This page provides a plain-English summary of key elder care and estate planning information specific to West Virginia residents. It covers West Virginia Medicaid limits, estate tax rules, advance directive information, and links to important West Virginia agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
West Virginia Medicaid — 2026 Eligibility Limits for Long Term Care
West Virginia’s Medicaid program is administered by the West Virginia Department of Human Services — DoHS — Bureau for Medical Services — BMS. West Virginia expanded Medicaid under the Affordable Care Act in 2014 providing coverage to adults up to 138 percent of the federal poverty level.
Income limit — single applicant The income limit for a single West Virginia nursing home Medicaid applicant is $2,982 per month in 2026. West Virginia is an income cap state meaning applicants whose income exceeds this limit must establish a Qualified Income Trust — also called a Miller Trust or QIT — to qualify.
Asset limit — single applicant A single applicant must have $2,000 or less in countable assets. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, life insurance policies with a combined face value up to $1,500, burial plots, and irrevocable burial funds up to $1,500. Note that IRAs and 401(k)s are counted as countable assets for the applicant in West Virginia. However the non-applicant spouse’s IRA or 401(k) is exempt — a favorable rule for married couples.
Home and community based care — Aged and Disabled Waiver West Virginia’s primary HCBS program for seniors is the Aged and Disabled — AD — Waiver which provides home and community based services for West Virginians aged 65 and older or adults aged 18 and older with physical disabilities who need nursing facility level care but want to remain at home. The asset limit is $2,000 for a single applicant and the income limit is $2,982 per month. Services include personal care homemaker services adult day services respite care home modifications and assistive technology.
Transitions to Home — nursing home to community program West Virginia offers a Transitions to Home component within the AD Waiver specifically for individuals who currently reside in a nursing facility and want to return to community living. Transitions to Home staff work one-on-one with participants to create personalized transition plans and secure appropriate community-based supports. This is especially relevant for West Virginians who entered nursing facilities during health crises and want to return home.
Personal Care Services Program West Virginia also offers a Personal Care Services — PCS — program that provides in-home personal care assistance for Medicaid members who need help with activities of daily living. Services can be provided at home at a workplace or in the community. The PCS program does not require nursing facility level of care making it more accessible than the AD Waiver for some applicants.
Married couples — one spouse applying When only one spouse applies for West Virginia Medicaid the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined countable assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $2,000.
Monthly Maintenance Needs Allowance The minimum Monthly Maintenance Needs Allowance for the community spouse is $2,644 per month in 2026. The maximum is $4,066.50 per month for community spouses with high housing costs.
Personal needs allowance West Virginia nursing home Medicaid recipients are allowed to keep $50 per month as a personal needs allowance. The remainder of income is applied toward the cost of care.
Look-back period and divestment penalty West Virginia has a 60-month — five year — look-back period for nursing home Medicaid and AD Waiver applications. The look-back period does not apply to the Personal Care Services program. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. The 2026 divestment penalty divisor in West Virginia is based on the statewide average monthly cost of nursing facility care.
Estate recovery West Virginia requires Medicaid estate recovery. After a West Virginia Medicaid recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney can help protect assets from estate recovery.
How to apply for West Virginia Medicaid Applications can be submitted online through WV PATH at dhhr.wv.gov, by phone at 1-877-716-1212, or in person at your local West Virginia Department of Human Services office.
West Virginia Medicaid administering agency West Virginia Department of Human Services Bureau for Medical Services — bms.wv.gov
West Virginia Estate Tax — 2026
No West Virginia state estate tax West Virginia does not impose a state estate tax. No West Virginia estate tax applies to any estate regardless of size.
No West Virginia inheritance tax West Virginia does not impose an inheritance tax. Beneficiaries who receive assets from a West Virginia decedent owe no West Virginia inheritance tax regardless of the size of the inheritance or their relationship to the deceased.
Federal estate tax West Virginia residents may be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses meaning a married couple can protect up to $30,000,000 from federal estate tax with proper planning. The top federal estate tax rate is 40 percent on amounts above the exemption.
No West Virginia gift tax West Virginia does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026.
West Virginia income tax — improving for retirees West Virginia has a progressive income tax with a top rate of 6.5 percent on income over $60,000. Social Security benefits are becoming fully exempt from West Virginia income tax in 2026 — a significant improvement for retirees living on fixed incomes. Military retirement pay is fully exempt from West Virginia income tax. Other pension and retirement account income is partially taxable.
