If your parent's Social Security check is over West Virginia's $2,982 monthly Medicaid income limit, you may have been told they earn too much for long-term-care coverage. That isn't how it works here. West Virginia runs a medically needy spend-down, so a senior over the income standard can still qualify by spending the excess on care.
This guide walks through the 2026 West Virginia Medicaid income limits and asset rules for aged, blind, and disabled residents who need nursing-home or home-based long-term care: the $2,982 income standard, the $2,000 asset cap, how the spend-down actually works, what a nursing-home resident keeps, and what a spouse at home is protected from.
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's 300% of the federal Supplemental Security Income (SSI) benefit rate, which is $994/month in 2026, and most states use that same 300% multiplier for long-term-care eligibility.
Here is where people get the wrong idea. Being over $2,982 does not disqualify a West Virginia applicant. The state is a medically needy state, which means it offers a second door for people whose income runs above the standard. That door is the spend-down.
How the spend-down works
West Virginia also operates a medically needy income limit, and it's low: roughly $200/month for an individual (about $275 for a couple). The gap between that low figure and your actual income is your spend-down amount. Once you've incurred that much in medical and care costs in a given budget period, West Virginia Medicaid covers the rest.
For someone receiving nursing-facility care, this rarely leaves them with 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 picks up 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 told they're simply "too rich" for long-term-care Medicaid.
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 doesn't count toward the $2,000:
- Your home, subject to a home-equity cap (the 2026 limit is $752,000 in equity).
- 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 a bit above the federal floor. 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:
| 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 over $4,000 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.
How to apply in West Virginia
West Virginia Medicaid is administered by the West Virginia Bureau for Medical Services, part of the state Department of Human Services (DoHS, formerly DHHR). You have two main ways to apply:
- Online through WV PATH, the state benefits portal at wvpath.wv.gov, which handles Medicaid alongside other assistance programs.
- By phone at 1-877-716-1212.
Long-term-care applicants also 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're disqualified are not.
Frequently Asked Questions
For nursing-facility and home- and community-based waiver coverage, the 2026 income standard is $2,982/month for a single applicant, equal to 300% of the SSI federal benefit rate. Income above that does not disqualify you: West Virginia is a medically needy state, so you can spend the excess down on care costs to qualify.
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.
West Virginia has a low medically needy income limit (roughly $200/month for an individual). If your income is above the $2,982 standard, the excess becomes a spend-down amount. Once you've 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.
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.
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
- Medicaid Planning Strategies
- How Medicaid Estate Recovery Works
- The Medicaid Personal Needs Allowance, Explained
Find personalized help working through West Virginia Medicaid eligibility and the spend-down for your family at brevy.com.
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.