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The following WVCHIP resources are available to be printed. Just click on the item you want below:
Income Guidelines and Co-Pays
Health Insurance - Family Application
Health Insurance-Single Streamlined Application
Summary Plan Description (SPD)
(July 2021- June 2022)
Current WVCHIP Preferred Drug Formulary
CVS_Caremark_prescription_claim_form.pdf
Medical Reimbursement Form
Notice of Privacy Practices
Non-State Agency List (Buy Into PEIA)
WVCHIP Generic Flyer
Antipsychotic Medicines for Children and Teens
Mental Health & Substance Use Disorder Benefits
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