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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 13 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

22.4 ELIGIBILITY DETERMINATION GROUPS 22.4.1 THE ASSISTANCE GROUP (AG) Only the West Virginia Children’s Health Insurance Program (WVCHIP) child is included in the WVCHIP AG as an eligible client of WVCHIP coverage. 22.4.2 THE MODIFIED ADJUSTED GROSS INCOME (MAGI) HOUSEHOLD INCOME GROUP (IG) See Section 3.7.2 for the MAGI methodology used for determining the MAGI household income group. 22.4.3 THE MAGI HOUSEHOLD NEEDS GROUP (NG) See Section 3.7.3 for the MAGI methodology used for determining the MAGI household needs group. A difference exists between Medicaid and WVCHIP when a pregnant woman is involved in the household composition. For the WVCHIP MAGI household, in determining family size for the eligibility determination, a pregnant woman is counted as herself, plus the number of unborn children she is expected to deliver. Example: Rose is a tax filer and claims her 14-year-old daughter, Lily, as a tax dependent. Rose is pregnant. Rose is a tax filer. Using STEP 1, her household includes herself, her unborn child and Lily – Rose, the unborn child and Lily = Three. Lily is a tax dependent. Using STEP 2, she did not meet any of the exemptions. Her household includes herself and her mother, Rose. However, because Rose is pregnant, Lily’s household also includes the unborn child – Lily, Rose and her unborn child = Three. This differs from Medicaid as the unborn child only pertains to the pregnant woman’s eligibility.

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Page 1799

Official source

West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 13 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

22.4 ELIGIBILITY DETERMINATION GROUPS 22.4.1 THE ASSISTANCE GROUP (AG) Only the West Virginia Children’s Health Insurance Program (WVCHIP) child is included in the WVCHIP AG as an eligible client of WVCHIP coverage. 22.4.2 THE MODIFIED ADJUSTED GROSS INCOME (MAGI) HOUSEHOLD INCOME GROUP (IG) See Section 3.7.2 for the MAGI methodology used for determining the MAGI household income group. 22.4.3 THE MAGI HOUSEHOLD NEEDS GROUP (NG) See Section 3.7.3 for the MAGI methodology used for determining the MAGI household needs group. A difference exists between Medicaid and WVCHIP when a pregnant woman is involved in the household composition. For the WVCHIP MAGI household, in determining family size for the eligibility determination, a pregnant woman is counted as herself, plus the number of unborn children she is expected to deliver. Example: Rose is a tax filer and claims her 14-year-old daughter, Lily, as a tax dependent. Rose is pregnant. Rose is a tax filer. Using STEP 1, her household includes herself, her unborn child and Lily – Rose, the unborn child and Lily = Three. Lily is a tax dependent. Using STEP 2, she did not meet any of the exemptions. Her household includes herself and her mother, Rose. However, because Rose is pregnant, Lily’s household also includes the unborn child – Lily, Rose and her unborn child = Three. This differs from Medicaid as the unborn child only pertains to the pregnant woman’s eligibility.