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West Virginia Medicaid Benefits

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We help make sure you and your family get all your Medicaid benefits. Plus, UniCare members get extra benefits at no cost!

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What you get with UniCare

Our benefits and services are designed to make a difference in your life.

There are no copays for behavioral health and emergency care services. Your Medicaid benefits include:

  • Primary care provider (PCP) visits
  • Immunizations and wellness visits
  • EPSDT (Early and Periodic Screening, Diagnosis and Treatment) services for members under 21
  • Specialist visits
  • Urgent and emergency care
  • Hospital care
  • Lab and X-ray services
  • Pregnancy services 
  • Family planning
  • Chiropractic services
  • Physical and occupational therapy
  • Speech and hearing services
  • Behavioral health care (mental and substance abuse services)
  • Home health care services
  • Disease management for asthma, diabetes and more

Some members will pay low copays for some care. See your member handbook for a full list of benefits. 

Find a Doctor

Registered nurses are available anytime, day or night. They can:

  • Advise you on where to go when you need care.
  • Help you with any health questions you have.

Call the 24-hour nurse help line 24 hours a day, seven days a week
1-888-850-1108 (TTY 1-800-368-4424)

Dental care for children and emergency dental services for adults are provided through SKYGEN USA Dental.

Members under 21 years

  • Diagnostic, preventive, restorative and surgical benefits
  • Routine dental care
  • Oral exams
  • Cleanings
  • X-rays
  • Orthodontic services
  • Flouride Varnish Program

Members age 21 and older

  • Treatment of jaw fractures
  • Biopsy
  • Removal of tumors
  • Emergency extractions
  • Medically necessary emergency procedures from a dentist or oral surgeon
Find a Dentist

Vision benefits are provided by Vision Service Plan (VSP). Vision services include:

Members under 21 years of age

  • Preventive screenings
  • Eye exam once a year
  • Glasses (frames and lenses) once a year
  • Repairs to glasses
  • Contact lenses (if medically necessary)
  • Eye surgery (not cosmetic)

Members 21 years of age and older

  • Medically necessary services needed to diagnose and treat eye conditions
  • Dilated eye exam for diabetic members
  • One pair of eyeglasses after cataract surgery
  • Some contact lenses

To learn more about your vision benefits, call VSP at 1-844-526-0198 (TTY 1-800-428-4833).

Find a provider

Your pharmacy benefits are covered under the state Medicaid program and managed by DXC Technology. If you have questions about your benefits, call the DXC Technology Help Desk at 1-888-483-0797.

You can get no-cost rides to your medical appointments. You or your provider should call to schedule your ride at least five business days before your appointment.

To schedule a ride

Call LogistiCare at 1-844-549-8353 (TTY 1-866-288-3133).

Learn more
  • Weight Watchers® meetings for eligible members
  • Anytime Fitness® gym vouchers for members age 18 and older
  • Cellphone with monthly minutes, texts and data
  • Boys & Girls Club memberships for members ages 6-18 at participating clubs (not summer camps)
  • Digital bathroom scale for members with congestive heart failure
  • Electric toothbrush for adults 21 and older
  • Dental hygiene kit with items like toothbrushes, toothpaste and dental floss for children ages 6-10
  • Hypoallergenic bedding — members with an asthma diagnosis get up to $100 for hypoallergenic bedding, like pillow cases and mattress covers
  • Pregnant members can get:
    • Portable crib or car seat for your new baby by going to prenatal visits
    • Pregnancy and childbirth classes to help you have a healthy pregnancy

Whether you’re thinking about having a baby, pregnant, already a new mom, or you’re not planning to have a baby, we can help you take steps to stay healthy at every stage.

Learn more

You can earn $20, $25, or $50 for getting certain health services. Each time you complete a healthy activity, you’ll get dollars added to your Healthy Rewards card. You can spend your Healthy Rewards dollars at certain stores on approved over-the-counter items to help you stay healthy like pain relievers and sleep aids.

Sign up for Healthy Rewards online or call 1-877-868-2004 (TTY 711).

Are you pregnant? Sign up for our Taking Care of Baby and Me Healthy Rewards program and earn debit card dollars for completing healthy activities.

  • $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 21 to 56 days after delivery
  • $25 for baby’s two-week checkup
  • $25 for attending at least six well-child checkups by 15 months of age

Sign up for Healthy Rewards online or call 1-877-868-2004 (TTY 711).

Referrals

A referral is when your primary care provider (PCP) sends you to some other provider for care. You’ll need to see your PCP for a referral before you see a specialist.

Self-referral

Some types of services are known as self-referral services. That means you can get these services without a referral from your PCP. You don’t need your PCP’s OK for a self-referral if the provider works with us.

  • Family planning
  • OB/GYN care from providers who work with UniCare
  • Pregnancy care
  • Emergency care
  • Vision care
  • Dental care
  • Behavioral health care

We’ll also pay for related lab work and most medicines you get at the same place as the self-referral service.

Preapprovals (also called prior authorization)

For some services, your provider will need to get approval, or an OK, from us before you get them. Your PCP will work with us to get preapproval.

You do not need an approval from your PCP for these types of care:

  • Family planning
  • OB/GYN services from plan providers
  • Emergency care
  • Vision care
  • Behavioral health services

For information about services that need preapproval, please see your member handbook.

Get the most from your benefits

New to UniCare?

As a new member, we know you have questions. We also know you’re short on time! Learn the basics about your health plan in these videos.

View videos

UniCare member handbook

Complete benefit information can be found in your member handbook.
 

Get help for addiction

If you are in need of substance use disorder (SUD) services, UniCare can help.

Learn about SUD services

Not a member yet? Choose UniCare.

You have a choice in your health care. Choose UniCare for the health care you need plus extra benefits to help you live a healthier life.

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