West Virginia Medicaid Personal Care Program: Qualifications and Services

Program Description

West Virginia Bureau of Senior Services offers the Medicaid Personal Care program to state residents to help them perform the activities of daily living. The 7 activities include personal hygiene, bathing, dressing, eating, transferring, mobility and maintaining continence. Services are provided by approved, licensed home care aides and agencies. A complete list of providers is available here. However, one should not contact providers directly until they have been admitted to the Medicaid program.

Services are offered to individuals in their place of residence, be that in their own homes, the homes of other family members or in assisted living residences. If the care is provided in an assisted living residence, no funds from this program can be put towards the cost of the room and board in the assisted living community.

 

Eligibility Guidelines

Medicaid Personal Care is offered under West Virginia’s regular Medicaid program (sometimes called “State Plan”). However, personal care is also a benefit under the state’s Aged and Disabled Waiver. The eligibility requirements differ for the two programs. What follows is current for 2017 and relevant to WV residents aged 65 or older or those who are designated as disabled.

Income – an unmarried or widowed applicant aged 65 or older is permitted monthly income equivalent to 100% of the Federal Poverty Level. In 2017, this means one’s monthly income cannot exceed $990 (note this figure is expected to be revised upwards very slightly later in 2017). WV also offers an alternative pathway into Medicaid called the Medically Needy pathway. For persons who have recurring medical expenses that each month require the vast majority of their income (all but $275), they can still be Medicaid eligible. As an example, if one has monthly income of $5,000, but each month pays $4,800 out-of-pocket for care, medical procedures and prescription medications, they will be eligible.

Assets – an unmarried and widowed applicant, 65+ years of age is permitted up to $2,000 in countable assets. Countable assets do not include resources, such as the home and property, provided the value of their home equity is less than $560,000. Also, exempt from the total is the value of the applicant's vehicle, burial plot, and various other personal effects.

Asset Transfers - past asset transfers for 5 years before the date of application are eligible for review by WV Medicaid to make sure the applicant did not give away or transfer assets under market value with the goal of qualifying for this program.

Persons a little over the eligibility limits or those with some hesitation regarding their eligibility are advised to find assistance qualifying for WV Medicaid before applying for the Personal Care Program or any other WV Medicaid program. More information.

 

Benefits and Services

Each beneficiary is reviewed and provided with a different set of approved services. These can include assistance with the following:

  • Dressing
  • Housekeeping
  • Feeding
  • Health-Related Tasks
  • Medication Reminders
  • Nutrition
  • Personal Hygiene

West Virginia residents are eligible to receive assistance from this program regardless of their geographic location in the state. However, they must be able to find a care provider who is willing to travel to their home or community to provide them with care services. One option when they have difficulty finding a provider is for a family member or friend who lives in the area to become a licensed home care aide.  To become a licensed aide, one can apply through the inROADS website.   

 

How to Apply / Learn More

To apply for Medicaid Personal Care, one should contact their local WV Area Agency on Aging.  One should expect an approximate 60-day review time after the completed application has been submitted.

This program is under the administration of the West Virginia Bureau of Senior Services. They maintain a webpage about the program however little additional information is provided. However, little additional information is provided at this page.