West Virginia residents shop for ACA health coverage through HealthCare.gov, the federal marketplace, since the state has not built its own exchange.
West Virginia expanded Medicaid under the ACA, so adults earning up to 138% of the federal poverty level generally qualify for coverage through the state's Medicaid program rather than needing a subsidized marketplace plan.
West Virginia's rural geography means plan networks can be thin in some counties, so checking which hospitals and clinics are included in a plan's network matters more here than in states with denser populations. The state's individual market has a limited number of insurers, so comparing the available options early in the enrollment window is a good habit.