West Virginia

In West Virginia, various health insurance options are available to help cover the costs of pregnancy and childbirth care. These include private insurance plans, Medicaid, and specialized programs aimed at ensuring expectant parents have access to necessary medical services. Here are some key programs and services:

1. State Plans and Programs

a. West Virginia Medicaid
West Virginia Medicaid provides comprehensive health coverage for low-income pregnant individuals and children. Covered services include:
Prenatal and postpartum care
Delivery services
Hospital stays
Infant care for up to one year after birth. To apply, click here

b. West Virginia CHIP (Children’s Health Insurance Program)
The West Virginia CHIP covers children up to age 19 and pregnant individuals under its CHIP Unborn Child Option, providing essential prenatal and delivery services. Learn More

1. Employer-Sponsored Plans

Pregnant individuals can enroll in coverage through their own or a spouse’s employer-sponsored insurance (ESC). Many employers offer health insurance that includes maternity and newborn care. Coverage typically includes:
Prenatal visits
Ultrasounds
Labor and delivery
Postpartum care
Consult your Human Resources office or insurance administrator for specific plan benefits.

1. Health Insurance Marketplace

Through the Health Insurance Marketplace, pregnant individuals can explore health insurance plans that cover pregnancy and childbirth.
Under the Affordable Care Act (ACA), all marketplace plans must include maternity and newborn care as essential health benefits. West Virginians can shop and enroll in plans through the federal marketplace.

1. Private / Individual Insurance Plans

Private health insurance purchased outside of the federal marketplace can also provide maternity and newborn care coverage. Coverage levels and costs may vary by provider.
Pregnant individuals under 26 years old may remain covered under a parent’s health plan, provided it offers dependent coverage.

1. Other Assistance Programs

a. Indian Health Service (IHS)
American Indian and Alaska Native individuals in West Virginia may access healthcare services, including maternity and childbirth care, through the Indian Health Service (IHS).
While West Virginia does not have direct IHS hospitals, eligible individuals can access IHS support through the Eastern Band of Cherokee Indians resources and contract health services.

b. Sliding Fee Scale Clinics
Federally Qualified Health Centers (FQHCs) and community health clinics throughout West Virginia offer prenatal and maternity care services at reduced costs based on family income.
These clinics offer prenatal visits, lab testing, delivery planning, and postpartum follow-up on a sliding fee basis.

Assistance Navigating Coverage
West Virginians seeking help with applying for Medicaid, CHIP, or Marketplace insurance can work with navigators and Certified Application Counselors.