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Patients - Apply Now

Step 1: Download and print the enrollment forms
Apply Now for WVRx

Download the enrollment packetDownload the enrollment packet
IMPORTANT: Adobe Reader is needed to view/print enrollment forms.
Download it for free now.
Get Adobe Reader

You may also obtain enrollment information by:

  • Sending an e-mail request to: wvrxinfo@wvrx.org
  • Calling WVRx toll-free at 877-388-WVRx (877-388-9879)
Step 2: Complete the WVRx application
Apply Now for WVRx

 Complete the application and gather necessary attachments. These will vary depending on your unique situation, but may include:

  • Proof of Household Income
  • Medicaid Denial Letter
  • Unemployment Documentation
  • Workers' Compensation Letter
Step 3: Mail in your WVRx application
Apply Now for WVRx

Send your application along with necessary documentation (e.g., proof of annual income) and $30 annual processing fee* to:

WVRx Patient Eligibility
1520 Washington Street East
Charleston, WV 25311

When we receive your complete application, turnaround time for approval takes about a week**. WVRx will notify you and your physician. You are eligible for one year from the date of your approval letter.

Eligibility Information

You are eligible for WVRx if:

  • You live in West Virginia
  • Your yearly income is 250% or less of the Federal Poverty Level
  • You do not receive government assistance such as Medicaid, Medicare Part D, or Veteran’s Benefits
  • You don’t have prescription drug coverage
  • You can provide a photo ID

To Fill Your Prescriptions

  • Mail your brand name prescriptions to WVRx
  • If your medicine is on our drug list it will be mailed to your home
  • If your medicine is not on our drug list, we will complete Patient Assistance Forms and forward them to your prescriber. Drug companies will mail your medicine to your prescriber or your home.

Please remember:

WVRx does NOT fill generic prescriptions.
WVRx does NOT fill or handle any controlled drugs.
**$30 processing fee will be returned if you are not approved for WVRx

Step 1: Download and print the enrollment forms
Apply Now for WVRx

Download the enrollment packetDownload the enrollment packet
IMPORTANT: Adobe Reader is needed to view/print enrollment forms.
Download it for free now.
Get Adobe Reader

You may also obtain enrollment information by:

  • Sending an e-mail request to: wvrxinfo@wvrx.org
  • Calling WVRx toll-free at 877-388-WVRx (877-388-9879)
Step 2: Complete the WVRx application
Apply Now for WVRx

 Complete the application and gather necessary attachments. These will vary depending on your unique situation, but may include:

  • Proof of Household Income
  • Medicaid Denial Letter
  • Unemployment Documentation
  • Workers' Compensation Letter
Step 3: Mail in your WVRx application
Apply Now for WVRx

Send your application along with necessary documentation (e.g., proof of annual income) and $30 annual processing fee* to:

WVRx Patient Eligibility
1520 Washington Street East
Charleston, WV 25311

When we receive your complete application, turnaround time for approval takes about a week**. WVRx will notify you and your physician. You are eligible for one year from the date of your approval letter.

Eligibility Information

You are eligible for WVRx if:

  • You live in West Virginia
  • Your yearly income is 250% or less of the Federal Poverty Level
  • You do not receive government assistance such as Medicaid, Medicare Part D, or Veteran’s Benefits
  • You don’t have prescription drug coverage
  • You can provide a photo ID

To Fill Your Prescriptions

  • Mail your brand name prescriptions to WVRx
  • If your medicine is on our drug list it will be mailed to your home
  • If your medicine is not on our drug list, we will complete Patient Assistance Forms and forward them to your prescriber. Drug companies will mail your medicine to your prescriber or your home.

Please remember:

WVRx does NOT fill generic prescriptions.
WVRx does NOT fill or handle any controlled drugs.
**$30 processing fee will be returned if you are not approved for WVRx