Find a plan.
West Virginia dental insurance guide 2022

West Virginia dental insurance guide 2022

West Virginia's health insurance marketplace has certified individual and family dental plans from one insurer

Dental insurance in West Virginia

West Virginia uses the federally facilitated health insurance marketplace HealthCare.gov for the sale of certified individual/family dental plans.

Not all insurers who offer medical plans through the West Virginia exchange include dental coverage with their health plans, but stand-alone dental plans are available for purchase that cover both adults and children.

How much does dental insurance cost in West Virginia?

For adults who purchase their own stand-alone or family dental coverage through the exchange, premiums range from $24 to $56 per month.

IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in West Virginia over a two-year period (2020-2021) was $39.78. (Typical family size was 1.2 to 1.4 persons.)

If a family is purchasing coverage through the West Virginia health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). Here’s more about how that works, depending on whether the health plan has integrated pediatric dental benefits.

Pediatric dental benefits in West Virginia

The pediatric stand-alone dental policies available on the West Virginia marketplace will comply with the ACA’s pediatric dental coverage rules. For residents, this means out-of-pocket costs for children’s dental care will not exceed $375 per child in 2022 (or $750 for all the children on a family’s plan), and there isn’t a cap on medically-necessary dental services.

As is the case for all essential health benefits, the specific coverage requirements for pediatric dental care are guided by the state’s essential health benefits benchmark plan.

You can see details here for West Virginia’s benchmark plan, which does include coverage for both basic and major dental services for children.

One insurer offers stand-alone dental plans through the West Virginia exchange

In 2022, there is only one insurer offering stand-alone individual/family dental coverage through the health insurance marketplace in West Virginia. These are dental plans that are not included with a medical plan and must be purchased separately:

  • Delta Dental PPO

These plans can be purchased through HealthCare.gov during open enrollment (November 1 to January 15) or during a special enrollment period triggered by a qualifying life event. Exchange-certified stand-alone dental plans are compliant with the ACA’s rules for pediatric dental coverage.

Can I buy dental insurance outside of West Virginia’s exchange?

There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in the Mountain State. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the West Virginia Offices of the Insurance Commissioner. If you would like to purchase a non-ACA qualified dental plan, ask a dentist for recommendations or search online.

In West Virginia, there are also various dental discount plans available. Dental discount plans are not insurance, but can offer discounted rates at participating dentists. Here’s what you need to know about the differences between dental insurance and dental discount plans.

To find plans in your area, search online for dental discount plans and the state you are looking to buy a plan in.

Medicaid/CHIP dental coverage in West Virginia

Adults enrolled in Medicaid in West Virginia are eligible for emergency dental services only, such as procedures to treat fractures, pain or infection. Children enrolled in Medicaid are eligible to receive more comprehensive dental services up to the age of 21.

WVCHIP, which is West Virginia’s CHIP, provides coverage for a broad range of dental services to uninsured children and pregnant women with income above the eligibility limits for Medicaid.

Dental resources in West Virginia

  • West Virginia Dental Association
  • West Virginia free or low cost dental clinics
  • West Virginia Medicaid
  • HealthCare.gov

Related articles

Here's what you need to know when you're shopping for adult dental coverage through a state health insurance marketplace or directly from a dental plan carrier.
There is no penalty for not having pediatric dental on your policy – and in most exchanges, you can purchase a plan without pediatric dental. But off-exchange, carriers are required ...
If you're an adult who bought a dental insurance plan, your out-of-pocket costs will depend entirely on the amount of dental care you need during the year. But for children, ...
For those who purchase their own insurance, the decision to purchase dental coverage is not always as clear-cut as the decision to purchase health insurance.
Pediatric dental is one of the essential health benefits, although it’s a bit more complicated than the other nine. Some medical policies have pediatric dental embedded in the plan, and ...
Dental insurance and dental discount plans can both be useful in terms of reducing your total dental costs, but they vary significantly in terms of the benefits you get and ...

Other types of coverage

Individual and Family
Short-term
Medicaid
Medicare

West Virginia health insurance marketplace 2023 guide

West Virginia's exchange has two insurers offering plans for 2023. Premiums are much higher than the national average in WV. But the American Rescue Plan's additional subsidies made coverage more affordable, and subsidies became even larger in 2022 due to silver loading the cost of CSR.

Compare plans!
West Virginia health insurance marketplace 2023 guide

Short-term health insurance in West Virginia

View plan availability in your state.
Short-term health insurance in West Virginia

West Virginia and the ACA’s Medicaid expansion

West Virginia’s leaders opted to expand Medicaid under the ACA as of January 1, 2014, and a 64% increase in enrollment has followed. West Virginia also expanded its CHIP coverage in 2019 to include pregnant women.

See if you're eligible.
West Virginia and the ACA’s Medicaid expansion

Medicare in West Virginia

For all information on Medicare in West Virginia, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.

Compare plans!
Medicare in West Virginia

Learn about health insurance coverage options in your state.

Our state guides offer up-to-date information about ACA-compliant individual and family plans and marketplace enrollment; Medicaid expansion status and Medicaid eligibility; short-term health insurance regulations and short-term plan availability; and Medicare plan options.