West Virginia CHIP benefits

WVCHIP benefits include:

• Doctor visits
• Checkups
• Hospital visits
• Urgent or after-hours care
• Immunizations (shots)
• Maternity benefits
• Tests and X-rays
• Emergency care
• Diabetic supplies
• Case management services

For a complete list of covered services, see your member handbook . Some services may have a small fee called a copay. See the "Your costs" section below for more information.

Dental care is provided through SKYGEN USA Dental. Services include dental exams, cleanings, and X-rays.

Vision benefits are provided by Superior Vision. Vision services include annual exams and eyewear.

Pharmacy benefits are covered under the state program and managed by ESI. If you have questions about your benefits, visit Express-Scripts.com or call ESI Express Scripts Pharmacy at 855-230-7778.

Maternity benefits include prenatal care, labor and delivery, and other medically necessary services. Pregnant members do not have copays. After delivery, new mothers will continue to receive benefits for 60 days.

• WW® (formerly Weight Watchers) meeting for eligible members ages 18 and older
• Active&Fit — eligible members ages 18 and older can receive one gym membership to participating gyms such as Anytime Fitness and YMCAs; or home fitness kits option.
• Youth club memberships to participating clubs like Boys & Girls Clubs for ages 6-18 (not summer camps)
• Oral Care Essentials box with items like electric toothbrushes, toothpaste, and floss
• No-cost laptop to help with educational pursuits for graduating high school students with a GPA of 3.5 or higher or students that have completed the GED/TASC
• Up to $75 in lifestyle aids from a catalog of healthy lifestyle products
• Personal hygiene box with up to $50 worth of hygiene products or a voucher to purchase personal hygiene products
• Feminine care collection for females 10-18; up to $75 worth of feminine care products
• A $100 gas card for members ($25 every 3 months per household) to help members and their families with transportation needs; limit 1 per household
• Family Coupon Book filled with special discounts for local retailers, restaurants, and entertainment
• Summer Camp Sponsorship to Camp KnoKoma for eligible members
• Online Well-Being program — online platform promoting behavioral health and wellness through instruction, games, goal setting, and monitoring for eligible members ages 13 and older
• SUD Recovery Support Program that provides daily motivations/check ins, peer support through discussion groups and peer-to-peer messages, and more for eligible members
• Community Resource Link to locate available local community-based programs, benefits, and services
• Help line and coaching to quit smoking

Pregnant members can get:

• Portable crib or convertible car seat for members completing 6 prenatal visits
• Pregnancy and childbirth classes to help you have a healthy pregnancy
• Fresh fruits and veggies program with up to $100 in fresh produce. All pregnant members are eligible. From 1st trimester up to 60 days post-partum.
• Electric Breast Pump Accessory Kit with disposable nursing pads and extra milk storage bags and bottles
• Preventive Dental Care which includes coverage for 2 dental visits per pregnancy
• Mail order diapers for babies of eligible members for completing 6 prenatal visits
• Safe sleep kit with items like a swaddle sleep sack, pacifier, and infant sleep guidelines for members with a baby under 1 year of age

You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on the Benefit Reward Hub or call the Customer Care Center at 800-782-0095 (TTY 711) Monday through Friday, 8 a.m. to 6 p.m. Eastern time.

Limitations and restrictions apply. Benefits may change.

Log in to get started today!

Visit the Benefit Reward Hub

Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages you to get the care you need to create a healthy lifestyle.

You can redeem these Healthy Rewards through the Benefit Reward Hub:

• $10 for completing a new member health screener
• $25 for childhood and adolescent wellness visits for members ages 3-19
• $50 for completing HPV vaccination series prior to member’s 13th birthday
• $25 for childhood and adolescent dental visits, ages 2-19
• Up to $80 for following up with your doctor after being hospitalized for a behavioral health condition
• Up to $40 for ADHD medication management, ages 6-12
• $50 for a diabetic retinal eye exam for members 18 and older
• $50 for a diabetic A1c screening for members 18 and older
• $5 for completing a What do you know about diabetes? quiz

For pregnant members:

• $25 for prenatal visit in the first trimester or within 42 days of enrollment into UniCare
• $25 for attending at least six prenatal visits
• $25 for attending postpartum visit 7 to 84 days after delivery
• $25 for first well-baby checkup within two weeks of delivery
• $25 for attending at least six well-child checkups by 15 months of age

Requesting benefits

Log in to the Benefit Reward Hub and redeem your Healthy Rewards. You can also call the Healthy Rewards Customer Service Line at 888-990-8681 (TTY 711) Monday through Friday from 9 a.m. to 8 p.m. Eastern time.

Redeem Healthy Rewards

Premiums

WVCHIP members in the Premium Plan pay a monthly payment, called a premium. You can make your premium payment online through the WVCHIP Premium Plan Payment System.

Copays

Copays are a set dollar amount you pay for a covered service like a doctor visit or going to get a prescription filled. Copay amounts vary based on the WVCHIP plan you are in.

Copayments
Medical Services and Prescription Benefits	Gold	Blue	Premium Plan
Generic Prescriptions	No Copay	No Copay	No Copay
Listed Brand Prescriptions	$5	$10	$15
Non-Listed Brand Prescriptions	Full Retail Cost	Full Retail Cost	Full Retail Cost
Medical Home or Well-Child Physician Visit	No Copay	No Copay	No Copay
Physician Visit (Non-Medical Home)	$5	$15	$20
Hospital/Inpatient Services	No Copay	No Copay	No Copay
Outpatient Surgical Procedures	No Copay	$25	$25
Emergency Room (waived if admitted)	No Copay	$35	$35
Dental Services	No Copay	No Copay	$25 for some non-preventive services
Vision	No Copay	No Copay	No Copay

Visit chip.wv.gov for more information about copays, or call the CHIP Helpline at 877-982-2447.

We put tools and technologies in your hands to make it easier to access care and services. Your Care Plan is a tool for UniCare Case Management members to help you:

• Stay connected with your care coordinator
• Get your care coordinator’s phone number and email address
• Send secure messages about diagnoses, goals, medicines, services and more
• View your goals and objectives
• Check due dates and statuses of goals and objectives