV cancer
• Care for pregnant women
• Vaccinations for children
• Equal coverage for mental and physical health conditions

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West Virginia Public Health Insurance Programs

Here are the public West Virginia health insurance programs that help low-income residents stay covered:

• Medicaid
  This program is funded by both the state and federal government to provide low-income residents and disabled citizens free access to health insurance. To learn more about the Medicaid program in West Virginia, visit them online.


• West Virginia Children's Health Insurance Program (WVCHIP)
  This state and federally funded program offers health coverage for children who do not qualify for Medicaid, but cannot afford their own plan. Learn more about this West Virginia health insurance program at http://www.wvchip.org/.


• West Virginia Breast and Cervical Cancer Screening Program
  Low-income women in West Virginia can receive free screening for breast and cervical cancer and get full health benefits through Medicaid through this program. Learn more about this women's West Virginia health insurance program online.


• West Virginia Medicare
  Seniors looking for West Virginia health insurance can get coverage through Medicare Advantage, Supplement and Original Medicare.

West Virginia trade workers and early retirees also can get financial assistance through the Federal Health Coverage Tax Credit. This tax credit helps pay for up to 60 percent of health plan premiums. Find out more about this program here.

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West Virginia Health Insurance High Risk Pools

The Patient Protection and Affordable Care Act established nationwide high risk pools to provide health insurance coverage for people with pre-existing conditions.

The Pre-Existing Condition Insurance Plan (PCIP) in West Virginia will run similar to regular West Virginia health insurance plans and require enrollees to pay monthly premiums and out-of-pocket costs.

West Virginia residents with PCIP will pay around the same amount that an individual without a medical condition pays for health insurance. There will also be a deductible that must be met before coverage for health insurance benefits will start.

Individuals with medical conditions will have health insurance coverage for prescription drugs, emergency services, doctor and hospital visits and more.

West Virginia residents are eligible if they are a United States citizen, have a pre-existing condition and have been without health insurance for six months.

For more information on the West Virginia health insurance high risk pools visit http://www.healthcare.gov/index.html.

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The following list of companies offer West Virginia health insurance plans:

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West Virginia Offices of the Insurance Commissioner and Department of Health & Human Resources

Find the contact information for the West Virginia health insurance and health and human resources departments at:

Go to Top of the West Virginia Health Insurance Page