The West Virginia Children’s Health Insurance Program (WVCHIP) is authorized under Title XXI of the Social Security Act. WVCHIP is financed by state and federal governments and is administered by the state. It is not an entitlement program. WVCHIP is administered by the West Virginia Children’s Health Insurance Agency that is housed within the Bureau for Medical Services (BMS). BMS is the single state agency responsible for administering the West Virginia Medicaid Program. BMS is administered by the West Virginia Department of Human Services (DoHS).
WVCHIP provides health care coverage to children from birth through their 19th birthday and to pregnant women over age 19 that have no other health insurance coverage and are not eligible for Medicaid. It pays for a full range of healthcare services that includes doctor visits, check-ups, vision and dental visits, immunizations, prescription drugs, hospital stays, behavioral health and special needs services. Benefits are the same for both children and pregnant women.
WVCHIP delivers benefits to members through arrangements with managed care organizations (MCOs) and some benefits are delivered through WVCHIP fee-for-service (FFS). Once determined eligible and enrolled into WVCHIP, members are enrolled into the Mountain Health Trust (MHT), the managed care program that offers members a choice of one of four MCOs in which to enroll: 1) Aetna Better Health of West Virginia; 2) The Health Plan; 3) Wellpoint West Virginia; and 4) Highmark Health Options of West Virginia.
