Medicaid Work Requirements in West Virginia
West Virginia's requirements start January 1, 2027 for adults 19 to 64 in the Medicaid Adult Expansion Group. Current members are not affected until their regular 2027 renewal, starting with renewals due in March 2027.
Check your situation in West Virginia
When it starts in West Virginia
- January 1, 2027: the requirement starts. Applicants may need to meet it the month before applying (for example, December 2026 for January 2027 coverage).
- March 2027: the first renewals that include the requirement.
Who has to meet it
The rule applies to people ages 19 to 64 in the Medicaid adult expansion group, unless they are pregnant, have Medicare, or are exempt. You meet it in a month with 80 hours of work, community service, a work program, or school (in any mix), by going to school at least half-time, or with at least $580 in monthly income.
You are exempt if, for example, you care for a child 13 or younger or a person with a disability, are pregnant or postpartum, are American Indian or Alaska Native, are medically frail, are a veteran with a total (100%) VA disability rating or TDIU, were in foster care at 18 and are under 26, are in drug or alcohol treatment, meet SNAP or TANF work rules, or left jail or prison in the last 3 months. See the full exemption list.
Court ruling, October 29, 2026. In Massachusetts v. Oz, a federal court struck down the CMS rule's extra "significantly impairs" test for the medically frail exemption. If you are in any of the five medically frail groups in the law, you qualify. The January 1, 2027 start date did not change, and CMS may appeal. What the ruling means.
How West Virginia checks and how to report
Months checked: Applicants: the month before applying. Members: at renewal.
The state checks information it already has first. If it needs more, you get a written request by mail or in your WV PATH account. Respond within 30 days online, in person, or by mail. If you are not contacted, you do not need to send anything.
Other things to know in West Virginia
- You can also reach the Customer Service Reporting Center by email at osacsrc@wv.gov, by fax at 304-558-1869, or by mail at P.O. Box 1668, Charleston, WV 25326-1668.
- The state's initial analysis found about 33,000 recipients not yet meeting the rule and not automatically exempt (West Virginia Watch, August 2026).
Official tools and contacts
- Report and upload: WV PATH
- Customer Service Reporting Center: 1-877-716-1212
- WV Medicaid Program: 304-558-1700
- WV Medicaid help site
- BMS: new Medicaid rules are coming
- Agency: West Virginia Department of Human Services, Bureau for Medical Services
Federal protections that apply in West Virginia
- The state must check its own records before asking you for proof.
- If it can't confirm you meet the rule, you get a notice and at least 30 days to respond, and your coverage continues meanwhile.
- You get written notice and the right to a fair hearing before coverage ends, and you can reapply at any time.
- If you lose Medicaid for not meeting the rule, you cannot get marketplace premium tax credits for those months. Learn more.
Frequently asked questions
When do Medicaid work requirements start in West Virginia?
January 1, 2027 (renewals from March 2027). Current members are usually checked at their first renewal on or after that date.
How many months does West Virginia check?
Applicants: the month before applying. Members: at renewal.
How do I report my hours or an exemption in West Virginia?
The state checks information it already has first. If it needs more, you get a written request by mail or in your WV PATH account. Respond within 30 days online, in person, or by mail. If you are not contacted, you do not need to send anything.
Who do I call about West Virginia Medicaid work requirements?
Customer Service Reporting Center: 1-877-716-1212
WV Medicaid Program: 304-558-1700
Can I lose West Virginia Medicaid right away if I don't meet the requirement?
No. Federal law requires a notice, at least 30 days to show you comply or are exempt, continued coverage during that time, and fair hearing rights before coverage ends.
Sources
- WV BMS: new Medicaid rules are coming
- WV DoHS: Medicaid help site
- West Virginia Watch (Aug. 12, 2026)
- Public Law 119-21 (H.R. 1), sec. 71119: community engagement requirement (GovInfo)
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- Massachusetts v. Oz, No. 1:26-cv-12962-RGS (D. Mass.), memorandum and order (Oct. 29, 2026)