Page 141

Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 January 2019 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.600 25

B. Nonfinancial Requirements Individuals in this covered group must meet the Medicaid nonfinancial requirements in chapter M02. Division of Child Support Enforcement (DCSE) services are available to all Medicaid recipients, but cooperation with DCSE is not a condition of eligibility for this covered group. C. Financial Eligibility Refer to chapters M05 and M07 for applications submitted before October 1, 2013 and for renewals completed before April 1, 2014. Refer to Chapter M04 for eligibility determinations completed on applications submitted on or after October 1, 2013. 1. Assistance Unit Use the assistance unit policy in chapter M05 to determine the individual’s financial eligibility for applications submitted before October 1, 2013 and for renewals completed before April 1, 2014. Refer to chapter M04 for eligibility determinations completed on applications submitted on or after October 1, 2013. 2. Resources There is no resource test. 3. Income The income limit for this group is 200% FPL. The income limits are contained in M04, Appendix 5. 4. Spenddown Spenddown does not apply to Plan First. However, because an individual enrolled in the Plan First covered group does not receive full Medicaid coverage, if he meets a MN covered group listed in M0320 or M0330, he must be evaluated to determine if he could become eligible for full Medicaid coverage as medically needy (MN) by meeting a spenddown. At application and redetermination, Plan First enrollees who meet the MN covered group and resource requirements are placed on two six-month spenddown budget periods within the 12 month renewal period. They may also be eligible for a retroactive MN spenddown determination. See chapter M13 for spenddown instructions. D. Entitlement and Enrollment 1. Begin Date Eligibility in the Plan First covered group begins the first day of the month in which the application is filed, if all eligibility factors are met in the month. 2. Retroactive Coverage Individuals in this covered group are entitled to retroactive coverage if they meet all the requirements in the retroactive period. 3. Enrollment The AC for Plan First enrollees is “080.”