West Virginia Medicaid Income Limits for Seniors (2026)
The income limit for seniors’ Medicaid in West Virginia is far lower than most people expect — but being over it does not mean you get nothing, and three other programmes have much higher limits.
Category: State Guides · 7 min read · Updated 2026-10-06
West Virginia has one of the oldest populations in the country, and the income limit for seniors’ Medicaid is far lower than most people expect.
Here are the 2026 numbers — and, more importantly, what to do if you are over them, because being over the Medicaid line does not mean you get nothing.
The limits, side by side
| Programme | Monthly income limit (one person) | Assets |
|---|---|---|
| Medicaid, age 65+ | About $994 ($1,491 a couple) | $2,000 / $3,000 |
| Medicaid, adults under 65 | About $1,835 (138% of poverty) | No asset test |
| Medicare Savings Program (QMB) | About $1,350 | $9,950 |
| Medicare Savings Program (SLMB) | About $1,616 | $9,950 |
| Medicare Savings Program (QI) | About $1,816 | $9,950 |
| Long-term care Medicaid | About $2,982 (300% of SSI) | Separate rules |
The first $20 a month of income is not counted in any of these, and your home and one car do not count as assets.
The trap: the senior limit is lower than the under-65 limit
West Virginia expanded Medicaid, so an adult under 65 can earn up to 138% of the poverty line — about $1,835 a month — and qualify.
On your 65th birthday that rule stops applying to you and the much lower SSI-based limit takes over. People lose coverage at 65 and assume it is a mistake. It is not — it is a different rule, and it is why the next two sections matter so much.
Over the limit? Ask about the spend-down
West Virginia has a medically needy pathway. If you are aged, blind or disabled with income above the limit, the medical bills you actually incur are subtracted from the income that counts — and once the total is low enough, you qualify.
Keep everything: Medicare premium statements, pharmacy printouts, dental and hearing bills, mileage to appointments. The spend-down only works if you can show what you paid.
Ask the county office to assess you for the medically needy group specifically. Ask for it by name.
The programme most West Virginians over the limit still qualify for
If you are on Medicare, the Medicare Savings Programs have limits far above Medicaid’s — up to about $1,816 a month — and they pay your Part B premium of $202.90 a month, roughly $2,400 a year back in your Social Security payment.
Qualifying for any tier also gives you Extra Help with prescription costs automatically. How to apply.
If you are turned down
Appeal — do not reapply. Reapplying starts a new claim and resets your filing date. For a Medicaid fair hearing the window is commonly up to 90 days from the date on the notice, and if your benefits are being cut, filing within about 10 days can keep payments running while it is decided. The full appeal guide.
Where to get free help applying
Your Area Agency on Aging will fill in the forms with you at no cost. Call the Eldercare Locator on 1-800-677-1116. If you receive SSI, you are enrolled in Medicaid automatically.
Everything else available in the state is in our West Virginia senior benefits guide , including the homestead exemption and the Senior Citizens Tax Credit. Our free benefits check takes about five minutes and asks no name and no Social Security number.
Frequently Asked Questions
What is the income limit for Medicaid in West Virginia if I am 65 or older?
For regular Medicaid based on age, West Virginia uses the SSI standard: about $994 a month for one person and $1,491 for a couple in 2026, with the first $20 of monthly income not counted. Assets must be within $2,000 for one person or $3,000 for two, not counting your home or one car. That is much lower than the limit for adults under 65, which is 138% of the poverty line — about $1,835 a month. Being over the senior limit does not mean you get nothing: see the spend-down and Medicare Savings Programs below.
What if my income is over the limit?
West Virginia has a medically needy pathway, usually called a spend-down. If you are aged, blind or disabled and your income is too high, you can subtract the medical bills you actually incur from the income that counts, and qualify once that total is low enough. Keep every bill, premium receipt and pharmacy printout — the spend-down only works if you can show what you paid. Ask your county Department of Human Services office to be assessed for the medically needy group specifically, not just regular Medicaid.
Are there programmes with higher income limits?
Yes, and most people over the Medicaid line still qualify for these. The Medicare Savings Programs pay your Medicare Part B premium of $202.90 a month — about $2,400 a year — and in West Virginia they use the federal limits: roughly $1,350 a month for QMB, $1,616 for SLMB and $1,816 for QI, with assets up to $9,950 for one person. Qualifying for any of them also qualifies you automatically for Extra Help with prescription costs. Extra Help itself reaches 150% of the poverty line on its own.
What about nursing home or long-term care Medicaid?
The income limit for long-term care is much higher: 300% of the maximum SSI payment, which works out to about $2,982 a month in 2026. Even above that, people can qualify if their monthly nursing care costs exceed the medically needy income limit and the other requirements are met. Long-term care Medicaid has its own rules about assets and transfers, so ask the county office to assess you for long-term care specifically.
How do I apply in West Virginia?
Apply through the state benefits portal or at your county Department of Human Services office. If you receive SSI you are enrolled in Medicaid automatically and do not need to apply separately. If filling in forms is hard, your Area Agency on Aging will sit down and do it with you for free — call the Eldercare Locator on 1-800-677-1116 and ask for your local agency. If you are turned down, appeal rather than reapplying.