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 or in-home care, the number that governs 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.,,

This guide covers both. It starts with the long-term-care rules for aged, blind, and disabled residents: the $2,982 income standard, the $2,000 asset cap, how West Virginia's medically needy spend-down lets a senior over the standard still qualify, what a nursing-home resident keeps, and what a spouse at home is protected from. It then walks through the MAGI limits that govern adults under 65, parents and caretaker relatives, children, and pregnant women.,

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 everyone applying for nursing-facility or waiver long-term care. That is the $2,982 standard, and it 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 for a single long-term-care applicant, 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 and home- and community-based waiver coverage, West Virginia sets its 2026 income standard at $2,982/month for a single applicant. That figure is not arbitrary: it is 300% of the federal Supplemental Security Income (SSI) benefit rate, which is $994/month in 2026. The 300% multiplier is the standard most states use for institutional long-term-care eligibility.,

Being over $2,982 does not disqualify a West Virginia applicant. West Virginia is a medically needy state, so it offers a second pathway for people whose income runs above the standard. That pathway is the spend-down.

How the spend-down works

West Virginia also operates a medically needy income limit, and it is low: $200/month for an individual ($275 for a couple). The gap between that figure and your actual income is your spend-down amount. Once you have incurred that much in medical and care costs in a given budget period, the West Virginia Bureau for Medical Services covers the rest.

For someone receiving nursing-facility care, this rarely leaves an unaffordable gap, because nursing-home charges themselves are an incurred medical cost. A resident with income above the standard contributes most of that income toward care, and Medicaid pays the remainder of the bill. The practical effect: even a senior with substantial Social Security and a pension can reach eligibility through the spend-down rather than being shut out of long-term-care coverage for having too much income.

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, because a long list of assets is exempt and does not count toward the $2,000 limit. The home, subject to a federal home-equity cap of $752,000 in equity for 2026, is the most important exemption.,

Your home, subject to the $752,000 equity cap above.
One vehicle, regardless of value, when used for transportation.
Household goods and personal effects.
Prepaid burial arrangements.

So the $2,000 applies to things like bank accounts, a second car, and investments, not the roof over a person's head. A common mistake is for families to assume the house must be sold before Medicaid will help. In most cases the primary residence is exempt while the applicant lives there or intends to return, and a community spouse living in it keeps it protected.

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., That money is reserved for small personal expenses a facility doesn't cover, such as clothing, a haircut, or a phone.

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 applies the federal figures for 2026, including the $752,000 home-equity cap:,

Protection	2026 Amount	What it does
Community Spouse Resource Allowance (CSRA)	Half the couple's countable assets, up to $162,660; minimum $32,532	The most in countable assets the at-home spouse may keep, separate from the applicant's $2,000 limit.
Minimum Monthly Maintenance Needs Allowance (MMMNA)	Up to $4,066.50/month	The most monthly income the at-home spouse may keep; income can be shifted from the applicant to reach it.
Home-equity limit	$752,000	Equity in the primary residence above this amount is countable for long-term-care eligibility.

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets and keep up to $4,066.50 a month in income while the other spouse receives Medicaid-funded care.

After death: estate recovery

Like every state, West Virginia runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, with the federally mandated exceptions (a surviving spouse, or a minor, blind, or disabled child) and an undue-hardship waiver., 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, or about $1,330 a month, under the guidelines that cover the 48 contiguous states and the District of Columbia (Alaska and Hawaii run on separate, higher guidelines).

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 mandatory floor is the state's own cash-welfare (AFDC) income standard as it stood on May 1, 1988, converted to a MAGI equivalent, which is typically far below the poverty level. The statute behind that rule, Social Security Act §1931, ties the group to the state's AFDC eligibility criteria as they were in effect on July 16, 1996, before welfare reform. Either way, the yardstick is a decades-old welfare standard rather than a current poverty measure. 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 frozen-AFDC floor bites hardest in states that did not adopt the ACA expansion, where a working parent can be over the income limit at a very low income. 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 household size and composition 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:

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:

So a 64-year-old covered at $1,600 a month with modest savings can be over both tests at 65 without a dollar of income changing. The limit drops beneath them, and an asset test that never legally applied to them appears.

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 West Virginia's medically needy 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, formerly DHHR). There are two main ways to apply, and long-term-care applicants complete one extra step.

Step 1

Apply online through WV PATH

Submit the Medicaid application through WV PATH, the state benefits portal, which handles Medicaid alongside other assistance programs.

Step 2

Or apply by phone

Call the Bureau for Medical Services at 1-877-716-1212 to start an application or ask which documents you need.

