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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page ii Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

22.4.2 THE MODIFIED ADJUSTED GROSS INCOME (MAGI) HOUSEHOLD INCOME GROUP (IG) ..........................................................................................................................13 22.4.3 THE MAGI HOUSEHOLD NEEDS GROUP (NG) ....................................................13 22.5 INCOME .....................................................................................................................14 22.5.1 MODIFIED ADJUSTED GROSS INCOME (MAGI) METHODOLOGY .....................14 22.5.1.A Determining the Household Size for WVCHIP ..................................................14 22.5.1.B MAGI Income Disregard for WVCHIP ...............................................................14 22.6 ASSETS .....................................................................................................................16 22.7 DATA EXCHANGE .....................................................................................................17 22.7.1 BMS THIRD PARTY INSURANCE VERIFICATION VENDOR ................................17 22.8 VERIFICATION ..........................................................................................................18 22.9 RESOURCE DEVELOPMENT ....................................................................................19 22.10 CLIENT NOTIFICATION .............................................................................................20 22.11 CASE MAINTENANCE...............................................................................................21 22.11.1 CLOSURES .........................................................................................................21 22.11.2 CHANGE IN INCOME OR NEEDS GROUP ........................................................22 22.11.2.A Increase in Income or Reduction in Needs Group (NG) ................................22 22.11.2.B Newly Eligible for Medicaid ...........................................................................22 22.11.2.C Updates in Assistance Group (AG) Information.............................................23 22.11.2.D Pregnancy of a WVCHIP Client ....................................................................23 22.12 BENEFIT REPAYMENT .............................................................................................25 22.13 BENEFIT REPLACEMENT ........................................................................................26 22.14 DETERMINING DISABILITY, INCAPACITY AND BLINDNESS .................................27 22.15 WORK REQUIREMENTS ...........................................................................................28 22.16 SPECIFIC WEST VIRGINIA CHILDREN’S HEALTH INSURANCE PROGRAM (WVCHIP) REQUIREMENTS (MGCH-Gold, MGCB-Blue, MGCP-Premium, MNCH-Deemed Newborn Gold, MNCB-Deemed Newborn Blue) ....................................................................29 22.16.1 REQUIREMENTS FOR WVCHIP CHILDREN .....................................................29 22.16.2 DEEMED WVCHIP NEWBORN ...........................................................................30 22.16.3 MEDICAID REQUIREMENTS APPLICABLE TO WVCHIP ..................................31