Tucked in the heart of the Appalachians, West Virginia is known for its scenic mountains and wild rivers. The state has also become a popular location for older adults. More than 20% of the state’s nearly 1.8 million residents are aged 65 or older, which is well above the national average. West Virginia claimed 14th place in our 2022 Senior Living Report, including first place for senior living and housing, and it ranked in the top 10 for community involvement. Retirees benefit from a reasonable cost of living that’s 22% lower than the national average due to the low cost of housing and utilities. Assisted living is also more affordable than in other parts of the country. Seniors can expect to pay $4,160 per month, which is $340 lower than the national average.

This guide explores long-term care costs and financial assistance programs in West Virginia, including state regulations and free resources that are available to older adults and their families.

The Cost of Assisted Living in West Virginia

Assisted living statistics from Genworth Financial’s 2021 Cost of Care Survey show that seniors in West Virginia pay about $4,160 per month. Statewide, prices are about $340 lower than the national average, although rates vary depending on your community and the facility that you select. Assisted living costs just $60 less per month in Pennsylvania, and seniors in Kentucky save about $712 per month based on average rates of $3,448. West Virginia’s prices are lower than many states in the region, including Ohio ($4,635), Maryland ($4,900) and Virginia ($5,250). Seniors in these states pay anywhere from $475 to $1,090 more per month.

$4160

West Virginia

$4500

The United States

$4635

Ohio

$5250

Virginia

$4100

Pennsylvania

$4900

Maryland

$3448

Kentucky

Assisted living prices vary by a considerable margin in West Virginia’s largest cities. Prices range from $3,675 in Wheeling to $5,700 in Morgantown, a difference of $2,025 per month. Weirton also provides a competitive value at $3,800. However, prices in other cities are higher than the state and national average. Martinsburg residents can expect to pay around $4,630, followed by Charleston at $4,750 and Huntington at $4,875. Seniors in Parkersburg pay $5,444 per month, which is $1,284 more than the state median. 

$4750

Charleston

$4875

Huntington

$5700

Morgantown

$5444

Parkersburg

$3675

Wheeling

$3800

Weirton

$4630

Martinsburg

Prices also vary depending on the type of care provided. Adult day health care is the cheapest option at $1,083. Home care agencies charge between $3,527 and $3,575 for personal care, medical monitoring and help around the house. Assisted living costs slightly more, but rates include room and board and 24-hour assistance. Nursing homes cost nearly three times as much as assisted living. Average prices range from $11,619 to $12,212 for a semiprivate or private room. 

$3527

Home Care

$3575

Home Health Care

$1083

Adult Day Health Care

$4160

Assisted Living

$11619

Nursing Home Care (semiprivate)

$12212

Nursing Home Care (private room)

Does Medicaid Cover Assisted Living in West Virginia?

West Virginia provides limited assistance with activities of daily living through its Medicaid State Plan. These benefits are part of the state’s Personal Care program, which covers the cost of one-on-one assistance provided at home or in another community-based setting, including an assisted living facility or residential care home. However, there are some restrictions. Applicants must be financially eligible for Medicaid based on their income and assets. They must require a nursing home level of care and provide medical verification from a primary care provider. This functional assessment determines how many hours of daily assistance you can receive. Additionally, the Personal Care program cannot duplicate services that assisted living facilities are required to provide. An itemized list of available services may be reviewed when evaluating your application.

What Assisted Living Services Are Covered by Medicaid in West Virginia?

West Virginia’s Medicaid program covers several Home- and Community-Based Services that help seniors and disabled adults maintain their independence and quality of life. The goal of these programs is to promote personal freedom, prevent nursing home placement and give older adults choice over where they live and receive care. The Personal Care Services program covers nurse-supervised supports that help with activities of daily living, including:

  • Eating
  • Bathing
  • Dressing
  • Meal preparation
  • Light housekeeping
  • Grooming
  • Mobility
  • Toileting

The Personal Care program doesn’t cover skilled nursing, wound care or medication administration. To learn more about available benefits, contact the Bureau of Senior Services at (866) 767- 1575, or call the state’s Aging and Disability Resource Center at (866) 987-2372.

