West Virginia Healthcare Assistance for Single Mothers [2025]: Medicaid, WVCHIP & More

Last updated: September 2025

This guide is built for single moms in West Virginia who need fast, accurate answers about health coverage—today. Everything here links to official state or federal sources, with current 2025 figures where available. No fluff. Just what to do, where to apply, and who to call.

Quick Help (fast actions + phone numbers)

• Apply for Medicaid/WVCHIP online now at WV PATH. Or call the Department of Human Services (DoHS) Customer Service Center at 877‑716‑1212 for application help. Apply at WV PATH (official portal). (learning-public.wvpath.wv.gov, dhhr.wv.gov)
• Need child coverage or pregnant and over Medicaid limits? Call the WVCHIP Helpline 877‑982‑2447 (M–F, 8–4) or apply by PATH/HealthCare.gov. WVCHIP Apply & Helpline. (chip.wv.gov)
• No ride to the doctor? Medicaid’s Modivcare transportation: 844‑549‑8353 (routine rides Mon–Fri 7–6; urgent discharges 24/7). WV Medicaid NEMT – Modivcare. (dhhr.wv.gov)
• Postpartum coverage now lasts 12 months for Medicaid & WVCHIP. If you delivered in WV, you likely qualify. Postpartum coverage—12 months. (dhhr.wv.gov)
• Free or low‑cost birth control, pregnancy testing, STI testing (Title X): 800‑642‑8522 or 304‑558‑5388. WV Family Planning Program clinics. (wvdhhr.org)
• Breast/cervical cancer screening if uninsured/underinsured (≤250% FPL): 800‑642‑8522. WV BCCSP eligibility & providers. (dhhr.wv.gov)
• Mental health/crisis now: call or text 988 (WV routes you to in‑state counselors). How WV 988 works. (wv988.org)
• Marketplace plans (if you don’t qualify for Medicaid/CHIP): Open Enrollment is Nov 1–Jan 15. Free enrollment help: WV Navigator 844‑982‑2737 or 304‑356‑5834. Open Enrollment dates. WV Navigator contact. (healthcare.gov, acanavigator.com)

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Quick Reference Cheat Sheet

Sources: WV BMS (Medicaid), WVCHIP, PATH, Modivcare, HealthCare.gov. (dhhr.wv.gov, chip.wv.gov, healthcare.gov)

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Who qualifies in 2025? (Know your income numbers first)

Federal Poverty Guidelines (FPL) rose in 2025. Medicaid uses these to decide eligibility. Here are the 2025 FPL baselines for the 48 states/DC (WV included): 1‑person $15,650;2‑person$21,150; 3‑person $26,650;4‑person$32,150; add $5,500 each person over 8. Official HHS Poverty Guidelines (2025). (aspe.hhs.gov)

Table: 2025 income cutoffs most single moms ask about

• 138% amounts: derived from 2025 HHS FPL; commonly used for Medicaid expansion adults. 2025 FPL and 138%/monthly breakdown. (medicaidplanningassistance.org)
• WV’s pregnancy Medicaid page lists income up to 158% FPL; annual/monthly shown here are 2025 HHS figures × 1.58 (rounded). Confirm exact limits when you apply. WV Medicaid pregnancy category reference. (dhhr.wv.gov)

Reality check:

• The state’s pregnancy limit page is a general reference. If you’re slightly above pregnancy Medicaid income, WVCHIP Maternity can cover you up to 300% FPL (details below). (dhhr.wv.gov)

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Medicaid for Single Mothers (Adults, Pregnancy/Postpartum, and Kids)

Start here: apply online via WV PATH or call 877‑716‑1212 to get help with your application. Apply at WV PATH (official). (learning-public.wvpath.wv.gov, dhhr.wv.gov)

What Medicaid covers:

• Primary care, OB/GYN, hospital care, prescriptions (with small pharmacy copays for some adults), mental health, substance use treatment, and non‑emergency medical transportation (NEMT). Copays never apply to pregnant women and kids. Medicaid copay & exemptions. (dhhr.wv.gov)
• Adults (age 19–64) with incomes up to 138% FPL. See the table above for 2025 dollar amounts. (medicaidplanningassistance.org)
• Pregnant people: If income is at or below ~158% FPL, you can qualify for full pregnancy Medicaid. Coverage now runs through 12 months postpartum, regardless of how the pregnancy ended. Report your pregnancy to DoHS so they tag your case correctly. Postpartum 12‑month extension—official BMS notice. (dhhr.wv.gov)
• Children: Babies and kids can qualify at higher income levels; if they’re over Medicaid limits, WVCHIP often covers them (below). EPSDT “HealthCheck” guarantees robust preventive, vision, hearing, dental, and treatment services. HealthCheck (EPSDT) overview and required services. (dhhr.wv.gov)

Managed care:

• Most Medicaid members are in Mountain Health Trust (managed care). You’ll pick or be assigned an MCO, typically Aetna Better Health, The Health Plan, or UniCare. Mountain Health Trust program. (dhhr.wv.gov)

MCO member help lines:

• Aetna Better Health of WV: 888‑348‑2922 (24/7), Nurse Line 855‑200‑5975. Aetna WV contact. (hi.aetnabetterhealth.com)
• The Health Plan (WV Medicaid): 888‑613‑8385. The Health Plan contacts. (healthplan.org)
• UniCare WV: 800‑782‑0095 (M–F 8–6), 24‑Hour Nurse Help Line 888‑850‑1108. UniCare WV contact. (mss.unicare.com)

Adult dental coverage (Medicaid)

West Virginia expanded adult dental. As of July 1, 2024, diagnostic, preventive, and restorative services are generally covered up to $2,000 every two years (excludes cosmetic; emergent services handled separately). Always check prior authorization rules with your dentist. State Plan Amendment public notice and dental policy chapter • Chapter 505 Oral Health Services. (dhhr.wv.gov)

Pharmacy coverage (Medicaid)

Small pharmacy copays may apply to some adults ($0.50to$3 depending on the prescription cost), but there’s a quarterly out‑of‑pocket cap and many groups are exempt (pregnant women, kids, etc.). See the copay table and exemptions here. WV Medicaid Copay Policy. (dhhr.wv.gov)

Preferred Drug List (2025 updates are posted): WV Medicaid PDL & updates. (dhhr.wv.gov)

Non‑Emergency Medical Transportation (NEMT)

• Call Modivcare at 844‑549‑8353. Routine ride scheduling is Mon–Fri 7 a.m.–6 p.m.; urgent requests and hospital discharges are 24/7.
• Gas mileage reimbursement is limited to the nearest medically appropriate provider, generally not to exceed 125 miles from home in‑state or within 30 miles of the WV border. NEMT member page (Modivcare). (dhhr.wv.gov)

Required documents (most common)

• Photo ID (you, and for kids if available)
• Proof of WV residence (lease, utility bill, mail)
• Social Security numbers (or proof you applied) for each person applying, if available
• Proof of income (last 30 days pay stubs, employer letter, child support award, unemployment proof)
• Proof of pregnancy (doctor’s note or test results) for pregnancy Medicaid/WVCHIP Maternity

Tip: Upload clear photos/PDFs in PATH. Keep a copy of everything you submit.

Real‑world example

Kayla in Logan County is 9 weeks pregnant with one child at home. Her 2‑person 2025 household income is $2,700/month\ast \ast .That’sunderthe\ast \ast$2,785/month (158% FPL) estimate for pregnancy Medicaid—so she should qualify for full pregnancy Medicaid with 12‑month postpartum coverage. If her hours increase later and she goes over, WVCHIP Maternity may cover her through pregnancy and postpartum. (dhhr.wv.gov)

Common mistakes to avoid

• Not reporting pregnancy to DoHS or your MCO—your case might not get the 12‑month postpartum protection.
• Forgetting to add your newborn to your case within 30 days—even though babies of Medicaid moms get a full year automatically, you still need to tell DoHS so claims pay smoothly.
• Uploading blurry documents to PATH—your case can stall.
• Missing rides because you called Modivcare less than 48–72 hours ahead for non‑urgent trips.
• Skipping your annual renewal—watch mail, PATH messages, and texts.

