Medicaid appeals in West Virginia: hearing deadline and keeping benefits
West Virginia Medicaid (Mountain Health Trust for managed care): you have 90 days to ask for a fair hearing.
Notices of adverse action must be mailed at least 13 days before the change takes effect. If you are receiving benefits and ask for a hearing before the effective date of the action, the action is delayed until the hearing decision.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Medicaid (West Virginia Medicaid (Mountain Health Trust for managed care)) denials in West Virginia
- Medicaid agency
West Virginia Department of Human Services (DoHS), Bureau for Medical Services (BMS)
- Who holds the hearing
West Virginia Office of Inspector General, Board of Review
- Hearing deadline
90 days
The effective date of the action
- How to ask for a hearing
- Online: Board of Review online fair hearing request form (linked from oig.wv.gov/BOR)
- Phone: Board of Review 304-352-0805 (requests can be made verbally)
- Mail: Board of Review, State Capitol Complex, Building 6, Room 817, Charleston, WV 25305
- Form: Email a written request to OIGBOR@wv.gov, or give it to the office that sent the notice. A mailed request counts as on time if postmarked within the time limit.
- Mail address
Board of Review, State Capitol Complex, Building 6, Room 817, Charleston, WV 25305
- Keeping your benefits during the appeal
Notices of adverse action must be mailed at least 13 days before the change takes effect. If you are receiving benefits and ask for a hearing before the effective date of the action, the action is delayed until the hearing decision. If your request was sent on time but arrives after the action starts, benefits are reinstated until the decision.
Law: 42 CFR 431.230
- When the hearing is held
A final decision must be made within 90 days of the hearing request (extended by any delay you ask for, up to 30 days). The scheduling notice is sent at least 13 days before the hearing. You can also ask for a pre-hearing conference within 90 days of the effective date of the action.
Medicaid health plan (managed care) in West Virginia
- Appeal to the plan first
About 87% of West Virginia Medicaid members are in Mountain Health Trust managed care, through Aetna Better Health of West Virginia, The Health Plan of West Virginia, Highmark Health Options or Wellpoint of West Virginia. If your plan denies, reduces or stops a service, appeal to the plan first using the instructions in its notice; then you can ask the Board of Review for a fair hearing.
Law: 42 CFR 438.402, 438.408
Write my appeal: free letters
Sources
The official sources for West Virginia are listed on the West Virginia page.