West Virginia Medicaid Income Limits 2026: Eligibility

The West Virginia Medicaid income limits are not one number. There are two, and most people arrive at the wrong one. If you are helping a parent qualify for nursing-home care, the income test is $2,982 a month, paired with a $2,000 asset cap. If the applicant is under 65 and not disabled, an entirely separate test applies: 138% of the federal poverty level, about $1,835 a month for one person, with no asset test at all.,,

Which West Virginia Medicaid income limit applies to you

West Virginia Medicaid runs two income tests. They use different yardsticks, different dollar figures, and different rules about savings, so the first job is knowing which one you are being measured against.

The SSI-related test, often called the aged, blind, and disabled (ABD) track, governs people 65 and older and people who qualify on disability, including people applying for nursing-facility or waiver long-term care. For nursing-home care its income test is the $2,982 standard, and the track carries an asset limit.,

The MAGI test (Modified Adjusted Gross Income) governs everyone else: adults ages 19 to 65 who are not disabled, parents and caretaker relatives, children, and pregnant women. It is expressed as a percentage of the federal poverty level (FPL), and federal law bars West Virginia from applying any asset test to these groups.,

If the applicant is	The test is	2026 income limit	Asset test
65+, blind, or disabled, or applying for long-term care	SSI-related (ABD)	$2,982/month gross income test for nursing-home care, with a spend-down above it	Yes, $2,000
Under 65, not disabled, not pregnant, not on Medicare	MAGI, expansion adult group	138% FPL, about $1,835/month for one person	No
A parent or caretaker relative	MAGI, Section 1931 group	16% FPL per the federal table; most qualify through the 138% adult group instead	No
A child under 19	MAGI	138% to 163% FPL, depending on age	No
Pregnant	MAGI	190% FPL	No

The long-term-care rules come first below, then the MAGI limits in detail.,

The income limit is a standard, not a wall

For nursing-facility coverage, West Virginia's Income Maintenance Manual runs a gross income test that compares income to 300% of the maximum SSI payment for one person: $2,982/month in 2026. The base is the federal Supplemental Security Income (SSI) benefit rate, $994/month in 2026. That 300% is not a national limit: federal rules tie matching funds to it, and each state sets its own standard.,

West Virginia's waiver programs, including the Aged and Disabled Waiver, also carry financial and asset limits, so ask the county DoHS office which income test applies to a waiver application.

Being over $2,982 does not by itself disqualify a West Virginia nursing-home applicant. The state's manual sends the worker on to a spend-down, covered next.

How the spend-down works

When income is over $2,982, West Virginia's Income Maintenance Manual has the worker test the applicant under SSI-Related Medicaid next, which sets a monthly spend-down amount. For a nursing-home resident, once the facility's monthly Medicaid rate equals or exceeds that spend-down, the spend-down is treated as met and Medicaid eligibility is established. Outside a nursing home, the West Virginia Bureau for Medical Services says some applicants over the income limit can still qualify through spend-down; the local DoHS worker explains how.

A resident who qualifies still contributes income toward care, with some allowance for a spouse at home, and Medicaid pays the rest. So a senior with a solid Social Security check and a pension is not shut out merely for having income over $2,982.

The $2,000 asset limit and what doesn't count

Separate from income, West Virginia limits a single long-term-care applicant to $2,000 in countable assets. When both spouses are applying, the limit is $3,000.

"Countable" is the word that matters. West Virginia is not a more restrictive 209(b) state, so federal rules have it use SSI financial methods for aged, blind, and disabled applicants, and SSI rules leave several things out of the count., The home is the most important, subject to a federal home-equity limit that starts at $752,000 of equity in 2026 (a state may set it as high as $1,130,000).,

So owning a home and a car does not by itself put an applicant over the $2,000 limit., A common mistake is for families to assume the house must be sold before Medicaid will help. SSI rules don't count the home the applicant lives in, and the equity limit does not apply at all while a spouse, a child under 21, or a blind or disabled child lives there., If no one else lives in the house after a nursing-home move, ask the county DoHS office how it is treated.