What to do if this doesn’t work

• Call DoHS Customer Service 877‑716‑1212 and ask for a status check in PATH. (dhhr.wv.gov)
• If you’re denied pregnancy Medicaid due to income, ask about WVCHIP Maternity (up to 300% FPL). (dhhr.wv.gov)
• If your child is denied Medicaid, ask the worker to evaluate for WVCHIP and verify current income documentation. (chip.wv.gov)
• Transportation issues? Call Modivcare 844‑549‑8353 and request help; escalate to your MCO if needed. (dhhr.wv.gov)

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WVCHIP (Children’s Health Insurance Program) — includes Maternity Coverage

If your children (or you as a pregnant adult) are over Medicaid limits but still can’t afford private insurance, WVCHIP is next. You can apply at PATH or HealthCare.gov and the state will sort out Medicaid vs. CHIP for you. WVCHIP eligibility & income. (chip.wv.gov)

Key points for 2025:

• WVCHIP has three tiers by income: Gold (lowest income), Blue (middle), Premium (highest).
• Pregnant adults with incomes roughly 185%–300% FPL may qualify for WVCHIP maternity if not eligible for Medicaid, with 12‑month postpartum coverage. WVCHIP maternity announcement; postpartum extension notice • Postpartum extension. (dhhr.wv.gov)

Table: WVCHIP Income Guidelines & Co‑Pays (Effective 2/2025)

Co‑pays (examples): Gold minimal; Blue includes office visit/prescription copays; Premium has $25copaysonsomedentalwitha$100 per member/$150 per family dental copay max per year. See full 2025 flyer for details. 2025 WVCHIP Income & Co‑Pay Flyer (PDF). (chip.wv.gov)

Covered services include doctor visits, hospital, prescriptions, mental health, dental, and vision. Dental copays vary by tier; details here. WVCHIP Covered Dental Services. (chip.wv.gov)

How to apply:

• Online via PATH or HealthCare.gov, by mail, or with a local DoHS office’s help. Help line: 877‑982‑2447 (M–F 8–4). WVCHIP Apply page. (chip.wv.gov)

Timeline:

• WVCHIP says decisions are made “about two weeks” after your local office receives a complete application. Watch your mail. WVCHIP FAQ—processing time and fair hearings. (chip.wv.gov)

Common pitfalls:

• Missing the mailed request for more income proof—check PATH messages and your mail weekly until approved.
• Not picking/confirming your MCO—WVCHIP is included in Mountain Health Trust; you’ll get enrollment instructions.
• Forgetting to report a new baby’s SSN once it arrives—claims can pend without it.

What to do if this doesn’t work:

• If you think your income was read wrong, request a Fair Hearing through your local DoHS office. WVCHIP FAQ (Fair Hearing). (chip.wv.gov)
• If you’re denied due to income, ask WV Navigator for Marketplace help (see below). WV Navigator help. (acanavigator.com)

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Marketplace Coverage (HealthCare.gov) when you’re over Medicaid/CHIP limits

Open Enrollment for 2025 coverage ran Nov 1, 2024–Jan 15, 2025 (normal window is Nov 1–Jan 15 each year). Outside of this, you’ll need a Special Enrollment Period (life event or certain income ranges). Marketplace dates & SEPs • Get coverage outside Open Enrollment. (healthcare.gov)

Free enrollment help:

• WV Navigator can check your eligibility for premium tax credits and cost‑sharing reductions and help you compare plans. Call 844‑982‑2737 or 304‑356‑5834 (M–F). WV Navigator (free help). (acanavigator.com)

Reality check:

• If your income dips during the year, you can qualify for Medicaid/CHIP anytime—apply as soon as you think you’re eligible. Marketplace one‑page guide. (healthcare.gov)

What to do if this doesn’t work:

• Try an FQHC (Community Health Center) for sliding‑fee care while you sort coverage (see Local Care section).

