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Blueprint
States/West Virginia
Medicare Advantage Network Adequacy · WV

Building a Medicare Advantage network in West Virginia? Blueprint knows West Virginia’s rules.

Blueprint is pre-configured with West Virginia’s 55 counties, CMS MA time-distance thresholds, and HSD specialty categories. Your adequacy score runs on day one.

West Virginia at a Glance

55

Counties tracked

12

MA plans competing

October 1 – March 31

Filing window

The West Virginia Adequacy Challenge

Why building in West Virginia requires local expertise.

West Virginia is a Charleston and Huntington metros with pervasive rural Appalachian gaps state. MA plan sponsors operating here must satisfy CMS time-distance standards across all 55 counties — a task that demands accurate county classifications and pre-loaded specialty categories. Getting it wrong means adequacy gap notices and potential filing rejections.

WV has the highest percentage of rural counties of any state — southern counties (McDowell, Wyoming, Mingo) have near-zero specialist supply and require exception filings across virtually every HSD specialty category

Key Specialties to Monitor in WV

Primary CareBehavioral HealthCardiologyNephrology

How Blueprint Handles It

How Blueprint handles West Virginia MA builds.

All 55 counties pre-loaded

No setup needed for the county map. Every West Virginia county is pre-loaded with the correct urban, suburban, and rural classifications Blueprint uses for adequacy scoring.

CMS MA rules for West Virginia

Time-distance thresholds, urban/suburban/rural county classifications, and HSD specialty requirements are all loaded. No manual configuration required.

Rural gap detection built in

Blueprint automatically flags counties that need waiver or good-faith effort documentation — so your team knows where to focus before the filing window closes.

Quick Reference

Key adequacy considerations for West Virginia.

County classificationCharleston and Huntington metros with pervasive rural Appalachian gaps
Top specialty gapsPrimary Care, Behavioral Health, Cardiology, Nephrology
Rural strategyWV has the highest percentage of rural counties of any state — southern counties (McDowell, Wyoming, Mingo) have near-zero specialist supply and require exception filings across virtually every HSD specialty category
Filing windowOctober 1 – March 31
Top counties:KanawhaCabellWoodBerkeleyRaleighMonongaliaHarrison

Customer Story

“Teams building MA networks in West Virginiause Blueprint to catch adequacy gaps at Week 4 — not Week 14.”

Ready to build in West Virginia?

Your West Virginia MA network build starts on day one.

All 55 West Virginia counties, CMS MA rules, and rural gap detection are pre-loaded. Schedule a demo and your adequacy score runs before the call ends.