Medicaid and Medicaid for Long Term Care

Medicaid provides medical care in the community or in an institutional setting, such as a nursing home, to individuals who otherwise may not be able to afford the care. A variety of services are provided, according to state and federal guidelines, depending upon the individual or family circumstances. Recipients of Supplemental Security Income (SSI) automatically qualify for Medicaid. In addition, other individuals or families may apply for and receive Medicaid if eligible and it is provided under a number of coverage groups. Medicaid is administered at the federal level by the Centers for Medicare and Medicaid Services (CMS) under the U.S. Department of Health and Human Services.

There are many ways to qualify for Medicaid. Some of these coverage groups are mandatory, i.e., required by CMS to be provided by each state, and some are optional. With the combination of the mandatory and optional coverage groups, and those for which West Virginia has received waivers from federal requirements, West Virginia offers coverage to a wide range of groups. 

This Medicaid coverage pays for care for persons in a Nursing Home Facility, an Intermediate Care Facility for Individuals with Intellectual Disabilities, or for persons who require the same level of care provided in a nursing home, but who chose to receive the care at home. Coverage also includes other medical expenses not covered by Medicare or other private health insurance. 

Medicaid Long Term Care coverage options:

The individual must meet certain medical criteria, as well as the financial requirements.​

​