West Virginia Medicaid planning,
in plain English.

The numbers that matter in West Virginia

• Penalty divisor (2026): $11,903/month — every $11,903 in gifted assets during the 5-year lookback = 1 month of Medicaid ineligibility.
• Nursing-home cost (2026, semi-private): ~$11,619/month = $139,428/year.
• CSRA ceiling: $162,660 (community-spouse resource allowance).
• MMMNA band: $2,643.75 to $4,066.50/month (minimum monthly maintenance needs allowance).
• Home equity limit: $752,000.
• Applicant asset cap: $2,000 (non-exempt).
• Applicant income cap: $2,901/month (state-federal common threshold, 2026).
• Managed long-term care: No — direct state Medicaid agency application.
• Estate recovery posture: Minimum (only TEFRA-required).

Programs and acronyms in West Virginia

If you're searching for help with long-term-care Medicaid in West Virginia, these are the names and acronyms you'll encounter on state-agency forms, in elder-law conversations, and in nursing-facility paperwork.

• West Virginia Medicaid — WV Medicaid. The state's Medicaid program brand.
• West Virginia Bureau for Medical Services (BMS) — administers West Virginia Medicaid and processes long-term-care eligibility decisions.
• Aged and Disabled Waiver (ADW) — HCBS waiver for West Virginia seniors and adults with physical disabilities providing personal care, respite, and homemaker services.
• Traumatic Brain Injury Waiver (TBIW) — HCBS waiver for West Virginians with traumatic brain injuries providing rehabilitation and community supports.
• Intellectual / Developmental Disabilities Waiver (IDDW) — HCBS waiver for West Virginians with intellectual or developmental disabilities providing residential and day habilitation.
• Mountain Health Trust (MHT) — West Virginia's Medicaid managed-care program for non-LTC populations.
• Mountain Health Promise — WV managed-care program for children and youth in foster care or with serious behavioral health needs.
• WV PATH — West Virginia's online Medicaid application portal: www.wvpath.wv.gov/
• DoHS — Department of Human Services (Parent agency (post-2024 split from DHHR)).
• BoSS — Bureau for Senior Services (Administers ADW).

The West Virginia planning levers

Every Medicaid plan in West Virginia pulls some combination of five levers: (1) community-spouse asset re-allocation inside the CSRA ceiling, (2) spend-down on exempt assets (home improvements, new car for the community spouse, pre-paid funeral), (3) irrevocable trust transfer outside the 5-year window, (4) caregiver-child exception or disabled-child exception on the home, and (5) personal-service contracts paying a family member for documented caregiving hours.

Which lever fits depends on the specific assets, the crisis timeline, and — critically — whether the applicant is already in a facility. If a family member is already admitted, the playbook narrows to levers (1), (2), and (5) only.

What planning looks like, by timeline

5+ years out: full menu available. Irrevocable-trust transfers, gifting, long-term-care insurance — all work if executed cleanly. Time is the most valuable asset in Medicaid planning.

1–5 years out: half-menu. Transfers still trigger the lookback but a known penalty period can be absorbed by private pay. Community-spouse re-allocation is still a big lever.

Already in a facility: crisis planning. Most gifting is off the table. Spend-down, community-spouse allowance, personal-service contracts, and exempt-asset purchases become primary. See the crisis playbook.