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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 21 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

22.11 CASE MAINTENANCE Although West Virginia Children’s Health Insurance Program (WVCHIP) issues the benefit to the client, action is taken on changes reported to the Department of Human Services (DOHS). Updated information can be reported to WVCHIP through the eligibility system. 22.11.1 CLOSURES WVCHIP is notified of clients’ ineligibility through an exchange of information with the eligibility system. Eligibility under all Medicaid coverage groups must be explored for clients for all who become ineligible for WVCHIP prior to the end of the 12-month period of continuous eligibility. This does not mean that applications for all coverage groups must be taken and processed. See Section 23.8. If the Medicaid evaluation results in an approval, the client receives a new Medicaid certification and redetermination period. A child may be determined ineligible prior to the expiration of the 12-month period of continuous eligibility only if the child: • Moves out of state; • Dies; • Reaches age 19. 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; • Becomes eligible for Medicaid. Medicaid eligibility starts the first of the month after the WVCHIP closure; • Becomes eligible for Supplemental Security Income (SSI); • Was approved or redetermined for WVCHIP in error and is not currently eligible; or When one member’s circumstances result in closure of the WVCHIP assistance group (AG), other WVCHIP member in the household, if otherwise eligible, continue to be eligible for the rest of their 12-month period of continuous eligibility, and are unaffected. NOTE: If a child is receiving inpatient hospital 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.