How health insurance works in West Virginia
West Virginians buying their own coverage have two markets: HealthCare.gov (healthcare.gov), where plans from Highmark Blue Cross Blue Shield West Virginia and CareSource are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is expanded in West Virginia. West Virginia has no state individual mandate.
What it costs
Full-price marketplace plans for a 40-year-old in Charleston commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. West Virginia has a progressive state income tax, so the self-employed health premium deduction helps at both the federal and state level.
The West Virginia picture
West Virginia's marketplace has very few carriers, so many people see only one or two plan families on HealthCare.gov — which is why a national PPO is the thing buyers ask about first.