West Virginia property taxes — among the lowest in the country West Virginia has an effective property tax rate of approximately 0.51 percent — well below the national average. West Virginia homeowners aged 65 and older or who are totally and permanently disabled are exempt from paying taxes on the first $20,000 of their home’s assessed value. This senior exemption combined with West Virginia’s already low property tax rates keeps property tax bills very modest for most senior homeowners.
Homestead Excess Property Tax Credit West Virginia offers a refundable Homestead Excess Property Tax Credit of up to $1,000 for low-income taxpayers whose property taxes exceed 4 percent of their annual gross income. Income must be at or below 300 percent of the federal poverty guidelines.
Step-up in basis Inherited assets in West Virginia receive a stepped-up tax basis to fair market value at the date of the original owner’s death. This can significantly reduce capital gains taxes when beneficiaries later sell inherited property.
West Virginia Advance Directives
West Virginia law recognizes the following advance directive documents:
West Virginia Medical Power of Attorney Names a healthcare representative to make medical decisions on your behalf when you are unable to do so. Must be signed and witnessed by two adults or notarized.
West Virginia Living Will Documents your wishes regarding life-sustaining treatment when you have a terminal condition or are in a persistent vegetative state. Must be signed and witnessed by two adults.
West Virginia POLST — Physician Orders for Life-Sustaining Treatment West Virginia uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or nurse practitioner.
West Virginia Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. West Virginia has standardized out-of-hospital DNR protocols.
West Virginia Advance Directive Registry West Virginia does not maintain a statewide advance directive registry. Copies of your advance directive should be given to your healthcare representative physician and any hospital or care facility where you receive care.
Free West Virginia advance directive forms Free West Virginia-specific advance directive forms are available at caringinfo.org and from the West Virginia State Medical Association at wvsma.org.
West Virginia Key Agencies and Resources
West Virginia Department of Human Services Bureau for Medical Services — BMS Administers West Virginia Medicaid including long term care programs. Website: bms.wv.gov WV PATH Portal: dhhr.wv.gov Phone: 1-877-716-1212
West Virginia Bureau of Senior Services — BOSS Coordinates programs and services for older West Virginians including home care nutrition programs caregiver support and the West Virginia SHIP program for free Medicare counseling. Website: wvseniorservices.gov Phone: 1-304-558-3317 West Virginia SHIP — free Medicare counseling: 1-877-987-4463
West Virginia Area Agencies on Aging West Virginia is served by 8 Area Agencies on Aging that coordinate local services for older adults and caregivers. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
West Virginia Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: wvseniorservices.gov/ombudsman Phone: 1-304-558-3317
West Virginia State Bar Lawyer Referral Service Connects West Virginians with attorneys including those who specialize in elder law and estate planning. Website: wvbar.org Phone: 1-866-989-8227
Legal Aid of West Virginia Provides free civil legal services to low income West Virginians including seniors on issues related to Medicaid benefits housing and elder law. Website: lawv.net Phone: 1-866-255-4370
West Virginia Veterans Resources
West Virginia Division of Veterans Affairs — WVDVA Provides services and benefits to West Virginia veterans and their families including free VA claims assistance and connections to West Virginia veterans resources. Website: veterans.wv.gov Phone: 1-304-558-3661
West Virginia State Veterans Homes West Virginia operates veterans homes providing long term care to eligible veterans and their spouses. Facilities are located in Clarksburg and Barboursville. Website: veterans.wv.gov/veterans-homes
West Virginia Senior Property Tax Benefits
Senior and Disabled Homestead Exemption West Virginia homeowners aged 65 and older or who are totally and permanently disabled are exempt from paying property taxes on the first $20,000 of their home’s assessed value. This reduces property tax bills for qualifying seniors across the state. Apply through your county assessor’s office.
Homestead Excess Property Tax Credit West Virginia offers a refundable property tax credit of up to $1,000 for qualifying low-income homeowners whose property tax exceeds 4 percent of their annual gross income. Income must be at or below 300 percent of the federal poverty guidelines. File with your West Virginia income tax return.
Disabled Veteran Property Tax Exemption West Virginia veterans who are totally and permanently disabled due to a service-connected disability may qualify for a property tax exemption on their primary residence. Contact your county assessor’s office for details.
Finding Elder Law and Estate Planning Attorneys in West Virginia
The following resources can help you find a qualified elder law or estate planning attorney in West Virginia:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- West Virginia State Bar Lawyer Referral Service — wvbar.org — 1-866-989-8227
- West Virginia Chapter of NAELA — West Virginia has an active NAELA chapter with members throughout the state
- Legal Aid of West Virginia — lawv.net — free legal assistance for income-qualifying seniors — 1-866-255-4370
The information on this page is for general informational purposes only and does not constitute legal or financial advice. West Virginia Medicaid rules and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: May 2026