Long-term care: what a nursing-home resident keeps

When West Virginia Medicaid pays for nursing-facility care, the resident contributes nearly all of their monthly income toward the cost of that care. What they keep for themselves is the Personal Needs Allowance (PNA): in West Virginia, $50/month ($90, in place of the $50, for someone receiving the reduced $90 VA pension)., That money is the resident's own, for personal expenses.

The PNA is modest by design, and West Virginia's $50 sits above the federal floor of $30/month. For the national picture on how the allowance works and how the rest of a resident's income is applied, see our explainer on the Medicaid personal needs allowance.,

The five-year look-back

West Virginia reviews asset transfers made in the 60 months before a long-term-care application., Giving away money or property for less than fair market value during that window, such as gifting a grandchild a down payment or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid won't pay for long-term-care services even though the applicant is otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. For the broader toolkit, see our guide to Medicaid planning strategies.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains at home, federal spousal-impoverishment rules keep the at-home spouse from being left without resources. West Virginia protects some of a couple's assets for the community spouse, but its Income Maintenance Manual has not been updated to the 2026 federal resource standards and still uses a substantially lower cap. The 2026 figures below are federal; a state elects its own standard within the federal range, so confirm West Virginia's with the county DoHS office.,,

Protection	2026 Amount	What it does
Community spouse resource standard	Federal range: $32,532 minimum to $162,660 maximum	The state elects its standard in this range, which sets how much of the couple's countable assets the at-home spouse keeps; a fair hearing or court order can set more.
Minimum Monthly Maintenance Needs Allowance (MMMNA)	Minimum $2,705.00/month (effective 7/1/2026); maximum $4,066.50/month (effective 1/1/2026)	A floor the at-home spouse's income is raised to, not a cap on it: income can be shifted from the applicant to reach the floor, and a spouse already above it keeps all of her own income. A fair hearing can raise it for exceptional financial duress.
Home-equity limit	$752,000 (federal minimum)	Above the applicable limit the applicant is not eligible for long-term-care assistance (a state may elect a higher limit, up to $1,130,000), but the limit does not apply at all while a spouse lives in the home.

So a married couple is in a very different position from a single applicant. Under the federal standards the community spouse can generally hold up to $162,660 in countable assets (more only through a fair hearing or court order), and none of her own income is counted as available to the spouse receiving Medicaid-funded care. Income is shifted from the applicant to lift her to the $2,705.00 floor; the standard maximum for that allowance is $4,066.50, which a fair hearing can raise in cases of exceptional financial duress.

After death: estate recovery

Like every state, West Virginia runs a Medicaid estate-recovery program. BMS states that Medicaid paid for long-term-care services, and related hospital and prescription drug services, for people 55 or older must be recovered, and recovery also reaches people deemed permanently institutionalized after notice and a chance for a hearing. An heir can apply for a hardship waiver. Federal law also sets timing limits: recovery can happen only after a surviving spouse has died, and not while there is a surviving child under 21 or a blind or permanently and totally disabled child. For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

The other test: West Virginia Medicaid income limits under MAGI

Everything above concerns the SSI-related track, the one a senior entering long-term care is measured against. The rest of West Virginia Medicaid runs on MAGI, and none of the asset rules above apply to it.

West Virginia publishes its 2026 MAGI limits as percentages of the federal poverty level. For one person in 2026, 100% FPL is $15,960 a year, which HHS publishes as an annual figure, under the guidelines that cover the 48 contiguous states and the District of Columbia (HHS publishes separate figures for Alaska and Hawaii).

Adults ages 19 to 65

West Virginia has adopted the ACA Medicaid expansion, so it covers adults ages 19 to 65 up to 138% FPL: about $1,835 a month for one person.,

The federal statute writes this group, the "new adult group," at 133% FPL, for people under 65 who are not pregnant and not entitled to or enrolled in Medicare. A 5-percentage-point income disregard applies on top of that, which is why the effective ceiling everyone quotes is 138%.

That 5-point disregard also explains a discrepancy families hit when they compare charts. West Virginia's own published 2026 figures are gross standards that already fold the disregard in. The federal medicaid.gov MAGI-conversion table lists the same groups as net standards, before the disregard. Each state figure sits exactly 5 points above its federal counterpart: the state's 138% adult limit is the table's 133%, the state's 163% infant limit is the table's 158%, and so on down the chart. The two sources are not in conflict; they describe the same underlying levels.

