How to Pay for Long-Term Care in West Virginia

By Gracie Davis – Deputy Executive Assistant at West Virginia Senior Legal Aid, Inc.

Paying for long-term care is one of the most pressing concerns for West Virginia seniors and their loved ones. The costs of nursing homes, assisted living, and in-home care can be emotionally taxing, especially for those on fixed incomes. Luckily, several programs and methods are available to help ease the burden.

Medicaid is the primary payer for long-term care. It covers a substantial portion of nursing home residents in West Virginia and also provides funding for home and community services through special waiver programs. To qualify for Medicaid long-term care, applicants must meet strict income and asset limits, be at least 65 years of age or disabled, and be a United States citizen or a qualified non-citizen residing in the state. Applying for Medicaid can be complex, but any of the state’s Department of Human Services offices can assist, and Medicaid applications may also be submitted online. For those who need help understanding eligibility or navigating the application process, Aging & Disability Resource Centers across the state offer free guidance, helping individuals make informed decisions about their care.

Additionally, many West Virginia seniors may qualify for Veterans Affairs benefits, particularly Aid and Attendance or Housebound allowances. These benefits are available to veterans and their surviving spouses who need aid with daily activities or are largely confined to their homes because of a disability. These supplemental payments can significantly reduce the cost of in-home care or assisted living. Veterans Service Officers through the West Virginia Department of Veterans Assistance can provide personalized assistance in filing claims and gathering required documentation, ensuring eligible veterans receive support they have rightfully earned.

For individuals who are not eligible for either Medicaid or Veterans Affairs benefits, these individuals often rely upon private options like long-term care insurance and personal savings. Long-term care insurance policies vary widely, so it is crucial to fully understand what services are covered, any waiting periods, and under what conditions benefits are paid. For individuals relying on savings, the cost of care may quickly erode retirement savings, which is why it is immensely important to do financial planning as soon as possible. Planning ahead with legal and financial tools can help protect assets while ensuring access to critical care.

Strategies such as Medicaid Asset Protection Trusts allow individuals to shelter resources if established far enough in advance. Because Medicaid imposes a 5-year look-back period on asset transfers, timing is everything. It is additionally important to have key documents in place (e.g., a durable power of attorney and advance directives) to ensure decisions can be made smoothly. For those who need help understanding how Medicare and Medicaid interact, or those who are exploring insurance coverage options, the West Virginia State Health Insurance Assistance Program (WV SHIP) offers free counseling.

For residents already in long-term care facilities, the West Virginia Long-Term Care Ombudsman Program is a valuable resource. Ombudsmen advocate for residents’ rights, help resolve issues with care or discharge, and ensure that individuals are treated with dignity and respect.

By exploring available programs and connecting with these resources, West Virginia seniors and their loved ones can take proactive steps toward managing long-term care needs. Planning does not just preserve financial stability, but it also empowers individuals to age with grace, choice, and support. For further aid, please contact a licensed attorney. West Virginia Senior Legal Aid is dedicated to defending West Virginia seniors’ rights.