West Virginia Long-Term Care Planning
West Virginia planning must coordinate a spend-down pathway, five-year transfers, a statutory TOD deed, waiver capacity, and estate recovery rather than rely on a single document.
West Virginia planning begins with the spend-down structure
West Virginia’s 2026 Medicaid guide says people who are initially ineligible because income exceeds the maximum may become eligible under spend-down. The state’s April 2025 long-term-care flyer says the nursing-facility and HCB waiver income rule is 300% of the one-person SSI payment and says people above that level may qualify when care costs exceed the Medically Needy Income Limit and other requirements are met (West Virginia Medicaid 2026 guide; West Virginia long-term-care eligibility flyer).
This makes West Virginia different from a simple “income-cap state, therefore use a Miller trust” description. The located public state materials describe spend-down and do not identify a Qualified Income Trust as the universal published answer. Before creating or funding any trust, obtain a current county-office interpretation of the applicant’s coverage group and patient-liability budget (West Virginia Medicaid 2026 guide).
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