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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 3 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

Child Under Age 19 Medicaid Policy IMM Location Coordination with the Marketplace Section 1.6.11.A Definition of Residency Section 2.2.3 Determining a Complete Application Section 1.6.5 Determining the Date of Application Section 1.6.3 Due Date of Additional Information Section 1.6.4 Eligibility System Action Section 1.6.8 Fair and Equitable Treatment Section 1.2.1 MAGI-based Financial Methodology Section 4.7 Redetermination Schedule and Special Procedures Section 1.7.7 Reporting Changes to the Department Section 10.7 Who Is the Child’s Representative/Payee Section 1.7.5 Who Must Sign the Application Section 1.7.2 22.2.3 POLICIES THAT DIFFER BETWEEN WVCHIP AND THE CHILDREN UNDER AGE 19 GROUP Differences between the Children Under Age 19 Group Medicaid and WVCHIP include the following: • WVCHIP is not Medicaid. Families enrolled in WVCHIP have cost-sharing responsibilities in the form of copayments for hospital and doctor visits and some prescriptions. Some families will be responsible for monthly premiums. • At application or redetermination, a child cannot have creditable private insurance and WVCHIP in the same month. However, if the child obtains creditable private insurance during the continuous eligibility period, the case remains open until the next determination. See Appendix A to determine if private insurance is creditable. • An applicant who indicates he has other insurance coverage on the date of application is denied WVCHIP unless the applicant indicates that coverage will terminate soon after application. The application is accepted and enrollment in WVCHIP occurs the first of the month after other coverage is terminated. • Eligibility is not backdated up to three months as is permitted for Medicaid. The only instances of allowable backdated WVCHIP coverage are identified in Section 22.16.4.C.