In West Virginia, as in many other states, your health insurance options are somewhat dependent on your health status.  Even if you are sick, however, the laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
• All group health plans in West Virginia must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new health plan will begin to pay for care for that condition. Generally, if you join a new group health plan your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
• Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable.
• In general, health maintenance organizations (HMOs) in West Virginia must have an annual open enrollment period of at least 30 days when you can buy individual health coverage regardless of your health status.
• If you leave your job, you may be able to remain in your old group health plan for a limited time. This is called COBRA continuation coverage or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
• If you lose coverage under a fully insured group health plan in West Virginia, you may be able to buy a conversion policy. This is an individual policy from the company that insured your former group. You will not face a new pre-existing condition exclusion period. There are no limits on what you can be charged for individual health plan coverage.
• If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you are guaranteed the right to buy an individual health insurance policy from any insurance company that sells such plans in West Virginia. Insurance companies must offer you a choice of at least two plans. You will not face a pre-existing condition exclusion period. However, they may charge you significantly higher premiums due to your health status, age, or other factors.
• If you are HIPAA eligible you also have the right to buy individual health insurance from AccessWV. You will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for an AccessWV policy.
• If you are not HIPAA eligible, but have difficulty obtaining an affordable individual health insurance policy because of your health condition, you may also be eligible for AccessWV coverage. In this case you may face a new pre-existing condition exclusion period. There are limits on what you can be charged for an AccessWV policy.
• If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All health plans for small employers must be sold on a guaranteed issue basis.
• If you are a small employer buying a group health plan, you can be charged more, within limits, due to the health status of those in your group. In addition, you can be charged higher premiums, within limits, because of industry and other factors.
• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The West Virginia Medicaid program offers free or subsidized health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes.
• If your children are under the age of 19, do not have health insurance and meet other qualifications, you may be able to buy insurance for them though the West Virginia Children’s Health Insurance Program (WVCHIP).
• If you believe that you have or are at risk for breast or cervical cancer, you may be eligible for free screening and treatment. The West Virginia Breast and Cervical Cancer Screening Program provides qualified women with free breast and cervical cancer screening. In addition, women diagnosed with cancer may be eligible for treatment through the West Virginia Medicaid Program.
• If you have lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, then you may be eligible for a federal income tax credit to help pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and it is equal to 65% of the cost of qualified health coverage, including COBRA.
• If you are a retiree aged 55-65 and receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), then you may also be eligible for the HCTC.