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West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 53 Chapter 10 The Case Maintenance Process

10.7 CHILDREN UNDER AGE 19 Children under age 19 should not be closed unless one of the changes specified below affect the 12-month Continuous Medicaid Eligibility (CME) period for Children Under Age 19 coverage. 10.7.1 AG CLOSURES A child may be determined ineligible prior to the expiration of the 12-month CME period only if the child’s payee requests closure or the child: • Moves out of state • Dies • Was approved for Medicaid in error • Was approved for Medicaid because of client misrepresentation • Reaches age 19 o The child is eligible until the end of the month in which he reaches the age limit. A child who reaches age 19 on the first day of the month remains eligible until the end of that month. o If a child is receiving inpatient services on the date, he would lose eligibility due to attainment of the maximum age, eligibility must continue until the end of that inpatient stay. • Does not have verification of citizenship and/or identity after match with the FDH (refer to Section 6.3) • Is approved for Supplemental Security Income (SSI) and is eligible for SSI Medicaid • Is institutionalized 10.7.2 CHANGE IN INCOME A change in income does not affect eligibility once the 12-month CME period is established. In addition, a reduction in the number of people included in the needs group (NG) of the child does not affect eligibility once the 12-month CME period has been established.

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Page 1044

Official source

West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 53 Chapter 10 The Case Maintenance Process

10.7 CHILDREN UNDER AGE 19 Children under age 19 should not be closed unless one of the changes specified below affect the 12-month Continuous Medicaid Eligibility (CME) period for Children Under Age 19 coverage. 10.7.1 AG CLOSURES A child may be determined ineligible prior to the expiration of the 12-month CME period only if the child’s payee requests closure or the child: • Moves out of state • Dies • Was approved for Medicaid in error • Was approved for Medicaid because of client misrepresentation • Reaches age 19 o The child is eligible until the end of the month in which he reaches the age limit. A child who reaches age 19 on the first day of the month remains eligible until the end of that month. o If a child is receiving inpatient services on the date, he would lose eligibility due to attainment of the maximum age, eligibility must continue until the end of that inpatient stay. • Does not have verification of citizenship and/or identity after match with the FDH (refer to Section 6.3) • Is approved for Supplemental Security Income (SSI) and is eligible for SSI Medicaid • Is institutionalized 10.7.2 CHANGE IN INCOME A change in income does not affect eligibility once the 12-month CME period is established. In addition, a reduction in the number of people included in the needs group (NG) of the child does not affect eligibility once the 12-month CME period has been established.