West Virginia CHIP and Medicaid for Kinship Caregivers

Your grandchild moved in three weeks ago, and the inhaler prescription is running out. The pediatrician's office wants to know who carries the child's insurance — and you have no answer yet.

West Virginia offers two public health coverage programs that children in informal kinship care can qualify for: Medicaid and the West Virginia Children's Health Insurance Program (WVCHIP). Neither requires you to have a court custody order.

How Eligibility Works for Kinship Households

Both Medicaid and WVCHIP assess income and family size. WVCHIP covers children who meet its income guidelines and are not eligible for Medicaid; its eligibility page defines family size as the people claimed on the federal tax return. For Medicaid and CHIP, CMS says a child claimed as a tax dependent generally includes the parents in the household. After a move to a caretaker relative, a state may use non-filer rules if the parents do not intend to claim the child for the next tax year; under those rules, neither the parents nor caretaker is included.

A kinship caregiver who is not the child's parent can apply on the child's behalf. You do not need a guardianship order or custody papers to apply.

Some WVCHIP families do pay modest premiums or copayments. Medicaid for eligible children is typically free.

Applying Through WV PATH

All applications go through the state's online portal at wvpath.wv.gov. You can also apply in person at your local county DoHS Bureau for Family Assistance office.

When you create a WV PATH account, you'll be asked about the child's living situation and your relationship to them. Have these ready:

• The child's Social Security number
• The child's birth certificate (or the information on it)
• Your identification and proof of address
• Any income information the child receives (Social Security survivor benefits, for example)

If you're already applying for WV WORKS (TANF) kinship relative payments through WV PATH, you can add WVCHIP or Medicaid to the same application.

Consent Authority for Medical Visits

Having WVCHIP or Medicaid coverage in the child's name solves the insurance question, but clinics also need consent authority for treatment. These are two separate requirements.

For consent, you'll need either a Caregiver Consent Affidavit under WV Code §49-2-703 (which you can execute without a parent's signature under specific conditions) or a Power of Attorney under §49-8-4 (which requires the parent's participation). The affidavit covers health care; the POA covers health care and school decisions.

Once you have both insurance coverage and a consent instrument, the child can see a doctor, fill prescriptions, and get routine care without delays.

What Coverage Includes

WVCHIP and Medicaid both cover pediatric visits, immunizations, dental care, vision, hearing, prescriptions, emergency room visits, mental health services, and hospitalizations. The specifics vary by program, but both are comprehensive enough to handle a child's routine and urgent medical needs.

If the child was already enrolled in Medicaid or WVCHIP before moving in with you, that coverage may still be active. Contact DoHS to update the child's address and household information rather than starting a new application from scratch.

Getting Help With the Application

If you run into questions or your application stalls, three resources can help:

• Your county DoHS office can walk you through the application in person
• Legal Aid of West Virginia (1-866-255-4370) assists kinship families with benefits access
• West Virginia 211 (dial 2-1-1) connects you with local family support services

The complete West Virginia school and medical consent guide walks through the consent instruments, school enrollment, and benefits access in one organized package — including a checklist you can print before your first clinic visit.

See more West Virginia guides →