What’s changing with West Virginia Medicaid?
We'll help you understand the new rules and how to stay covered
Starting January 1, 2027, some West Virginia Medicaid members will need to complete at least 80 hours of approved community engagement requirements each month. These are activities like employment, volunteering, attending school, or participating in a job training program. Meeting these requirements can help you keep your Medicaid coverage.
Everything you need to know
Use the links for helpful information for understanding West Virginia Medicaid coverage.
Do these community engagement requirements apply to me?
How do I keep my Medicaid coverage?
How do I renew my Medicaid coverage?
What if I lose my Medicaid coverage?
Resources to help you meet the Medicaid community engagement requirements
When will the rules take effect?
Current Medicaid members
If you're already enrolled, you won’t need to meet the requirements until your regular renewal in March 2027.
Future Medicaid members
If you're applying for coverage, you may need to meet the requirements the month before your coverage begins.
For example, you may need to meet the requirements in December 2026 to get coverage in January 2027.
Do these community engagement requirements apply to me?
You may need to meet the community engagement requirements if you:
- Are between the ages of 19 and 64
- Qualify for Medicaid based on your income
- Are not eligible for Medicare
- Are not pregnant
- Are a U.S. citizen or meet immigration rules
You may need to meet these requirements soon if you:
- Are turning 19
- Are a woman who’s had a baby in the past 12 months (12 months postpartum)
- Have aged out of foster care and are turning 26
- Are a parent or caregiver with your youngest dependent turning 14
Who doesn’t meet the requirements?
You may not have to meet the requirements if you are:
- Under age 26 and aged out of foster care
- An American Indian or Alaska Native who is eligible for Indian Health Service (IHS)
- A parent or caregiver of:
- A child age 13 or younger
- Someone with a disability
- A veteran with a total disability rating
- Medically frail or have serious health needs, such as:
- Blindness or disability
- Serious mental health conditions
- Substance use disorder
- Major physical or developmental disabilities
- Already meeting SNAP or TANF work requirements
- In drug or alcohol treatment
- Incarcerated or have been recently released (within 90 days)
- Pregnant or had a baby less than 12 months ago (12 months postpartum)
The West Virginia Department of Human Services (DoHS) will review your information and determine whether you qualify for an exemption. An exemption is an approved reason why the requirements do not apply to you. DoHS may contact you if additional information is needed.
Are there any other exceptions?
If you’re facing a medical issue, major life event, or other temporary hardship, you may qualify for a short-term exception. For example, if you:
- Are in the hospital or a nursing home
- Need to travel far for major medical care
- Live in a county with a declared emergency
You may need to tell DoHS if any of these possible exemptions apply to you.
What do I need to do now?
Visit the WV PATH Portal to make sure your contact information is up to date and accurate.
How do I keep my Medicaid coverage?
You may need to complete at least 80 hours of approved community engagement activities each month to keep your Medicaid coverage. Approved work requirements could include:
- Work (or earn at least $580 per month)
- School (Attending at least half-time)
- Job training
- Volunteering
If your work is seasonal, your average earnings over six months must be at least $580 per month (or $6,960 per year).
You can mix and match activities to reach 80 hours per month. For example, you can:
- Work 50 hours as a barista and volunteer 30 hours at a local food bank
- Be enrolled in an electrician program at least half-time
- Volunteer 72 hours with an animal shelter and work 8 hours as a grocery clerk
How do I report my work, school, or volunteer activities?
When it's time to renew your West Virginia Medicaid coverage, you may need to report your community engagement activities.
DoHS will first review information it already has. If DoHS needs more information, you'll receive a notice by mail or through your People’s Access to Help (PATH) account explaining what to submit. If you're asked to provide information, be sure to respond within 30 days to avoid delays or potential loss of coverage.
DoHSmay ask for:
- Pay stubs
- School records
- Proof of volunteer hours or work program hours
You can send this information online, in person, or by mail. If DoHS doesn’t contact you, there is nothing you need to submit.
How do I renew my Medicaid coverage?
As Medicaid changes, you may need to renew more often and provide updated information — including work or activity details. You will receive a notice when it’s time to renew your coverage.
Renewing your Medicaid benefits is as easy as Ready. Set. Renew.
Step 1: Ready
Get your information ready before you start. This can help you finish faster and avoid delays.
Step 2: Set
Make sure your form is complete and up to date. You can renew using the option that works best for you:
- Online: Visit West Virginia PATH to complete your renewal.
- By mail: Send your completed forms to the address on your notice.
- In person: Visit a local Department of Human Services office.
- By phone: Call 1-877-716-1212 for help with completing your renewal.
Step 3: Renew
Submit your renewal and wait for updates. You’ll get a notice from the West Virginia DoHS letting you know if your coverage has been renewed.
What if I lose my Medicaid Coverage?
If your Medicaid coverage recently ended, you may still be able to reapply and get your benefits back.
What can I do next?
Follow each step to get your renewal on track.
Step 1: Find out why your coverage ended.
Step 2: Complete your renewal or submit a new application.
Step 3: Submit missing documents:
- Income
- Household
- Work hours
- Proof of exemption
Step 4: Wait for confirmation
What if my situation changes?
Report any changes in your life as soon as possible to DoHS. Certain life changes could affect whether you qualify for Medicaid or need to meet community engagement requirements.
- A change in your income or job
- A new address
- Someone moving in or out of your home
- Family changes including marriage, divorce, pregnancy, or adoption
If the DoHS asks you for information, or if you need to report a change, you can contact the Customer Service Reporting Center:
- By phone: 1-877-716-1212
- By email: osacsrc@wv.gov
- By fax: 304-558-1869
- By mail (U.S. Postal Service): P.O. Box 1668, Charleston, WV 25326-1668
You can also report changes, apply for benefits, and complete reviews through West Virginia PATH.
Resources to help you meet the Medicaid community engagement requirements
If you need help finding work, job training, or other support services, these West Virginia resources may be able to help.
Frequently asked questions (FAQs)
Review our FAQs for additional help with understanding West Virginia Medicaid community engagement requirements.