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Women’s & Family Health Programs (add these to your toolkit)

• West Virginia Family Planning Program (Title X): contraception, pregnancy tests, STI screening, Pap tests—free or low cost. Statewide clinic locator and help lines 800‑642‑8522 / 304‑558‑5388. WV Family Planning Program. (wvdhhr.org)
• WVBCCSP (Breast & Cervical Cancer Screening Program): Uninsured/underinsured women up to 250% FPL can get screening and diagnostic services at little/no cost; if diagnosed through the program, treatment can be covered via Medicaid. WVBCCSP eligibility + Medicaid treatment note. (dhhr.wv.gov)
• HealthCheck (EPSDT) for kids on Medicaid: required well‑child checks; lead tests at 12 and 24 months; vision, hearing, dental, and any medically necessary treatment to “correct or ameliorate” conditions found. Help line 800‑642‑9704. HealthCheck services. (dhhr.wv.gov)
• WIC (nutrition for pregnant/postpartum women, infants, kids <5): WIC uses 185% FPL and updates income charts each April. Use the quick check and “Apply Now” online. Do I Qualify for WIC?. (dhhr.wv.gov)
• Vaccines for Children (VFC): Free vaccines for eligible kids (Medicaid‑eligible, uninsured/underinsured, AI/AN). Info and hotline 800‑642‑3634. WV VFC Program. (oeps.wv.gov)
• Ryan White (HIV care & meds): WV Part B serves eligible residents; ADAP helps with HIV meds and premiums—generally up to 500% FPL for ADAP and ≤400% FPL for some services. HIV/STD Hotline 800‑642‑8244. WV Ryan White Part B & ADAP. (oeps.wv.gov)

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Local care when money is tight (FQHCs, free clinics, dental, mental health)

• Community Health Centers (FQHCs) offer primary care, behavioral health, dental, and often same‑day sick visits on a sliding fee scale. Use the statewide map. Find a Community Health Center (WVPCA map). (wvpca.org)
• WV Health Right (free & charitable clinics – Kanawha area + mobile):
  East End Clinic: 304‑414‑5930 (1520 Washington St E, Charleston)
  West Side Clinic: 304‑340‑1555 (511 Central Ave, Charleston)
  WV Health Right locations & hours. (wvhealthright.org)
• Cabin Creek Health Systems (Kanawha area FQHC network). Multiple sites; main contacts listed here. Cabin Creek Health Systems – locations & phone numbers. (cabincreekhealth.com)
• Community Care of West Virginia (statewide FQHC network)—corporate/appointments info: 304‑924‑6262; billing: 888‑702‑2188. Community Care WV – contact. (communitycarewv.org)
• Prefer a consolidated map? HRSA’s “Find a Health Center” tool works by ZIP code. Find a Health Center (HRSA). (datawarehouse.hrsa.gov)

If you need local DoHS office help in person:

• Use the county directory for addresses and phone numbers. Find your local DoHS (county) office. (dhhr.wv.gov)

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Application Checklist (grab and go)

• Government‑issued ID (you)
• Proof of WV residency (lease, utility, official mail)
• Social Security numbers (or application receipts) for everyone applying
• Proof of income (last 30 days pay stubs, employer letter, child support order/payments, unemployment)
• Pregnancy proof (doctor’s note or lab result) if applying for pregnancy Medicaid/CHIP
• Child documents: birth certificate if available (not required to start), school ID/report card can help verify identity/relationship
• Any current insurance info (if you have a plan you want to drop because it’s unaffordable, say so in PATH)

Tip: If you can’t get something right away, apply anyway. PATH lets you upload after you submit. PATH “My Account” status & messages. (learning-public.wvpath.wv.gov)

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Timelines: what to expect

• WVCHIP: “About two weeks” after the local office receives your completed application. Watch your mail and PATH messages. WVCHIP FAQ. (chip.wv.gov)
• Medicaid: Varies by case. Use PATH to check messages and requests; call 877‑716‑1212 if you don’t see movement after a couple weeks. DoHS Customer Service Center. (dhhr.wv.gov)
• Transportation: Routine rides are scheduled Mon–Fri 7–6. Urgent discharges 24/7. Modivcare NEMT. (dhhr.wv.gov)

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Common Mistakes to Avoid (and how to fix them)

