Finance West Virginia

Medicaid Unwinding in West Virginia Leave 254K Behind after Eligibility Check

Medicaid Unwinding in West Virginia Leave 254K  Behind after Eligibility Check

West Virginia’s Medicaid-managed care plans have seen a decrease in enrollment, with less than 514,000 residents currently being covered. This decline can be attributed to the gradual easing of eligibility checks that took place over the past year following the pandemic.

In April 2023, the state experienced a significant increase in the number of individuals enrolled in Medicaid plans, surpassing 667,000. This surge occurred as the federal government lifted the pause on eligibility checks, which had been in effect since March 2020.

States were mandated to verify the eligibility of all individuals on Medicaid during the period from April 2023 to March 2024.

Eligibility checks, on the other hand, are a continuous process that involves reviewing paperwork and occasionally requesting additional documentation from the West Virginia Bureau for Medical Services.

During a 14-month period from April 2023 to May 2024, the department has thoroughly assessed the eligibility of 571,276 members.

Out of that number, over 317,000 individuals were able to maintain their coverage, while more than 254,000 were unfortunately denied future coverage. Enrollment numbers have continued to rise, resulting in a total of 514,000 enrollees as of the latest figures released by the department in June.

Over 168,000 individuals were denied continuing coverage because they failed to return the necessary paperwork, while more than 53,000 were found to be ineligible. Additionally, more than 32,000 individuals returned incomplete paperwork, resulting in their denial of coverage as reported by The Center Square.

Enrollment for first-time Medicaid beneficiaries can be done by visiting, calling 1-877-716-1212, or visiting their local DoHS office.

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