How to Know if You’re Eligible for Medicaid in West Virginia

Medicaid Home- and Community-Based Services are available to seniors who have limited assets and require a nursing home level of care. The state sets the monthly income limit at 300% of the federal benefit rate. For 2022, applicants can have up to $2,523 in earned and unearned monthly income. Assets are limited to $2,000 for individuals and $3,000 for couples. There are considerable exemptions for spouses who will remain in the community. If only one spouse requires care, the state excludes $137,400 in assets. A home, vehicle and certain valuables are exempt. Your spouse may also qualify for a monthly needs allowance.

2022 Medicaid Income Limits for Seniors in West Virginia

Income Limits* 

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household
(Only One Person Applying)

$30,276 for applicant

$2,000 for applicant
$137,400 for non applicant

Two-Person Household
(Both People Applying)

$60,522

$3,000

To qualify for Medicaid long-term care, you must:

  • Be a West Virginia resident
  • Provide proof of citizenship or legal residency
  • Have a disability or be aged 65 or older
  • Have low or very low income 

How To Apply for Medicaid in West Virginia 

To see if you’re eligible for benefits, your first step is to submit an application and a Medical Necessity Evaluation Request signed by your primary care physician. The Department of Health and Human Resources provides several application options. 

Information You Will Need

The state’s Medicaid application asks for detailed information about you and other members of your household. Make sure that you have the following records on hand.

  • Name
  • Address
  • Social Security number
  • Proof of residency and citizenship
  • Tax filing status and deductions
  • Information about existing insurance coverage
  • Employment information
  • All sources of income
  • Expected annual income
  • Medical or disability information

How to Get Help Applying for Medicaid

Applying for Medicaid is a complex process, and if you require long-term care, you must complete additional assessments to verify your medical or functional needs. For questions about your eligibility or help with your application, contact the following agencies for assistance. Counseling may be available through your Area Agency on Aging, local senior centers and other organizations.

Contact

Resource

Description

(304) 558-3317

For help with Medicaid long-term care benefits, including Personal Care and Home- and Community-Based Services, contact the West Virginia Bureau of Senior Services. The agency provides a variety of resources to promote healthy, safe and independent aging.

(877) 716-1212

The Department of Health and Human Resources administers a number of financial assistance programs to residents who need help paying for medical care and other essentials. Medicaid applicants may be screened for food stamps and other DHHR benefits.

(304) 558-1700

The Bureau of Medical Services is responsible for managing the state’s Medicaid program. You can get help with your application or benefits by calling the agency or by visiting the local field office in your county.

(304) 352-0805

The Board of Review is part of the Office of Inspector General. This expert panel oversees hearings related to Medicaid and other state benefits. If your application has been denied or your benefits have been terminated, you have a right to a fair, timely and impartial hearing.

Does Medicare Cover Assisted Living in West Virginia?

The short answer is that no, Medicare does not cover the cost of assisted living in West Virginia. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in West Virginia.

Other Financial Assistance Options for Assisted Living in West Virginia

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in West Virginia

Government agencies and nonprofit groups provide a number of resources to help seniors and families who are considering assisted living or are looking for ways to maintain their independence. Learn more about some of the agencies that are active statewide.

RESOURCE
CONTACT
SERVICE

(877) 987-3646

Seniors in West Virginia are served by four Area Agencies on Aging, based in Princeton, Petersburg, Dunbar and Wheeling. These Agencies are part of a national network that includes more than 600 state-operated offices that administer programs funded by the Older Americans Act. Your AAA can provide information about services available in your area, including meals, transportation, in-home care and programs on healthy aging.

(800) 834-0598

Long-term care ombudsmen are independent advocates who act as liaisons between seniors, families and long-term care providers. They visit local assisted living facilities, inform seniors about their rights and provide information to individuals who are considering long-term care. Regional ombudsmen are available to resolve disputes between residents and providers, including issues about food, privacy and personal care.

(800) 772-1213

The Social Security Administration operates 16 field offices across the state. This federal agency administers a number of valuable financial benefits, including Social Security retirement and disability. Supplemental Security Income is another benefit available to adults who can't work and need help paying for their basic living expenses, including room and board in an assisted living facility. You can apply for assistance and manage your benefits online or by calling a local office.

(800) 698-2411

The VA provides an extensive array of services and benefits to veterans and their families. Veterans in West Virginia have access to VA hospitals, outpatient clinics and counseling centers. Residents are served by a number of community-based VSOs who can help with applications for state and federal benefits, including pensions, disability payments and the Aid and Attendance or Housebound supplement, which can help with the cost of personal care.