• Using net (take‑home) pay instead of gross pay on your application. Use gross. If you’re paid weekly, multiply by 4.3; biweekly × 2.15; semi‑monthly × 2. WVCHIP shows helpful examples.
  WVCHIP income calculation tips. (chip.wv.gov)
• Not reporting a change (new job, maternity leave). Update PATH right away to avoid closures or overpayments. PATH “My Account” change reporting. (learning-public.wvpath.wv.gov)
• Missing your managed care enrollment window. If you don’t pick an MCO, one will be assigned—switching later can be a hassle.
  Mountain Health Trust overview. (dhhr.wv.gov)
• Not asking for help with rides. If you miss visits because of transportation, call Modivcare. Keep appointment letters and ask your clinic to help schedule.
  NEMT details & phone. (dhhr.wv.gov)
• Paying cash for dental you could get covered. Adult Medicaid now covers many dental services up to $2,000/2 years. Ask your dentist to bill Medicaid first.
  Adult dental coverage notice & manual. (dhhr.wv.gov)

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Detailed Program Guides

A) Pregnancy & Postpartum Coverage (Medicaid + WVCHIP Maternity)

Do this first: Apply through PATH and report your pregnancy. If your income is at/below ~158% FPL, Medicaid should cover you; if you’re over, WVCHIP Maternity can cover you up to 300% FPL. Medicaid pregnancy category • WVCHIP maternity expansion. (dhhr.wv.gov)

What you get:

• Prenatal care, delivery, labs, ultrasounds (as medically necessary), prescriptions, mental health/substance use care, and 12 months postpartum coverage. 12‑month postpartum—official. (dhhr.wv.gov)
• Transportation to appointments through Modivcare (call early to schedule). NEMT. (dhhr.wv.gov)
• Family Planning (contraception) at no cost. WV Family Planning. (wvdhhr.org)

Reality check: Hospital billing and MCO prior authorizations can slow things down. Keep copies of every bill and EOB and call your plan as soon as you get assigned to confirm your OB is in‑network.

Plan B if denied:

• If denied Medicaid for income, ask the worker to evaluate you for WVCHIP Maternity (up to 300% FPL) and/or apply directly through PATH/HealthCare.gov indicating you’re pregnant. WVCHIP Apply. (chip.wv.gov)

B) Kids’ Coverage: Medicaid + HealthCheck (EPSDT) + WVCHIP

Start with PATH. If over Medicaid limits, your case should route to WVCHIP automatically. WVCHIP eligibility. (chip.wv.gov)

Don’t miss HealthCheck (EPSDT):

• Medicaid guarantees well‑child exams, vaccines, vision, hearing, dental, developmental screenings, and treatment to correct/ameliorate problems found. Lead testing at 12 and 24 months is required. HealthCheck services. (dhhr.wv.gov)

What to do if this doesn’t work:

• For a fast appointment, try an FQHC near you (sliding fee). WVPCA map. (wvpca.org)

C) Behavioral Health & Substance Use Services

• Medicaid covers an extensive continuum of care (counseling, MAT, inpatient as medically necessary). WV has a CMS‑approved 1115 behavioral health demonstration through 2029. WV behavioral health 1115 extension. (dhhr.wv.gov)
• Crisis now: 988. Chat/text/call routes to WV counselors first; specialized pathways for children and people with disabilities have state focus. WV 988 transition and policy initiatives • WV Selected for 988 Policy Academy. (dhhr.wv.gov)

What to do if this doesn’t work:

• Use your MCO’s 24/7 Nurse Line or behavioral health line (see numbers above). (hi.aetnabetterhealth.com, healthplan.org, mss.unicare.com)

D) Special Needs & Home‑ and Community‑Based Services (HCBS) for Children

Some families need more than standard coverage. WV offers Medicaid waivers and programs that keep kids with complex needs at home:

• Children with Serious Emotional Disorder Waiver (CSEDW): services for ages 3–21 with serious emotional/behavioral needs; connects families to Wraparound care. CSEDW overview. (dhhr.wv.gov)
• Children with Disabilities Community Services Program (CDCSP): Medicaid card for severely disabled children under 18—covers therapies, equipment, supplies when institutional‑level care could otherwise be needed. CDCSP program. (dhhr.wv.gov)
• Broader HCBS list (ADW, IDDW, TBIW, Personal Care): HCBS programs directory. (dhhr.wv.gov)

