If you live in West Virginia, the following health insurance contact information may be helpful to you:
West Virginia Offices of the Insurance Commissioner
The West Virginia Offices of the Insurance Commissioner are responsible for regulating all types of insurance sold in the state of West Virginia, including health insurance policies.
If you are looking for health insurance coverage, the Offices of the Insurance Commissioner keep a list of insurance companies licensed to sell policies in West Virginia.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Offices of the Insurance Commissioner. You can find a complaint form on the offices' website.
West Virginia Offices of the Insurance Commissioner
1124 Smith Street
Charleston, WV 25301
Phone: 1-888-TRY-WVIC or 304-558-3386
Email: Consumer.Service@wvinsurance.gov
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees. For example, your employer cannot single out an individual employee and exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage (for example, if you think you should have been offered COBRA continuation coverage, but were not), contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Washington District Office
1335 East-West Highway, Suite 200
Silver Spring, MD 20910
Elizabeth Bond - Supervisor
Phone: 202-693-8700
Fax: 202-693-8736
Buying Individual Policies in West Virginia
As a general rule, insurers in West Virginia are allowed to reject your application for coverage based on your health status. However, some HMOs in West Virginia have open enrollment periods during which they are not permitted to reject any applicants due to pre-existing conditions. Contact the HMO directly to find out if they have an open enrollment period. You may also qualify for coverage as a "HIPAA-eligible" individual if you:
- had at least 18 months of continuous creditable coverage, the last day of which was under a group plan
AND
- you have exhausted all COBRA continuation coverage available to you
People who are HIPAA-eligible are guaranteed the right to buy an individual policy from a private insurer. You can also buy insurance through AccessWV (described below). If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the West Virginia Offices of the Insurance Commissioner can help you find out.
Access WV
AccessWV offers coverage to individuals who are unable to purchase an individual health insurance policy because they have pre-existing health conditions. It also covers "HIPAA-eligible" individuals, as described above. For more information about the program, including premium rates, contact AccessWV.
AccessWV
Phone: 866-445-8491 or 304-558-8264
West Virginia Children's Health Insurance Program (CHIP)
The CHIP program provides health insurance coverage for children whose family's income meets certain guidelines.
CHIP
Phone: 877-982-2447
West Virginia State Health Insurance Assistance Program (SHIP)
SHIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit or Medigap coverage.
SHIP
Phone: 877-987-4463
West Virginia Medicaid
Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals.
West Virginia Medicaid
Phone: 800-642-8589 or 304-558-2400
