Medicaid dental coverage for kids in West Virginia
A practical, parent-friendly guide written for families in West Virginia looking for affordable pediatric dental care. Every clinic referenced below is a federally-funded community health center listed in our West Virginia directory.
Pediatric dental care in West Virginia is one of the most thoroughly covered benefits in the entire Medicaid program. Federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) law requires WV Medicaid / WVCHIP to provide every child enrolled in WV Children's Health Insurance Program or full Medicaid with comprehensive dental services from the first tooth onward. That means twice-yearly cleanings, fluoride treatments, sealants on permanent molars, fillings, root canals on baby teeth, stainless-steel crowns, extractions, and even orthodontia when it is medically necessary — all at no out-of-pocket cost to your family.
Who is eligible for WV Children's Health Insurance Program in West Virginia?
Children under age 19 in West Virginia qualify for WV Children's Health Insurance Program if their family's gross income is at or below 305% of the federal poverty level. Using the 2024 federal poverty guidelines, that translates to:
| Family size | Annual income limit | Monthly income limit |
|---|---|---|
| 1 | $45,933 | $3,828 |
| 2 | $62,342 | $5,195 |
| 3 | $78,751 | $6,563 |
| 4 | $95,160 | $7,930 |
| 5 | $111,569 | $9,297 |
| 6 | $127,978 | $10,665 |
Limits assume one parent's reportable income; pregnant women and children with medical disabilities may qualify above these thresholds. WV Medicaid Dental for Kids: preventive, restorative, and orthodontic services covered.
What does WV Medicaid / WVCHIP actually cover for kids?
Coverage is divided into three tiers — preventive, basic, and major — and unlike adult Medicaid dental, every tier is included for children with no annual dollar cap.
Preventive (covered 100%, no copay)
- Periodic oral exams every six months from age 1.
- Prophylaxis (cleanings) every six months.
- Fluoride varnish up to four times per year for high-risk children.
- Dental sealants on first and second permanent molars.
- Bitewing and panoramic x-rays at age-appropriate intervals.
- Patient education and oral-hygiene counseling.
Basic restorative (covered 100%)
- Amalgam and composite fillings.
- Stainless-steel crowns on baby teeth.
- Pulpotomies (baby root canals) and pulpectomies.
- Simple and surgical tooth extractions.
- Space maintainers when a baby tooth is lost prematurely.
Major services (prior authorization usually required)
- Permanent crowns and root canals on adult teeth.
- Orthodontia for severe malocclusion, cleft palate, or craniofacial conditions.
- Sedation dentistry (nitrous oxide, oral conscious sedation, or hospital general anesthesia) for very young children or those with special health-care needs.
- Periodontal scaling for adolescent gum disease.
How to enroll in WV Children's Health Insurance Program
Apply at WV Medicaid / WVCHIP's online portal, by mail with a paper application, or in person at any community health center listed in our West Virginia directory. Most CHCs employ a dedicated enrollment counselor who can complete the application with you in 30 minutes and submit it electronically. You will need:
- Proof of West Virginia residency (utility bill, lease, school enrollment letter).
- Birth certificates or hospital records for each child.
- Social Security numbers for everyone applying.
- Recent pay stubs (last 30 days) or last year's tax return.
- Immigration documents if applicable — note that DACA recipients in West Virginia may also qualify.
What if your application is denied or your child is between coverages?
You still have options. Federal law requires every community health center in West Virginia — there are 538 of them across 191 cities — to charge on a sliding-fee scale tied to household income. Families at or below 100% FPL typically pay nothing; those between 100% and 200% FPL pay a small nominal fee, often $25 to $45 for a complete pediatric dental visit. Read our companion guide on sliding-fee pricing in West Virginia for the full breakdown.