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View our comprehensive guides to coverage in West Virginia.

Individual and Family

The American Rescue Plan's premium-cutting subsidies

Find out how the American Rescue Plan and Inflation Reduction Act have reduced marketplace health insurance costs for West Virginians from Charleston, to Wheeling, Morgantown, and beyond. Enroll during open enrollment (November 1 to January 15 in West Virginia) or during a special enrollment period if you experience a qualifying life event.

Learn about Marketplace insurance in West Virginia

Short-term coverage in West Virginia

Consumers in West Virginia can purchase short-term health insurance plans with initial durations up to 364 days, and total duration – including renewals – of up to 36 months. Read more about short-term health insurance in West Virginia.

View short-term health insurance in West Virginia

Medicaid in West Virginia

West Virginia opted to expand Medicaid eligibility under the Affordable Care Act in 2014. Learn more about Medicaid expansion in West Virginia.

Learn more about Medicaid in West Virginia

Medicare enrollment in West Virginia

There were 444,923 West Virginia residents enrolled in Medicare as of late 2022, amounting to about a quarter of the state’s total population. Learn more about Medicare coverage in West Virginia.

View our West Virginia Medicare enrollment guide

Flexible dental benefits. Fast approval.

Protect yourself from the soaring costs of dental procedures. Compare plan options to see premiums and deductibles that fit your budget.

Compare dental insurance in West Virginia

Frequently asked questions about health insurance coverage options in West Virginia

The West Virginia health insurance marketplace/exchange is a partnership exchange, which means individuals and families enroll in plans through The enrollment site is run by the federal government, with the state overseeing the qualified health plan certification process for the plans that are offered in West Virginia. The marketplace was established by the Affordable Care Act.

You can use the marketplace to enroll in healthcare for yourself or your family and to see if you qualify for premium subsidies or cost-sharing reductions (CSR) to help you pay for monthly premiums and other costly out-of-pocket expenses (like a deductible or copay). The health insurance marketplace is a good option for people who are self-employed, retired prior to Medicare eligibility, or employed by a business that doesn’t provide health insurance coverage.

Read our overview of the West Virginia health insurance marketplace.

The open enrollment period for individual/family health coverage runs from November 1 to January 15 in West Virginia.

Outside of the annual open enrollment window, you’ll need a special enrollment period to enroll or make a change to your coverage. Most special enrollment periods are linked to qualifying life events, but there are some special enrollment periods (such as the enrollment opportunity for Native Americans, or for people earning under 150% of the poverty level) that don’t depend on experiencing a specific life event.

If you have questions about enrollment opportunities, you can read more in our comprehensive guide to open enrollment and our comprehensive guide to special enrollment periods.

In West Virginia, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA Marketplace ( 95% of West Virginia’s exchange enrollees were receiving premium subsidies as of early 2022, and the subsidies averaged over $1,000 per month, covering the vast majority of most enrollees’ total premiums.

West Virginians may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in West Virginia.

For people who aren’t eligible for marketplace premium subsidies or Medicaid, short-term health insurance is also a lower-cost coverage option in West Virginia, where at least eight insurers offer short-term plans.

West Virginia’s health insurance marketplace continues to offer plans from two carriers, both of which offer coverage statewide:

  • Highmark
  • CareSource

Health Plan of West Virginia (Optum) also offers ACA-compliant coverage in the state, but only outside the exchange (and their enrollment is very low).

Overall average rates for health plans sold in West Virginia’s exchange increased by about 5% for 2023, after growing by nearly 13% the year before. The following average 2023 rate changes were approved for West Virginia’s marketplace insurers:

  • CareSource: 11.9% average increase
  • Highmark: 0.9% average increase

But many residents may have found that their coverage became more affordable starting in 2022 than it was in previous years.

Beginning with the 2022 plan year, West Virginia regulators instructed insurers to start adding the cost of cost-sharing reductions (CSR) to silver plan rates, instead of spreading the cost across rates for all plans (West Virginia had been one of just three states taking that approach through 2021). The result is that silver plan rates became disproportionately larger starting in 2022, which result in larger premium subsidies as well (subsidies are based on the price of the second-lowest-cost silver plan). 

The combination of enhanced premium subsidies under the American Rescue Plan (extended through the end of 2025 by the Inflation Reduction Act) and the silver-loading approach to CSR result in larger subsidies and more affordable coverage for enrollees who receive subsidies.

There are very few West Virginia enrollees who don’t qualify for subsidies. The American Rescue Plan temporarily eliminated the income cap for subsidy eligibility and the Inflation Reduction Act extended that through the end of 2025. And the state’s highest-in-the-nation full-price premiums (an average of $1,152 per month in 2022) mean that nearly all enrollees qualify for subsidies.

During the open enrollment period for 2023 coverage, 28,325 people enrolled in private plans through West Virginia’s exchange. That was the highest enrollment had been since 2017

Read more about West Virginia’s health insurance exchange.

