For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background
Medicaid in West Virginia:
The WV Department of Health and Human Resources, Bureau for Medical Services administers the state’s Medicaid Program.
Information about West Virginia Medicaid, including beneficiary enrollment information, can be found at: http://www.wvdhhr.org/
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services.
Information about enrolling in the Medicaid fee-for-service program can be found at: http://www.wvdhhr.org/.
Medicaid website provides information about services covered by fee-for-service payments and payment amounts: http://www.wvdhhr.org/
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.
Medicaid Managed Care:
Some managed care plans cover individual West Virginia counties and independent cities. The Medicaid website has jurisdictional information: http://www.wvdhhr.org/.
Beneficiaries Participating in Managed Care:
Managed care plans participating in the Mountain Health Trust offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.
The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state Medicaid Office:
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
Managed Care Plans Participating in Mountain Health Trust:
Coventry Health Care of WV
Health Plan of the Upper Ohio Valley
West Virginia Family Health