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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 11 Chapter 23 Specific Medicaid Requirements

23.8 MEDICAID ELIGIBILITY BETWEEN COVERAGE GROUPS The Worker must consider all the following information in determining eligibility and in establishing eligible cases. 23.8.1 CONSIDERATION OF ALL MEDICAID COVERAGE GROUPS The client cannot be expected to know which Medicaid coverage group to apply for. When the client expresses an interest in applying for Medicaid, the Worker must explore eligibility for all Medicaid coverage groups. The Worker does not have to take and process applications for all coverage groups, but Medicaid eligibility cannot be denied until the client has been considered for each coverage group. If the client is eligible under more than one coverage group, he is approved for the one that will provide him with the most benefits in the shortest time frame. Certain programs, including long-term care programs, require a medical and/or other determination by a agency other than Division of Family Assistance (DFA) as part of the eligibility process. The financial determination is made by the Department of Human Services (DOHS). When an applicant’s medical eligibility for, or enrollment in these programs is pending, he must not be refused the right to apply, but must be evaluated for any or all DFA programs. 23.8.2 CONSIDERATION OF MAGI AND NON-MAGI COVERAGE GROUPS Applicants who have income below the Modified Adjusted Gross Income (MAGI) standard and are determined eligible for coverage in a MAGI coverage group should be promptly enrolled into the MAGI coverage group. MAGI Medicaid groups are: • Adult Group • Parents/Caretaker Relatives • Pregnant Women • Children Under Age 19 West Virginia Children’s Health Insurance Program (WVCHIP) is also a MAGI group. The client may also pursue eligibility for non-MAGI Medicaid coverage groups while enrolled in the MAGI group.