Easy Answers

Federal law now requires certain adults in the Medicaid members under the Adult Group to take part in work or community activities unless they qualify for an exemption. These individuals were able to enroll in Medicaid through the Affordable Care Act and receive their benefits through Mountain Health Trust.

No. Many people will be exempt, including parents, caregivers, people with disabilities, people in treatment, pregnant women, and people in hardship.

You will report your activity when you renew your enrollment. You also may need to confirm your information during the year if anything changes.

You must report the change to DoHS. You may switch to another qualifying activity or apply for an exemption if you meet the criteria.

You may qualify for an exemption if you are medically frail. For this exemption, you may need to provide proof from a doctor or provider.

Possibly. If you do not meet the requirements and are not exempt, your Medicaid coverage may stop until you come back into compliance or qualify for an exemption.

Starting with your first scheduled renewal after January 1, 2027, DoHS will begin checking if you are meeting the engagement requirements.

Visit the WV PATH Portal to make sure your contact information is correct and up to date.

Adults who:

• Are 19–64
• Are not pregnant
• Are not disabled
• Are not on Medicare
• Are a Medicaid member under the Adult Group

Some people will not need to meet the requirements if they are exempt or have a hardship.

If any of the following apply to you, you may soon be transitioning to a Medicaid member under the Adult Group and will also need to meet the Work and Community Engagement requirements:

• Children who are turning 19
• Women in the 12-month postpartum period
• People under age 26 who aged out of foster care at age 18, up to age 21
• Parent or caregiver with the youngest dependent turning 14

People must do 80 hours per month of:

• Working
• Job training programs
• Volunteering
• Going to school or an apprenticeship

Or a combination of these that total 80 hours per month.

Any of these:

• Being employed 80 hours a month
• Earning about $580 a month (the equivalent of working 80 hours at the $7.25 minimum-wage)
• Seasonal work where income averages out to $580 a month

Seasonal work is a job that happens only at certain times of the year (like farming or holiday jobs).

No. Searching for a job only counts if it is part of an <approved work program>.

Volunteering in your community for 80 hours a month counts, if it is an <approved volunteer activity.>

Those who are:

• Under 26 and left foster care at age 18, up to age 21
• In a Native American tribe
• Caring for young children or someone with a disability
• Veterans with total disability
• Medically frail
• In SNAP/TANF work programs
• In treatment for substance use
• In jail or recently released
• Pregnant or within 12 months after pregnancy

You may:

• Lose Medicaid coverage
• Need to reapply
• Not qualify for certain tax credits

DoHS will:

• Use information it already has
• Ask for more if needed

If you are asked for more information, you can provide it online, by phone, in person, or by mail.

Yes. Report changes in:

• Address
• Job or income
• Household size
• Pregnancy
• Marriage or divorce