As a result of the Affordable Care Act, the uninsured rate in West Virginia declined from 14% in 2013 to just 5.3% in 2016, according to U.S. Census data. But it had increased to 6.7% by 2019, in line with a nationwide trend of increasing uninsured rates under the Trump administration. (For perspective, the national average uninsured rate in 2019 was 9.2%).

A large part of the reason for West Virginia’s lower-than-average uninsured rate is the state’s decision to accept federal funding for Medicaid expansion under the ACA.

Nearly 190,000 people were enrolled as of mid-2021 under the expanded eligibility guidelines in West Virginia. And total Medicaid/CHIP enrollment in West Virginia has grown by 81% since the fall of 2013, due in large part to the ACA’s Medicaid expansion as well as the COVID-related continuous coverage rule that prevented Medicaid disenrollments between March 2020 and March 2023.

Read more about Medicaid and Medicaid expansion in West Virginia.

In addition, 95% of West Virginia’s Marketplace/exchange enrollees receive federal premium subsidies that amount to an average of more than $1,000 per month. This helps to make coverage affordable for thousands of residents who don’t have access to Medicaid, Medicare, or an employer’s health plan.

Sen. Joe Manchin is the only Democratic member of West Virginia’s Congressional delegation, and the only one who supports the ACA.

Although Senator Shelly Capito has taken a more moderate stance than many of her fellow Republican Senators, she ultimately voted in favor of all of the Better Care Reconciliation Act and “skinny repeal” in July 2017, although she voted against the Obamacare Repeal Reconciliation Act. Capito voted in favor of the tax reform bill that passed the Senate in early December 2017, which included some of the provisions of the “skinny repeal” bill, including repeal of the ACA’s individual mandate.

In the House of Representatives, both of West Virginia’s representatives are Republicans, and opposed to the ACA.

Gov. Jim Justice won the 2016 gubernatorial election in West Virginia. Justice ran as a Democrat (albeit a conservative one, intent on reviving the coal mining industry in West Virginia), and won despite the fact that the state overwhelmingly voted for Donald Trump for president. In August 2017, however, Justice announced that he was switching to the Republican party. While he was a Democrat, Justice had voiced his opposition to the US House legislation that would have repealed the ACA.

The previous governor, Democrat Earl Ray Tomblin took office in 2010 (replacing Manchin, who left the Governor’s office for the Senate), and was generally supportive of the ACA. He opted to expand Medicaid, which has had a huge impact on the uninsured rate in West Virginia. But Tomblin was term-limited, and could not run again in 2016.

West Virginia operates a partnership exchange with the federal government, using as their portal for residents to select plans. They opted for this route instead of running their own exchange, because they felt that they would get more bang for their buck by expanding Medicaid and letting HHS handle the operational aspect of the exchange. The state has frequently been held up as an example of how successful Medicaid expansion can be when implemented well.

West Virginia opted to expand Medicaid eligibility under the Affordable Care Act in 2014. Under the new eligibility guidelines, West Virginia’s total Medicaid/CHIP enrollment was 81% higher by late 2022 than it had been in 2013, prior to the expansion of Medicaid (the growth was due to both the expansion of Medicaid and the COVID-related ban on Medicaid disenrollments between March 2020 and March 2023.

Total Medicaid/CHIP enrollment, including people who were eligible under the pre-ACA rules, stood at 640,820 by November 2022; it had been at around 510,000 in the spring of 2020. 

West Virginia expanded CHIP in 2019 to include coverage for pregnant women.

Read more about West Virginia’s Medicaid expansion.

Starting in October 2018, new federal rules regarding short-term insurance allow plans to have initial durations of up to 364 days, and renewals are permitted as long as the total duration of the coverage doesn’t exceed 36 months. Since West Virginia does not have regulations pertaining to the maximum duration for short-term health plans, the state defaults to the federal rules.

The Biden administration is expected to propose rule changes in the spring of 2023 that would roll back or change some of the flexibilities that the Trump administration created for short-term health plans.

Read more about short-term health insurance in West Virginia.

There were  444,923 West Virginia residents enrolled in Medicare as of late 2022. That’s about a quarter of the state’s total population; nationwide, about 19% of Americans are covered by Medicare.

The state has a relatively high percentage of individuals who qualify for Medicare due to disability, at about 17% (the other 83% are eligible due to being at least 65 years old). Nationwide, about 12% of Medicare beneficiaries are under 65 and eligible due to a disability.

Read more about Medicare in West Virginia, including the state’s rules for Medigap plans.

From 2005 until 2014, West Virginia did have a high-risk pool. Prior to Obamacare, in nearly every state, applicants’ medical history could prevent them from obtaining coverage in the private individual insurance market, or could result in significantly higher premiums or pre-existing condition exclusions. Thirty-five states – including West Virginia – took it upon themselves to create their own high-risk pools (not to be confused with the PICP risk pools created by the ACA in 2010).

AccessWV was created in 2005 to give people an alternative coverage option if they could not get individual health insurance because of their medical history. Now that all health insurance plans are guaranteed issue – thanks to the ACA – high-risk pools are largely obsolete. AccessWV stopped accepting new members in November 2013, but continued to cover existing members until March 31, 2014. At that point, the program ceased operation.