What to do if this doesn’t work:

• Call your local DoHS office and ask for a waiver screening; if waitlists exist, ask about interim services via your child’s MCO care coordinator. County office directory. (dhhr.wv.gov)

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Tables You Can Use

Table: Adult Medicaid vs. Marketplace—quick financial comparison

Source: 2025 HHS Poverty Guidelines; Medicaid expansion uses 138% FPL. (medicaidplanningassistance.org)

Table: WVCHIP 2025 income bands (selected sizes)

Full 2025 WVCHIP flyer (income and copays). (chip.wv.gov)

Table: Key phone numbers (keep this handy)

Table: Medicaid copays—what most single moms ask about

Details and exemptions: WV Medicaid Copays & OOP maximums. (dhhr.wv.gov)

Table: Transportation (NEMT) basics

Source: NEMT (Modivcare) member guidance. (dhhr.wv.gov)

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Real Examples (how families actually used these programs)

• Prenatal switch with zero gap: Brandi switched OBs mid‑pregnancy when her MCO changed. She called Aetna 888‑348‑2922 to update her PCP/OB and had Modivcare move her ride. No gap in care. (hi.aetnabetterhealth.com, dhhr.wv.gov)
• Child screening + services: Sam’s 2‑year‑old had a HealthCheck visit and got the required 24‑month lead test. Elevated lead led to home follow‑up and developmental speech services covered by Medicaid. HealthCheck services. (dhhr.wv.gov)
• Above Medicaid, covered by CHIP: Tasha (single mom, 2 kids) earned about $4,900/month. Her kids landed in WVCHIP Blue; dental and vision were covered with small copays. WVCHIP income bands. (chip.wv.gov)

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Diverse Communities: targeted tips and resources

LGBTQ+ single mothers:

• Title X Family Planning clinics serve all patients regardless of orientation/identity; ask for confidential services. WV Family Planning (clinic locator). (wvdhhr.org)
• Crisis support: 988 (WV routing). Ask for specialized LGBTQ+‑competent support if needed. WV 988. (wv988.org)

Single mothers with disabilities or disabled children:

• Explore Medicaid waivers and CDCSP to keep care at home (CSEDW, IDDW, ADW, TBIW, Personal Care). HCBS programs directory. (dhhr.wv.gov)
• Transportation accommodations are available through NEMT. Note mileage rules; ask your plan for help arranging accessible vehicles. NEMT info. (dhhr.wv.gov)

Veteran single mothers:

• You can use Medicaid/CHIP alongside VA care when eligible. Apply for Medicaid in PATH and continue to use your VA providers for covered services. For care coordination, call your MCO member line (see numbers above). (hi.aetnabetterhealth.com, healthplan.org, mss.unicare.com)

Immigrant/refugee single moms:

• Title X Family Planning and BCCSP focus on service access regardless of insurance; call to ask about what documents are needed. Family Planning • BCCSP. (wvdhhr.org, dhhr.wv.gov)
• If you have limited status or no SSN, apply in PATH anyway for any eligible family members (citizen children often qualify). Use DoHS Customer Service 877‑716‑1212 if you have questions about documentation. DoHS contact. (dhhr.wv.gov)

Tribal citizens:

• American Indian/Alaska Native members are exempt from Medicaid/CHIP copays and some CHIP premiums. Call WVCHIP Helpline 877‑982‑2447 for details. WVCHIP—AI/AN policy. (chip.wv.gov)

Rural single moms with limited access:

• Use FQHCs for sliding‑fee care; many offer same‑day sick visits and telehealth. Find a Health Center (WVPCA map). (wvpca.org)

Single fathers:

• All programs here are gender‑neutral: Medicaid, WVCHIP, HealthCheck, WIC (for kids), Family Planning services for men, too. Check the same links above.

