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West Virginia

West Virginia Health Insurance

West Virginia has moderate health insurance regulations. It's important to familiarize yourself with them, so you can exercise your rights should the need ever arise.

This guide:

  • Describes West Virginia health insurance policy regulations.

  • Lists rules West Virginia health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. West Virginia health insurance companies and policyholders alike must abide by established insurance laws.


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Do You Qualify For A Subsidy?


Find out if you qualify for a government subsidy under Obamacare. Millions of Americans will have their insurance rates reduced under the new health care law. Learn how much you could save with our simple calculator.

West Virginia health insurance policy provisions

Some of the most important West Virginia health insurance laws are the ones that influence the health insurance policy specifically.

For instance, West Virginia health insurance policies must contain a guaranteed renewability provision. This mandatory clause ensures you will be able to renew your health insurance policy every year as long as you follow the terms outlined in the insurance contract.

In West Virginia, insurance policies can include exclusion periods for pre-existing conditions. Since the duration of the exclusion period is not limited, pre-existing conditions can be excluded permanently.

The definition of a pre-existing condition varies from state to state. In West Virginia, it refers to a condition you received medical treatment for or were diagnosed with in the 2 years prior to the beginning of the plan.

If you are switching West Virginia health insurance policies and you have had no breaks in your coverage, your old policy can be used to credit the pre-existing condition period of your new West Virginia health insurance plan.

Also, West Virginia health insurance policies already covering dependents, must also cover newborns and newly adopted children for a minimum of 31 days. After this time has passed, your health insurance policy must be amended to include children under your coverage.

Regulating West Virginia health insurance companies

Health insurance laws in some states strictly regulate the cost and availability of health insurance policies, instead of letting insurance companies have total freedom. West Virginia health insurance laws are rather relaxed in this area, which means you just have to be more aware of what liberties your health insurance company are allowed.

For one, West Virginia health insurance companies are permitted to deny health coverage because of poor health.

Although any West Virginia health insurance company is free to refuse you coverage, there are HMO's that have an open enrollment period in which you can purchase insurance regardless of your health status.

Also, the cost of West Virginia health insurance is not controlled by the state. Therefore, you can be charged more because of your health status and your premiums can significantly increase due to age and declining health.

However, it is illegal for any West Virginia health insurance company to deny your request to renew your policy on the basis of declining health.

Temporary West Virginia health insurance

Temporary West Virginia health insurance is more expensive than regular insurance, however, in instances of breaks in coverage, it is a necessity. One good option for temporary insurance is a conversion policy

You qualify for a conversion policy if you are leaving a group health insurance policy. Your former West Virginia health insurance company is required to offer you three basic policies with varying degrees of coverage. These policies, however, are likely to be much more costly than your former West Virginia health insurance policy.

In order to obtain a conversion policy, you must complete and return the application within 31 days from the last day of coverage under your old health insurance.

If you do not qualify for a conversion policy, there are West Virginia health insurance companies that provide other types of temporary health insurance.

More WV health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to West Virginia small business health insurance.


To find out more about WV health insurance laws and regulations, visit the official website of the West Virginia Insurance Commission.





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This internet site provides information of a general nature for educational purposes only and is not intended to be legal advice. We make no guarantees as to the validity of the information presented. Your particular facts and circumstances, and changes in the law, must be considered when applying insurance law. You should always consult with a competent insurance professional licensed in your state with respect to your particular situation.