Medicaid for nursing home and home care in West Virginia

Who qualifies

You must live in West Virginia, meet the financial rules below, and have a medical need for nursing-home-level care. For the waiver, a doctor, nurse practitioner or physician assistant starts the referral, and an assessment checks how much help you need with daily tasks.

Nursing home Medicaid

Medicaid pays the nursing home after you pay your share. Your share is most of your monthly income. A small amount is kept for your personal needs, and some can go to a spouse or dependent at home. Ask the Bureau for Family Assistance for the current personal needs amount.

If your income is above $2,982, you are not automatically shut out. The Bureau for Family Assistance says you may still qualify for nursing home care if your monthly nursing care costs exceed the Medicaid Medically Needy Income Limit. Ask DoHS to check this for you. The state's fact sheet does not say this route is open for the Aged and Disabled Waiver.

Care at home: the Aged and Disabled Waiver

The Aged and Disabled Waiver (ADW) is for adults 18 and older who need nursing-home-level care but want to stay at home. It can pay for:

• Case management.
• A personal attendant to help with bathing, dressing, meals and other daily tasks.
• Some nursing services.
• Transportation.

You can choose Personal Options, which lets you hire and direct your own attendant. If no slot is open, you are put on a waiting list (the Managed Enrollment List) and offered a slot when one opens.

Other home care help:

• Personal Care Program: For people who already have full Medicaid and need help with daily tasks.
• Lighthouse Program: State-funded personal care for people 60 and older who need a lot of help but do not qualify for Medicaid home care.
• FAIR (Family Alzheimer's In-Home Respite): Up to 16 hours a week of respite for unpaid family caregivers of a person with dementia.

What counts and what does not

• Countable assets include cash, bank accounts, stocks, bonds and other property that could be turned into cash.
• Your home: Federal rules set a home equity limit of at least $752,000 for long-term care Medicaid in 2026. Ask DoHS how your home, car and burial funds are counted.
• For a married couple, the spouse at home can keep a share of the couple's assets (see below).

Protections for a spouse at home

When one spouse needs long-term care, the spouse at home can keep part of the couple's assets and some income.

• Assets: Under federal rules for 2026, the spouse at home can keep at least $32,532 and no more than $162,660. Ask the Bureau for Family Assistance which amount applies to you.
• Income: If the spouse at home has little income, part of the other spouse's income can go to them each month.

Giving away money or property

Giving away money or property, or selling it for less than it is worth, before you apply can lead to a penalty period when Medicaid will not pay for long-term care. Tell your worker about any gifts or transfers, and ask DoHS how far back it will look.

How to apply, step by step

1. For home care, get a referral. Ask your doctor, nurse practitioner or physician assistant to refer you for the Aged and Disabled Waiver, or call the Aging and Disability Resource Network at 1-877-987-3646 for help.
2. Apply for Medicaid online at wvpath.wv.gov, by phone at 1-877-716-1212, or at your county DoHS office. If a disability keeps you from going to an office, call 1-800-642-8589 to ask for a home visit.
3. Send proof of income, bank balances, property and insurance. If married, include your spouse's assets.
4. Meet both tests. You must meet the medical rules and the financial rules to get long-term care Medicaid.

After you are approved

• Report changes in income, assets, address or living situation to DoHS.
• Renew your Medicaid when DoHS asks.
• If you are denied: Your notice tells you how to ask for a fair hearing and by when. Act quickly.
• Estate recovery: After death, West Virginia can recover what Medicaid paid for nursing home care, home and community-based care, and related hospital and drug costs for people 55 and older. Estates worth $5,000 or less are not pursued. Nothing is taken while a spouse, a child under 21, or a blind or disabled child lives. Heirs can ask for a hardship waiver within 45 days.

Free help

• Aging and Disability Resource Network: 1-877-987-3646.
• DoHS Customer Service Center: 1-877-716-1212.
• West Virginia SHIP (Medicare counseling): 1-877-987-4463.

More on costs: paying for a nursing home. See all benefits in West Virginia and Medicare.

Phone numbers: Free help lines for West Virginia agencies

Check what you may qualify for