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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 46 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

Return of Absent Father Example: A WVCHIP Pregnancy woman is approved. A week after approval, her estranged husband returns. The husband works, and his income exceeds 300% of the FPL. The continuous eligibility remains the same.

The case information in the eligibility system must be updated based on changes reported by the client and by other valid sources during the certification period, even though the client is eligible for continuous coverage. 22.17.11.C Newly Eligible for Medicaid When a WVCHIP Pregnancy woman becomes income eligible for Medicaid during the continuous eligibility period, the woman remains in WVCHIP Pregnancy for the duration of the pregnancy and the 12-month postpartum period. If the client chooses to close WVCHIP coverage they are not eligible for the remainder of the 12-month postpartum in Medicaid. 22.17.12 Benefit Repayment Medicaid Estate Recovery provisions do not apply to WVCHIP Pregnancy. Repayment by the client of incorrectly paid medical claims is the responsibility of WVCHIP and/or the DOHS fiscal agent. 22.17.13 Benefit Replacement The Medical ID card must be replaced any time a client reports she has not received the card or received the card and it is lost, stolen, or destroyed, and she requests a replacement.

When the client reports non-receipt of the Medical ID card, the Worker must check the eligibility system to determine if a card was issued and/or if an incorrect entry is found, the Worker must correct the information and reissue the benefit.

If the client’s address is incorrect and the card has not been returned to Accounts Receivable or the local office, the Worker must correct the address in the eligibility system and issue a replacement card or verification letter for the correct period of eligibility.