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West Virginia Income Maintenance Manual Chapter 22

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

22.11.2 CHANGE IN INCOME OR NEEDS GROUP 22.11.2.A Increase in Income or Reduction in Needs Group (NG) Any change in circumstances not listed in Section 22.11.1 above does not affect eligibility once the 12-month period of continuous eligibility is established. This includes an increase in income or a reduction in the number of people included in the Needs Group. See Section 22.11.2.C below for instructions on updating case information. Increased Income Example: A child is approved for WVCHIP beginning in March. His 12-month period of continuous eligibility ends in the following February. In August, his father changes jobs and the income of the family now exceeds 300% of the FPL. The child’s eligibility under WVCHIP continues through February. Return of Absent Father Example: A child is approved for WVCHIP Premium beginning in September and ending the following August. A week after approval, his absent father returns to the family. The father works and his income exceeds 300% of the FPL. The child’s eligibility under WVCHIP continues through August. Reduction in Size of Needs Group Example: A man and woman with two children apply for WVCHIP coverage for the children, ages 12 and 18, in April. The children are approved for coverage from April through the following March. In October, the 18-year- old attains the age of 19. His WVCHIP coverage must be stopped October 31st. At the point that the 19-year-old loses coverage and is removed from the Needs Group, the income of the parents exceeds 300% of the FPL for a Needs Group of three. However, the 12-year-old child’s WVCHIP eligibility continues through March. 22.11.2.B Newly Eligible for Medicaid When a WVCHIP child becomes income eligible for Medicaid during the 12-month period of WVCHIP continuous eligibility, notification of Medicaid eligibility is sent to the client. The client must be enrolled in Medicaid without the option to remain enrolled in WVCHIP.