West Virginia Health Insurance Guide

Health Insurance Overview in West Virginia

West Virginia expanded Medicaid in 2014 and saw one of the most dramatic reductions in uninsured rate of any state — from approximately 20% to under 7% by 2016. West Virginia uses the federal HealthCare.gov marketplace. The state has limited marketplace competition given its small population and rural character. West Virginia has significant healthcare access challenges in rural areas.

Average Health Insurance Costs in West Virginia

Marketplace Enrollment in West Virginia

West Virginia residents can enroll in individual and family health insurance plans through HealthCare.gov (Federal). Open enrollment runs November 1 – January 15 (federal marketplace).

Average Premiums by City in West Virginia

Medicaid in West Virginia

West Virginia Medicaid expanded in 2014, covering adults with incomes up to 138% of the federal poverty level. The expansion dramatically reduced the uninsured rate.

Children's Health Insurance (CHIP) in West Virginia

WV CHIP covers children under 19 in families with incomes up to 300% of the federal poverty level.

What Makes West Virginia Unique

West Virginia's Medicaid expansion reduced the state's uninsured rate by more than 13 percentage points — one of the largest reductions in the nation. The expansion was particularly impactful given West Virginia's high rates of substance use disorders and mental health conditions, providing access to behavioral health services for previously uninsured residents.

ACA Subsidies: What West Virginia Residents Should Know

The enhanced subsidies first enacted in the American Rescue Plan expired at the end of 2025. For 2026, premium tax credits follow the original ACA rules: there is no credit above 400% (the “subsidy cliff”), and enrollees are expected to pay up to 9.96% of income toward the benchmark Silver plan. House in January 2026 but has not become law, so 2027 plans are being priced and subsidized under the same rules unless Congress acts.

West Virginia’s Marketplace for 2027: Insurers, Rates, and Dates

West Virginia residents enroll through HealthCare.gov. Full-price premiums rose about 12.2% on average for 2026, before subsidies. 2 insurers sold plans for 2026; for 2027, CareSource is leaving and Peak Health is entering. Proposed 2027 changes average about 18.3% (Highmark) before subsidies.

About 56,000 people enrolled for 2026. About 89% received premium tax credits, and the average net premium after credits was about $208 a month.

Open enrollment for 2027: November 1, 2026 through January 15, 2027 on HealthCare.gov; enroll by December 15 for coverage starting January 1.

What’s Different About Health Coverage in West Virginia

West Virginia has the highest average full-price marketplace premiums in the country — and therefore the largest credits, averaging about $1,244 a month in 2026. That makes the 400% FPL cliff especially severe here. CareSource exits for 2027 and Peak Health enters alongside Highmark. Medicaid expansion adults face the federal work requirement starting in 2027.

Tips for Choosing Health Insurance in West Virginia

West Virginia Medicaid covers low-income adults comprehensively, including behavioral health services — important given the state's high rates of substance use disorders. Marketplace options may be limited — comparing all available plans is critical. WV CHIP provides children's coverage. Telehealth is particularly valuable for rural West Virginians with limited provider access.

• Enroll during open enrollment (November 1 – January 15 (federal marketplace)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.

Frequently Asked Questions

Which insurers are leaving the West Virginia marketplace for 2027?

CareSource is leaving for 2027. Enrollees with that insurer should choose a new plan during open enrollment; an automatic replacement may have a different network or drug list.

When is open enrollment in West Virginia for 2027?

November 1, 2026 through January 15, 2027 on HealthCare.gov; enroll by December 15 for coverage starting January 1.

How much do West Virginia marketplace enrollees pay after subsidies?

In 2026 about 89% of West Virginia enrollees received premium tax credits, and the average net premium was about $208 a month. There is no credit above 400% of the federal poverty level.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official HealthCare.gov (Federal) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.