Paying for assisted living in West Virginia
Most families in West Virginia begin by paying for assisted living privately, using savings, retirement income, the proceeds of a home sale, or a long-term care insurance policy. Costs vary widely from one part of the state to another and depend on a community's size, amenities, and the level of personal care a resident needs. You can compare current pricing for specific communities in the pricing tables below.
Because assisted living is rarely fully covered by a single program, it helps to understand early on what public benefits can and cannot do.
Does West Virginia Medicaid cover assisted living in West Virginia?
West Virginia Medicaid never pays for the room-and-board portion of assisted living. What it may help with is the personal-care side of your stay.
- The state's main home- and community-based waiver, the Aged and Disabled Waiver (ADW), supports care at home or in a family member's home and generally cannot be used to live in an assisted living residence.
- The Medicaid Personal Care Services Program can, in some cases, provide hands-on help with daily activities (bathing, dressing, mobility, and similar tasks) for an eligible member living in an assisted living residence, as long as the residence is not already providing that care. It still does not cover room and board.
Eligibility for both programs depends on income, assets, and a medical assessment showing you need a nursing-home level of care. You apply for Medicaid through WV PATH or your local county office, and a separate medical evaluation determines clinical eligibility.
Does Medicare cover assisted living in West Virginia?
Medicare does not pay for assisted living room and board or for the ongoing custodial (personal) care that defines assisted living. It is health insurance, not long-term care coverage.
Medicare may still cover medical services a resident uses, such as doctor visits, hospital stays, short-term skilled nursing or rehabilitation after a qualifying hospital stay, and some home health care when criteria are met.
For free, unbiased help understanding Medicare, Medicare Advantage, Part D, and Medigap, contact West Virginia SHIP (State Health Insurance Assistance Program) at 1-877-987-4463.
