The following WVCHIP resources are available to be printed. Just click on the item you want below:
- Public Notice: WVCHIP Transitions Benefits to Match Medicaid
- State Plan Amendment: Effective July 1, 2023
- 2025 Income Guidelines and Co-Pays
- 2025 CHIP Information Flyer
- Summary Plan Description (SPD) (July2021-June 2022) (60 pages)
- Health Insurance - Family Application
- Health Insurance - Single Streamlined Application
- Current WVCHIP Preferred Drug Formulary (Beginning 7/1/2023)
- Express Scripts (ESI) Prescription Claim Form
- Antipsychotic Medicines for Children and Teens
- Mental Health and Substance Use Disorder Benefits
- Non-State Agency List (Buy Into PEIA)
- WVCHIP Privacy Notice
