How West Virginians on Medicaid can keep health insurance

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When COVID first upended West Virginia in spring 2020, the federal government took steps to make sure people had access to the food and health insurance they needed. In some cases, benefits increased. In others, like Medicaid, state officials were allowed to temporarily stop checking eligibility requirements. Since then, the insurance plan intended to help low-income Americans has allowed anyone using it to stay on the plan, regardless of their family income.

Many of those changes, however, are now starting to switch back to the way they were. At the beginning of March, the federal nutrition assistance program lowered their payments to pre-pandemic numbers. And starting April 1, West Virginia’s Department of Health and Human Resources will begin checking Medicaid users’ income requirements again.

Throughout April and the coming months, many West Virginians who have the insurance will be sent forms to the physical address DHHR has for them. If they do not respond to that letter quickly, they will likely lose their health insurance.

DHHR expects over 100,000 West Virginians to lose Medicaid, which could lead to a huge jump in uninsured state residents. According to Rhonda Rogombe, the health policy analyst at the West Virginia Center on Budget and Policy, many of the people expected to lose Medicaid are still eligible but have lost contact with the health department, often because they moved and didn’t update the health department.

But there are a number of resources available to help people either keep Medicaid or switch to another affordable health insurance plan.

“We help you figure all that out,” said Jeremy Smith, the program director of the state’s health insurance helpline. “We really just go through that whole process with people.”

Here’s how West Virginians using Medicaid can find out whether they can keep their plans and which next steps they should take.

Step 1: Making contact with DHHR

For the more than 600,000 West Virginians who use Medicaid, the first step to keeping their health insurance is making sure DHHR has their correct physical address. If someone has changed addresses without updating the state health department, they will not receive the forms needed to keep Medicaid. 

There are a few ways to update contact information. For those who know their login for DHHR’s online portal, WV PATH, they can go there and click “sign in.” Then, before logging in, they should then click “Manage your Optum GovID.” 

After following the prompts, folks will be directed to a form in which they can check and update their contact information, including their physical address. If folks prefer to make the change over the phone, they can call the DHHR Medicaid customer service line at 1-877-716-1212. 

People can also review and change their physical at a local DHHR office, which can be found in all 55 of the state’s counties. Additionally, if they email [email protected] with their full name and current address, the department will update their files. 

According to Smith, there are options for Medicaid users who are experiencing homelessness or don’t have permanent mailing addresses. He said that if someone calls his organization, West Virginia Navigator, his coworkers can find a group that will let the person receive mail at a physical building. 

“A lot of the coalitions that help homeless individuals have some tricks up their sleeves to advise people what to do,” Smith said. “But [people using Medicaid] definitely need to figure out what address they want to use.”

Step 2: Be on the lookout for DHHR documents

Starting in April, DHHR will begin sending Medicaid forms through the mail to West Virginians who have the insurance. The forms will be sent out periodically, and the program’s users should expect to receive them anytime between April 2023 and April 2024.

The documents will ask for various information, including what someone’s salary is, and folks are required to respond. DHHR will expect the person to respond by the date listed on the documents; Smith said if someone doesn’t respond by that date, they could be at risk of losing their health insurance.

“You’re not going to have an unlimited amount of time to get all this stuff back to them,” he said. 

Smith said most of the documents should only be asking for information, and he doesn’t expect that people will need to send back any other documentation in most cases. But, if people have questions about how to fill the forms out, they can always call and ask the Navigator program.

Even if people believe they are no longer eligible for Medicaid, it’s still important to fill out the papers from DHHR. Rogombe said the forms are an important way to connect people no longer eligible for the program with other health insurance resources.

Step 3: Determine health insurance options

After someone sends their forms back, DHHR will respond shortly as to whether they are or are not still eligible for the insurance. If they still qualify, they will be set to remain on Medicaid. 

If someone is no longer eligible, Smith said they should call the Navigator program immediately to discuss other health insurance options. The federal government acted last year to keep insurance options for working-class Americans inexpensive — Smith said that many people who no longer qualify for Medicaid can find plans for free or $10 a month. The bills will keep plan costs low until at least the end of 2025, according to the Kaiser Family Foundation.

People who are no longer eligible for Medicaid can also check with their employer to see if it provides a good insurance option. In some cases, when those plans are found to be too expensive, people can still be eligible for cheap options from the federal government’s insurance marketplace. Smith said the Navigator program can advise people on their best option for them and their family and guide them until they have new insurance.

If people search for health insurance on their own, they should try to sign up before their Medicaid coverage ends, a date that will be listed on the response sent by DHHR. Additionally, Smith noted that there are a lot of scam websites with options that do not meet federal requirements. He says the only place people should be shopping for health insurance is on the government website, HealthCare.gov.

Helpful Resources

• West Virginians can reach the state’s insurance helpline, West Virginia Navigator, at 304-356-5834, or at one of its four offices across the state. Funded by the federal government, the organization has employees to make sure that current Medicaid users stay insured. They have people who speak Spanish and can find online interpreters for West Virginians who speak other languages.
• At 6 p.m. on March 28, the West Virginia Center on Budget and Policy will host a Facebook webinar to walk people who use Medicaid through the income-check process and to answer questions. 
• DHHR has multiple call-desks to answer questions related to Medicaid. For questions about its online portal, the technical support number is 844-451-3515. For questions related to the insurance program, the customer service number is 877-716-1212. 
• The national website for health insurance is HealthCare.gov. There are resources on it to find out what plans are options for you and your family.

Reach reporter Allen Siegler at [email protected]