Step 3

Complete the level-of-care screening

Long-term-care applicants go through a medical level-of-care screening to confirm they need nursing-facility-level services. Apply even if you think the income is too high: between the $2,982 standard and the medically needy spend-down, many people who assume they are disqualified are not.

If an application is denied, you have the right to request a fair hearing. The denial notice states the deadline (generally within 90 days of the notice) and how to file the appeal; submit the request to the agency in writing before that deadline so an administrative law judge can review the decision.

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, or anyone seeking nursing-facility or waiver long-term care, the 2026 standard is $2,982/month for a single applicant, equal to 300% of the SSI federal benefit rate of $994, with a $2,000 asset limit. Income above it does not disqualify you: West Virginia is a medically needy state, so you can spend the excess down on care costs. 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 yardstick is the $994/month SSI federal benefit rate rather than 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. The home (subject to a $752,000 equity cap), one vehicle, household goods, and prepaid burial arrangements are exempt from the count.,

How does the West Virginia Medicaid spend-down work?

West Virginia has a low medically needy income limit, $200/month for an individual. If your income is above the $2,982 standard, the excess becomes a spend-down amount. Once you have incurred at least that much in medical and care costs in a budget period, Medicaid covers the rest. For nursing-home residents, the care charges themselves usually satisfy the spend-down.

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

For 2026, the at-home (community) spouse can keep up to $162,660 in countable assets (the Community Spouse Resource Allowance, minimum $32,532) and monthly income up to $4,066.50 (the Minimum Monthly Maintenance Needs Allowance). The home is also generally protected up to $752,000 of equity.,

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

A Personal Needs Allowance of $50/month for small personal expenses. The rest of the resident's monthly income goes toward the cost of care, after deductions for a community spouse 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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Centers for Medicare & Medicaid Services. (2023). Medicaid.gov — Medicaid, CHIP & Basic Health Program Eligibility Levels (national MAGI-conversion table; December 1, 2023 snapshot). medicaid.gov. Retrieved Jul 14, 2026, from https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels
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U.S. Government Publishing Office. (n.d.). 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) and (e)(14) — State plans for medical assistance (Social Security Act §1902), govinfo USCODE Title 42. govinfo.gov. Retrieved Jun 26, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2022-title42/html/USCODE-2022-title42-chap7-subchapXIX-sec1396a.htm
U.S. Government Publishing Office. (n.d.). 42 CFR 435.110 — Parents and other caretaker relatives (Mandatory Coverage), eCFR. ecfr.gov. Retrieved Jul 15, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-B/subject-group-ECFR5862e2658e2b5d6/section-435.110
U.S. Government Publishing Office. (n.d.). 42 CFR 435.603(f) — Household (Application of modified adjusted gross income), eCFR. ecfr.gov. Retrieved Jul 15, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-I/subject-group-ECFRea9a5b3f889febd/section-435.603
U.S. Government Publishing Office. (n.d.). 42 CFR 435.118 — Coverage of children under age 19 (Mandatory Coverage), eCFR. ecfr.gov. Retrieved Jul 15, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-B/subject-group-ECFR5862e2658e2b5d6/section-435.118

Also reviewed

dhhr.wv.gov. (n.d.). West Virginia Income Maintenance Manual, Chapter 17.9 — Long Term Care: Income (gross income test + post-eligibility PNA). Retrieved Jun 24, 2026, from https://dhhr.wv.gov/bcf/Services/familyassistance/PolicyManual/Documents/Chapter%2017/ch17_9.pdf
wvdhhr.org. (n.d.). West Virginia Income Maintenance Manual, Chapter 10 Appendix A — Income Limits (MNIL $200/$275); wvdhhr.org. Retrieved Jun 24, 2026, from https://www.wvdhhr.org/bcf/policy/imm/immanualchanges/556/ch10_apa.pdf
wvdhhr.org. (n.d.). West Virginia Income Maintenance Manual, Chapter 17.9 — Long Term Care: Income (independent wvdhhr.org mirror; corroborates PNA $50 + 300% SSI test). Retrieved Jun 24, 2026, from https://www.wvdhhr.org/bcf/policy/imm/new_manual/immanual/manual_pdf_files/chapter_17/ch17_9.pdf
bms.wv.gov. (2026). West Virginia Bureau for Medical Services (DoHS) — Your Guide to Medicaid 2026 (MAGI income-limits table). Retrieved Jul 15, 2026, from https://bms.wv.gov/media/41130/download?inline=
U.S. Government Publishing Office. (n.d.). 42 CFR 435.603(g) - No resource test or income disregards for individuals whose financial eligibility is determined using MAGI. ecfr.gov. Retrieved Jul 16, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-435/subpart-G/section-435.603
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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