Language access:

• WVCHIP offers TDD/TTY and translation services; MCOs and DoHS can arrange interpretation on request. WVCHIP Apply page (TTY/translation note). (chip.wv.gov)

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Resources by Region (sampling—use the maps/directories for more)

Kanawha/Charleston:

• WV Health Right (free/charitable clinics): 304‑414‑5930 (East End), 304‑340‑1555 (West Side). Locations & hours. (wvhealthright.org)
• Cabin Creek Health Systems (multiple clinics): phones by site listed here. CCHS contacts. (cabincreekhealth.com)

Huntington/Cabell & Tri‑State:

• Valley Health Systems sites (primary care, behavioral health, dental) listed via FQHC maps. Find a Community Health Center (map). (wvpca.org)

Morgantown/Monongalia:

• FQHCs and free clinics in Monongalia via map; consider local sliding‑fee clinics if new to the area. Find a Community Health Center. (wvpca.org)

Eastern Panhandle (Berkeley/Jefferson):

• Shenandoah Valley Medical Systems and other FQHCs: use the map. WVPCA map. (wvpca.org)

Southern WV (Raleigh/Mercer/Logan/McDowell):

• Community Care of West Virginia and local FQHCs; call 304‑924‑6262 for CCWV office navigation. CCWV contact. (communitycarewv.org)

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If You Hit a Roadblock (appeals, corrections, escalations)

• PATH issues or missing notices: Call 877‑716‑1212 and ask a worker to read notes on your case. (dhhr.wv.gov)
• WVCHIP denial you don’t agree with: You can request a Fair Hearing through your local DoHS office. Save your denial letter and ask about deadlines right away. WVCHIP FAQ—Fair Hearing. (chip.wv.gov)
• Can’t get through to Modivcare or repeated ride no‑shows: Call your MCO’s Member Services to log a complaint and request assistance. Numbers above. (hi.aetnabetterhealth.com, healthplan.org, mss.unicare.com)

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About This Guide

Compiled by the ASingleMother.org Editorial Team

• This guide uses official sources from West Virginia Department of Human Services, WV Department of Health (Bureau for Public Health), WVCHIP, CMS/HHS, and established nonprofits.
• We follow our Editorial Standards (primary sources only, links tested and archived, routine re‑checks).
• Last verified September 2025; next review April 2026.
• Questions or corrections? Email info@asinglemother.org. We respond within 48–72 hours.

This page cites: HHS 2025 FPL, WV Medicaid/BMS, WVCHIP 2025 income flyer, WV PATH training/portal, DoHS county office directory, WV Family Planning, WVBCCSP, HealthCheck/EPSDT, NEMT/Modivcare, Medicaid PDL/copays, HCBS/CSEDW/CDCSP programs, WV 988, WVPCA FQHC directory, WV Navigator, and MCO contact pages. (aspe.hhs.gov, medicaidplanningassistance.org, chip.wv.gov, learning-public.wvpath.wv.gov, dhhr.wv.gov, wvdhhr.org, wv988.org, wvpca.org, acanavigator.com, hi.aetnabetterhealth.com, healthplan.org, mss.unicare.com)

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FAQs (West Virginia‑specific, 2025)

