Who is eligible for WVCHIP?
Your children are eligible if they:
- Live in West Virginia .
- Are 18 or younger.
- Don't have health insurance now and haven't had it in the past six months (some exceptions apply, click here for more information).
- Are not eligible for the West Virginia State Employee Health Insurance - PEIA
- Are not eligible for West Virginia Medicaid .
- Live in families meeting WVCHIP Income Guidelines.
- Are United States citizens or qualified aliens (Children who are not U.S. citizens must provide verification of their alien status.).
List of eligibility facts found on this page.
Income Guidelines
WVCHIP income guidelines are based on family size. Family size means the number of parents living with their natural or adopted children plus the number of children under age 19.
Only the income of the child and/or the natural or adoptive parent is counted to qualify. This means income from grandparents, stepparents, or other relatives or adults in the home are not counted as part of the qualifying income level.
Blended Family
For example, a family of five blended from prior marriages with two children biologically related to the father and one to the mother will have their income counted in two separate qualifying groups. Their income will only be counted as a family of five if one parent has legally adopted their stepchildren.
Grandparents
Only the income of the child will be counted when being raised by grandparents (unless the child is legally adopted by the grandparents).
Expecting A Child
If you are expecting a child and would like the child to be counted as a part of your family size to qualify for WV CHIP, the pregnancy must be confirmed with a doctor's statement. WV CHIP does not cover labor or delivery costs for the child. After the child has been born and you want to apply for coverage for the child under WV CHIIP, you can call the DHHR Change Service Center (DHHR CSC) at 1-877-716-1212. All claims related to the child will be put on hold by WV CHIP until a social security number has been reported to the DHHR CSC for thc child being born. Please remember to apply for the child's social security card right away and report the social security number immediately upon receiving.
Can my family qualify for WVCHIP if our income is over the amount listed on the income chart?
There are several income disregards that may help you qualify for the program if your income is above the maximum limit for your family size. Income disregards are subtracted from each applicant's gross income. Listed below are the types of disregards that are available to applicants:
- $90 monthly deduction for each parent working full-time or part-time.
- $50 monthly deduction on total child support income.
- Up to $175 monthly deduction for child care expenses for each child over age 2.
- Up to $200 monthly deduction for child care expenses for each child under age 2.
- Up to $175 monthly deduction for dependent adult care expenses.
Your self-employment income is counted minus allowable business expenses paid. WVCHIP allows the following deductions: employee labor costs, stock and supplies, raw material, seed, fertilizers, repair and maintenance on machinery or property, cost of rental space used for conducting business, interest & taxes, but not principal paid on purchase of capital assets, interest & taxes on a portion of residence used to produce income, advertising costs, utilities, office expenses (stamps, pens, etc.) and legal costs.
- Paystubs or earning statements for the last thirty days.
- Most recent quarterly or yearly tax return, if self-employed.
- Proof of most recent alimony and/or child support payment or court order, if applicable.
- Proof of most recent payment or current award letter for Social Security, S.S.I., Worker's Compensation, Unemployment benefits, Veteran's benefits, or any other income source .
- If your income is seasonal or highly variable through the year, income is based on what you have earned in the month you are applying. You may also use your yearly tax return.
SSI is not countable income and also the person who receives SSI is not counted in the family size. For example, if you have a family of 6 (2 parents and 4 children) and 2 children are receiving SSI, then it would be considered a household of 4. This family would have to fall within the income guidelines of a family of 4 not a family of 6.
RSDI is countable income. For example, if you have a family of 4 (father receives $1,000 RSDI; mother receives $500 RSDI; and the two children are receiving $250 a piece), the family income would be counted as $1,750 (not $2,000 – because one child’s income is not counted against the other). The family would have to fall within the income guidelines of a family of 4. How Is Income Counted for WVCHIP?
Applications are reviewed based on most recent income received in the month (equal to the past 30 day period). All income shown on your application form will be converted to a monthly basis. For more information on how to calculate your monthly income please call 1-877-982-2447.
There are many facilities in the state of West Virginia that offer discounted or free services to families who do not have health insurance. Click on one of the resources listed below for more information. These links are to other web sites which may or may not be text based.
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