There is no asset test. Federal law bars West Virginia from applying any asset or resource test to the MAGI groups. The $2,000 limit at the top of this page is an SSI-related rule, and it does not reach an adult qualifying through the expansion group, whatever they hold in the bank.

Parents and caretaker relatives

Parents and other caretaker relatives are their own federally mandatory Medicaid group, and it is the group a grandparent raising a grandchild would look to. Whether a particular grandparent meets the definition of a caretaker relative is a determination for the state agency, so ask the West Virginia Bureau for Medical Services rather than assuming it either way.

The income standard for this group is unusually low, and the reason is structural. Federal law does not peg it to the poverty level the way it pegs children and the expansion adults. Under 42 CFR 435.110, the state sets the standard inside a federal floor and ceiling. The floor is the state's own cash-welfare (AFDC) income standard as it stood on May 1, 1988, converted to a MAGI equivalent. The ceiling is the higher of the state's 2010 or 2013 coverage level for this group or its July 16, 1996 AFDC standard, which a state may raise by no more than inflation. So the yardstick traces back to an old welfare standard rather than to a current poverty measure, and the number to check is the state's own published standard. The federal MAGI-conversion table puts West Virginia's parent and caretaker-relative standard at 16% FPL.

That figure matters less in West Virginia than it would elsewhere. The AFDC-based standard does its real work in states that did not adopt the ACA expansion, where it, not a poverty-level percentage, decides whether a working parent qualifies. Because West Virginia did expand, a low-income parent or caretaker relative under 65 generally qualifies through the 138% adult group instead.

One more thing differs on this track: who counts as the household. MAGI households generally follow federal tax-filing relationships, so whether a grandchild is claimed as a tax dependent can change both the household size and whose income is counted. The ABD track uses different household rules for the same family.

Children and pregnant women

For household completeness, West Virginia's 2026 chart sets these limits:

Two notes travel with the state's chart. A pregnant applicant counts as a household of at least two, including the unborn baby. And the chart is general guidance, not an eligibility decision, so check your own figures with your county DoHS office.

Coverage of children under 19 is federally mandatory at a floor of 133% FPL, and states may set higher standards, which is what West Virginia has done for the younger age bands. Separate CHIP coverage for children extends to 300% FPL per the federal table.

What changes on the 65th birthday

This is the transition that catches West Virginia families, because nothing about the person's money has to change for their coverage to change.

The expansion adult group is written for people under 65 who are not enrolled in Medicare. On the 65th birthday that pathway closes, and the same person is assessed on the SSI-related ABD track instead. Two things change at once:

The income yardstick changes. It stops being 138% FPL, about $1,835 a month, and becomes the SSI-related standards, which are built on the SSI Federal Benefit Rate of $994 a month for an individual.,
A resource test appears. The MAGI groups are barred from having one; the ABD track is not, and West Virginia's resource level is $2,000 for one person.,

So a 64-year-old covered at $1,600 a month with a few thousand dollars saved can find at 65 that the income yardstick has moved and that savings above $2,000 now count against them, without a dollar of income changing.

The same door closes early for someone under 65 who reaches Medicare through disability, because the adult group also excludes anyone entitled to or enrolled in Medicare.

Neither case leaves a person without options, but the options are the ones described earlier on this page rather than the MAGI ones, starting with the spend-down. If the person is also on Medicare, see our guide to West Virginia Medicaid premium and cost-sharing help.

How to apply, and what the West Virginia Medicaid income limits mean for your application

West Virginia Medicaid is administered by the West Virginia Bureau for Medical Services, part of the state Department of Human Services (DoHS). There are several ways to apply, and long-term-care applicants must also meet medical criteria.

Step 1

Apply online through WV PATH

Submit the Medicaid application through WV PATH, the state benefits portal, which BMS calls the recommended way to apply for most types of healthcare.

Step 2

Or apply by phone, by mail, or in person

The DoHS hotline at 1-877-716-1212 takes applications for some types of Medicaid. You can also mail a completed application to your local county office or apply there in person.

Step 3

Meet the medical criteria

Long-term-care applicants must meet medical criteria as well as the financial and asset limits. Apply even if you think the income is too high: income over the $2,982 limit is not by itself a bar to nursing-home Medicaid.

