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West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 56 Chapter 10 The Case Maintenance Process

• Begins receiving Medicare Part A or B; or • Are parents or other caretaker relatives living with a dependent child under the age of 19 and the child no longer receives minimum essential coverage. The AG is closed the month following the month of the change and after advance notice for the adverse action. The AG must be evaluated for all other Medicaid coverage groups prior to closure. 10.8.4 OTHER CHANGES: PREGNANCY When a woman reports a pregnancy, coverage is opened in the Pregnant Women Group beginning the following month if otherwise eligible. Adult Group coverage will also remain open in the eligibility system. The client receives the same benefits and protections while receiving Adult Group coverage as if receiving Pregnant Women Group coverage only, including: • Co-pay exclusions • 12-month post-partum coverage Coverage will not be impacted by changes in income or household composition. If a change reported during the pregnancy makes the client ineligible for the Adult Group, the Adult Group coverage ends, and the client continues to receive coverage under the Pregnant Women Group through the 12-month post-partum period. Redetermination for the Adult Group occurs on the regularly scheduled review date. If at that time the client is still in the postpartum period, the Adult Group coverage closes, and the client continues in the Pregnant Women Group throughout the post-partum period.

NOTE: Backdating for Pregnant Women Group coverage does not apply when Adult Group coverage already exists.