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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 April 2024 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.400 26
• All individuals requesting enrollment in MEDICAID WORKS must also sign a MEDICAID WORKS Agreement, available at https://fusion.dss.virginia.gov/bp/BP-Home/Medical-Assistance/Forms. The agreement outlines the individual’s responsibilities as an enrollee in the program.
D. Financial Eligibility
1. Assistance Unit Initial eligibility determination
To qualify for MEDICAID WORKS, the individual must meet the assistance unit policy and procedures in chapter M05 that apply to ABD non-institutionalized individuals. Individuals receiving SSI or who have 1619(b) status also meet the income requirement for entry into MEDICAID WORKS. Income from a non-ABD spouse, non-applicant/member ABD spouse, or parents is not considered deemable income and is not counted for the initial eligibility determination for individuals requesting to participate in MEDICAID WORKS. Resources from the individual's spouse with whom he lives or, if under age 21, the individual’s parents with whom he lives, must be deemed available.
b. Ongoing eligibility Once the individual is enrolled in MEDICAID WORKS, the individual is treated as an assistance unit of one. Spousal and parental resources and income are disregarded for ongoing enrollee eligibility.
2. Resources a. Initial eligibility determination For the initial eligibility determination, the resource limit is $2,000 for an individual and $3,000 for a couple. Resources must be evaluated for all individuals, including SSI recipients and QSII/(1619(b) individuals, who wish to qualify for MEDICAID WORKS. The resource requirements in chapter S11 and Appendix 2 to chapter S11 apply for the initial eligibility determination. The individual's countable, nonexempt resources must be verified. All countable resources, must be added together to determine if the individual’s countable resources are within the limit.