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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 July 2022 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.801 31

2. Resources All of the individual’s resources must be verified, evaluated, and counted together to determine if the individual meets the Medicaid resource requirements. The resources policy in chapter M06 applies. If the individual is married and institutionalized, use the resource policy in subchapter M1480. a. Resources Within The Limit If current resources are within the limit, go on to determine income eligibility. b. Resources Exceed The Limit If current resources exceed the limit, she is not eligible in this covered group. 3. Income Determine MN countable income according to chapter M07. Subtract the appropriate exclusions. Compare the total countable income to the MN income limit for the individual’s locality group (see M0710, Appendix 5 for the MN income limits). 4. Income Exceeds MN Limit Because the MN pregnant woman’s income exceeds the 133% FPL limit, it also exceeds the MN limit. She becomes eligible in this MN covered group when she has incurred medical expenses equal to the difference between her income and the MN income limit (spenddown). See chapter M13 for spenddown policy and procedures. 5. Income Changes Any changes in a medically needy pregnant woman’s income that occur after her eligibility has been established, do not affect her eligibility as long as she meets the pregnant woman definition, the nonfinancial and MN resource eligibility requirements. The spenddown liability must be recalculated when an income change is reported prior to eligibility being established.

C. Entitlement Eligible women in this MN group are entitled to full Medicaid coverage beginning the first day the spenddown is met. The woman is entitled to MN coverage for 12 months following the end of the month in which her pregnancy ends. Her MN Medicaid coverage ends the last day of the 12th month following the month her pregnancy ends, regardless of when the spenddown period ends, without the need for a new application or an additional spenddown period. Retroactive coverage is applicable to this covered group.