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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 40 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

made available to the OMCFH. This permits OMCFH to evaluate the client for other available government-sponsored health care. 22.17.2.E Redetermination

A redetermination is completed the twelfth month of the postpartum period. Redeterminations are scheduled 12 months after the pregnancy end date, or, if information about the pregnancy is not updated, 12 months after the pregnancy due date.

In no instance is WVCHIP Pregnancy stopped without consideration of eligibility under other coverage groups. This is determined before the client is notified her eligibility will end. If eligible for any other coverage group, the benefits must not begin until expiration of the postpartum period.

If the redetermination is not completed, coverage is automatically closed after the advance notice period.

Rolling Redeterminations do not apply to the WVCHIP Pregnancy. 22.17.2.F The Benefit The WVCHIP Pregnancy Medical ID card is included in all approval notices. Clients will receive one Medical ID card per case each time there is an approval or renewal for any household member. In situations where retroactive eligibility is established, coverage will be validated appropriately for each back-dated month.

The eligibility system determines the level of cost sharing for which the client is responsible (Blue or Premium), based on countable income. The WVCHIP Helpline at 1 (877) 982-2447 handles any questions concerning co-payments.

In compliance with the requirements of the Patient Protection and Affordable Care Act, Public Health Service Act, effective July 1, 2011, WVCHIP clients do not have an annual and/or lifetime benefit maximum. 22.17.2.G Ending Date of Eligibility