Medicaid plans › West Virginia
West Virginia Medicaid Managed-Care Plans for Providers
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
West Virginia Medicaid is run by the West Virginia Bureau for Medical Services. 407,316 people were enrolled in its 3 managed-care plans in 2024. To see their patients, a provider enrolls with West Virginia Medicaid through the West Virginia Medicaid provider portal (Gainwell), then applies to each plan separately.
| Plan | Members (2024) | Share | Parent |
|---|---|---|---|
| Aetna Better Health of WV | 164,545 | 40.4% | CVS Health |
| Unicare of Health Plan of WestVirginia | 145,177 | 35.6% | Elevance Health |
| The Health Plan of WV | 97,594 | 24% | In-state |
How Joining Works in West Virginia
First the state: West Virginia Medicaid enrollment through the West Virginia Medicaid provider portal (Gainwell), which gives you the Medicaid ID every plan asks for. Then the plans: each takes its own participation request and credentials you from your CAQH ProView (DataSpring) profile. 2 parent companies run plans here, and plans owned by the same company still contract state by state.
How to Join Each West Virginia Plan
Aetna Better Health of WV (CVS Health): Aetna Better Health plans each have a state-specific "Join our network" request on aetnabetterhealth.com. They are separate from Aetna's commercial network, so an Aetna commercial contract does not carry over.
Unicare of Health Plan of WestVirginia (Elevance Health): Elevance Health plans take participation requests through the plan's provider site for that state, most of them now inside Availity Essentials, and credential from your CAQH ProView (DataSpring) profile. Each state is its own contract.
The Health Plan of WV: This plan is run in-state rather than by a national carrier, so participation requests go to the plan's own provider relations or contracting team, listed on its provider website.
Also in West Virginia: Medicare, West Virginia Medicaid and commercial credentialing.
Questions
Which West Virginia Medicaid plan is the largest?
Aetna Better Health of WV, with 164,545 members in 2024, 40.4% of the 407,316 people enrolled in West Virginia's Medicaid managed-care plans.
Do I have to join every West Virginia Medicaid plan?
No. Each plan is a separate contract. Practices usually start with the two or three largest plans in their county, then add others as patients ask for them. All of them require West Virginia Medicaid enrollment first.
Membership from KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Plans change when the state rebids its contracts; we confirm the current list on every file.