If an application is denied, you have the right to a fair hearing before the West Virginia Board of Review. You can ask for one within 90 days of the effective date of the action, by phone, mail, email, or the Board's online form, and a mailed request counts as on time if it is postmarked within the deadline.

Frequently Asked Questions

What are the West Virginia Medicaid income limits in 2026?

There are two, and which applies depends on the applicant. For someone 65 or older, blind, or disabled, the SSI-related track applies; for nursing-home care its 2026 income test is $2,982/month, equal to 300% of the SSI federal benefit rate of $994, with a $2,000 asset limit. Income above it does not by itself disqualify a nursing-home applicant: West Virginia then sets a monthly spend-down, met once the facility's monthly Medicaid rate equals or exceeds it. For an adult under 65 who is not disabled, the MAGI test applies instead: 138% of the federal poverty level, about $1,835/month for one person, with no asset test.,,,,

What is the West Virginia Medicaid income limit for an adult under 65?

West Virginia has adopted the ACA Medicaid expansion, so it covers adults ages 19 to 65 with household income up to 138% of the federal poverty level, about $1,835/month for one person in 2026. The group is limited to people who are not pregnant and not entitled to or enrolled in Medicare, and federal law bars any asset test on it, so the $2,000 asset limit that applies to long-term-care applicants is irrelevant here. Eligibility is based on household MAGI and household size.,,,

Can Medicaid stop when someone turns 65 in West Virginia?

Yes, and it is a common surprise. The 138% FPL expansion adult group covers only people under 65 who are not enrolled in Medicare, so the pathway closes on the 65th birthday. The person is then assessed on the SSI-related track, where the income standards are built on the $994/month SSI federal benefit rate rather than on 138% FPL, and where a $2,000 resource test applies that the MAGI groups are barred from using. Income does not have to change for eligibility to.,,,

What is the West Virginia Medicaid asset limit?

A single long-term-care applicant is limited to $2,000 in countable assets; a married couple with both spouses applying is limited to $3,000. Under SSI rules the home (subject to a federal equity limit that starts at $752,000 in 2026), one vehicle used for transportation, household goods and personal effects, and burial spaces don't count.,,

How does the West Virginia Medicaid spend-down work?

Above the $2,982 test, West Virginia sets a monthly spend-down under SSI-Related Medicaid; for a nursing-home resident it is met, and eligibility established, once the facility's monthly Medicaid rate equals or exceeds it. Outside a nursing home, the local DoHS worker explains how spend-down applies to you.

How much can a spouse keep when the other goes into a nursing home?

Under the 2026 federal standards, the at-home (community) spouse can generally keep up to $162,660 in countable assets (more only through a fair hearing or court order), and none of her own income counts toward the applicant. The Minimum Monthly Maintenance Needs Allowance is the income floor she is protected to, not a cap on her: if her own income is below $2,705.00 a month, income can be shifted from the applicant to reach it, up to a standard maximum of $4,066.50. The home-equity limit does not apply at all while she lives in the home., West Virginia's own manual still uses a much lower cap, so confirm the figure with the county DoHS office.

What does a nursing-home resident on West Virginia Medicaid keep each month?

A Personal Needs Allowance of $50/month for personal expenses ($90, in place of the $50, for someone receiving the reduced $90 VA pension). The rest of the resident's monthly income goes toward the cost of care, after deductions such as a maintenance allowance for a spouse at home and certain health-insurance premiums.,

Learn More

Find personalized help working through West Virginia Medicaid eligibility and the spend-down for your family at brevy.com.

References

Cited in this article

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Also reviewed

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wvdhhr.org. (n.d.). West Virginia Income Maintenance Manual, Chapter 17.10 — Long Term Care: Assets (LTC asset level = SSI-Related standard, community-spouse asset attribution steps, 60-month look-back); WV DoHS/DHHR own-site PDF copy — dhhr.wv.gov is WAF-blocking retrieval. Retrieved Sep 6, 2026, from https://www.wvdhhr.org/bcf/policy/imm/new_manual/immanual/manual_pdf_files/chapter_17/ch17_10.pdf
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