1. How fast can I get pregnancy coverage?
   If you’re pregnant and meet income rules, coverage can start quickly once a complete application is processed. If your due date is near, call DoHS 877‑716‑1212 and your local office to flag urgency, and ask your clinic about “presumptive eligibility.” Postpartum lasts 12 months. Postpartum extension. (dhhr.wv.gov)
2. My child needs a dentist. Does Medicaid cover it?
   Yes. Kids on Medicaid have robust dental through EPSDT. For adults, Medicaid covers many dental services with a $2,000/2‑year cap. Ask your provider to verify coverage. Adult dental benefit. (dhhr.wv.gov)
3. We don’t have a car. How do we get to the pediatrician?
   If you have Medicaid, call Modivcare 844‑549‑8353 a few days in advance. Gas reimbursement is limited to the nearest appropriate provider and distance limits apply. NEMT policy. (dhhr.wv.gov)
4. My income fluctuates weekly. How does CHIP count it?
   WVCHIP uses gross (before‑tax) income and shows how to convert weekly/biweekly pay to monthly. WVCHIP income calculation examples. (chip.wv.gov)
5. How long does WVCHIP approval take?
   About two weeks after your local office receives a complete application. Watch your mail and PATH. WVCHIP FAQ. (chip.wv.gov)
6. Do I have copays on Medicaid?
   Children and pregnant members are exempt. Some adults have small copays; there’s also a quarterly out‑of‑pocket cap. Medicaid copays & exemptions. (dhhr.wv.gov)
7. I think the office miscounted my household. What can I do?
   Call 877‑716‑1212, upload proof in PATH (tax return or lease listing household), and request they re‑evaluate. If CHIP denies in error, you can request a Fair Hearing. DoHS contacts • WVCHIP FAQ (hearings). (dhhr.wv.gov, chip.wv.gov)
8. My teen needs counseling. Where do I start?
   Call your MCO member line to find an in‑network therapist. If in crisis, dial 988. Kids on Medicaid get behavioral health benefits; CSEDW/Wraparound supports exist for serious needs. CSEDW overview. (dhhr.wv.gov)
9. We’re a working family over Medicaid limits—any chance at help?
   Yes: WVCHIP for kids (see 2025 income table). For adults, check Marketplace savings with free help from WV Navigator (844‑982‑2737). WVCHIP flyer 2025 • WV Navigator. (chip.wv.gov, acanavigator.com)
10. Who do I call if I’m stuck and PATH won’t work?
    DoHS Customer Service 877‑716‑1212 and your county office. You can also visit an FQHC to see a clinician while your application processes (sliding‑fee). DoHS county directory • Find a Health Center (map). (dhhr.wv.gov, wvpca.org)

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What to Do Next (step‑by‑step)

• Gather your docs (see checklist) and apply at PATH. Note your application number.
• Answer any PATH messages fast—deadlines matter.
• When you get your approval, pick your managed care plan promptly and choose your PCP/OB.
• If you need a ride, call Modivcare early. Save your appointment letters.
• If anything changes (job, address, birth), update PATH right away.

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Disclaimer

We verify program rules and dollar amounts against official sources and update regularly. Policies and amounts can change mid‑year. Always confirm with the agency or plan before making financial or medical decisions. We do not provide legal advice or guarantee outcomes for individual cases.

Security note: For your privacy, never share full SSNs or case numbers by email or text with unknown parties. Use official portals (PATH), phone numbers listed above, or in‑person offices.

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🏛️More West Virginia Resources for Single Mothers

Explore all assistance programs in 34 categories available in West Virginia

• 📋 Assistance Programs
• 💰 Benefits and Grants
• 👨‍👩‍👧 Child Support
• 🌾 Rural Single Mothers Assistance
• ♿ Disabled Single Mothers Assistance
• 🎖️ Veteran Single Mothers Benefits
• 🦷 Dental Care Assistance
• 🎓 Education Grants
• 📊 EITC and Tax Credits
• 🍎 SNAP and Food Assistance
• 🔧 Job Training
• ⚖️ Legal Help
• 🧠 Mental Health Resources
• 🚗 Transportation Assistance
• 💼 Job Loss Support & Unemployment
• ⚡ Utility Assistance
• 🥛 WIC Benefits
• 🏦 TANF Assistance
• 🏠 Housing Assistance
• 👶 Childcare Assistance
• 🚨 Emergency Assistance
• 🤝 Community Support
• 🎯 Disability & Special Needs Support
• 🛋️ Free Furniture & Household Items
• 🏫 Afterschool & Summer Programs
• 🍼 Free Baby Gear & Children's Items
• 🎒 Free School Supplies & Backpacks
• 🏡 Home Buyer Down Payment Grants
• 🤱 Postpartum Health & Maternity Support
• 👩‍💼 Workplace Rights & Pregnancy Protection
• 💼 Business Grants & Assistance
• 🛡️ Domestic Violence Resources & Safety
• 💻 Digital Literacy & Technology Assistance
• 🤱 Free Breast Pumps & Maternity Support
• 📈 Credit Repair & Financial Recovery