(800) 229-5068

West Virginia Senior Legal Aid operates a free telephone hotline for seniors aged 60 and older. This nonprofit has advocated for rural, low-income, minority and disabled seniors since 1967. It provides an array of educational guides about Medicaid, long-term care facilities, Social Security, housing, family law and consumer finance that are published as part of The Purple Book.

(304) 558-3317

The Bureau of Senior Services works with the state’s Area Agencies on Aging and county aging offices to administer programs that benefit older adults and support healthy, independent aging. It provides information about Medicaid Personal Care, the Aged and Disabled Waiver and other financial benefits. It also offers chronic disease management programs and Medicare insurance counseling for older adults.

(304) 558-3317

Seniors who have questions about government benefits or local services can contact their county aging provider for assistance. Each county has at least one office on aging, and satellite centers are available in some locations. These offices can provide information about in-home care, community-based services and Medicaid benefits. The Bureau of Senior Services maintains a comprehensive directory of these locations.

COVID-19 Rules for Assisted Living in West Virginia

The following information is based on research done on several government websites, including dhhr.wv.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 4/25/22, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for West Virginia Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Not Available*

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Outings & Social Activities

Rules for West Virginia Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Not Available*

Are residents who leave required to quarantine when they return?

Not Available*

Are senior living communities required to cancel all group outings?

Yes

Are residents allowed to eat meals together in a common area?

No

Are residents allowed to gather in common areas for group activites?

No

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Rules for West Virginia Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in West Virginia

Assisted living residences, residential care communities and residential board and care homes in West Virginia are licensed by the Department of Health and Human Resources Office of Health Facility Licensure and Certification. This agency is responsible for handling licensing applications, performing routine inspections and investigating complaints.

WEST VIRGINIA LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

Facilities must prepare a written service plan for each resident within 7 days of admission. This document is based on a functional needs assessment performed by a licensed healthcare professional within 5 days of admission or up to 60 days before admission. The plan of care must be reviewed annually or following a significant change in health.

Assisted Living Admission Requirements

Residents who require extensive nursing or services that the facility isn't licensed to provide aren't eligible for admission. Individuals who require intensive care may be able to receive some services through a hospice or home health care provider. Facilities are prohibited from admitting individuals who have mental or behavioral disorders if they could pose harm to themselves or others.

Assisted Living Scope of Care

Facilities must provide a comprehensive range of services to help residents with daily activities as needed. These services include one-on-one personal assistance, medication management and help with instrumental activities, including housekeeping, laundry, meal preparation and appointment scheduling. Facilities must provide three daily meals as well as social and recreational activities.

Assisted Living Medicaid Policy

West Virginia’s Medicaid program may cover some Personal Care services provided in assisted living residences. Restrictions may apply.

Assisted Living Facility Requirements

Assisted living residences must provide private or semiprivate bedrooms with sufficient square footage depending on the facility’s classification. There must be at least one bathing area per floor for every 10 residents. Facilities must also provide adequate dining areas and activity space for each resident.

Medication Management Regulations

Residents may self-administer medications if deemed capable by a licensed medical professional. Staff members can provide reminders and help to open containers or read labels if needed. If residents can't complete these activities independently, medications may be administered by licensed health care professionals or unlicensed staff who have completed an approved training course and competency evaluation. Medication records must be reviewed at least once a year.

Staffing Requirements

Facilities must have at least one direct-care staff trained in first aid and CPR available on-site 24 hours a day and a sufficient number of qualified employees to provide adequate care for all residents. During the day, facilities must provide one staff member for every 10 residents or two or more if residents have more substantial needs. Staffing requirements may be reduced at night. A licensed nurse must be available to oversee training and perform certain activities.

Staff Training Requirements

All new employees must complete a training and orientation program within their first 15 days of employment before providing unsupervised assistance. Facilities must conduct annual in-service training and maintain appropriate records. Administrators must complete 8 hours of continuing education annually.

Background Checks for Assisted Living

Background checks are required for owners, administrators and all direct-care staff. The Department of Health and Human Resources provides a comprehensive screening system in partnership with other state and federal agencies. Facilities may not employ staff who have a history of abuse, fraud or similar crimes.

Requirements for Reporting Abuse

Instances of suspected abuse or neglect should be reported to the Department of Health and Human Resources by calling the Adult Protective Services Abuse and Neglect hotline. Certain individuals, including health care workers, are mandated reporters.