Page 1854

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 12 Chapter 23 Specific Medicaid Requirements

Clients who are determined to meet the eligibility requirements for coverage in both a MAGI category and a non-MAGI category at application may choose to enroll in the non-MAGI category. The DOHS must request all additional information needed to evaluate the client’s potential eligibility for a non-MAGI group when the client: • Requests such a determination; • Submits the application developed for non-MAGI coverage groups; • Indicates potential eligibility on the single-streamlined application or renewal form; or, • If the DOHS otherwise has information indicating such potential eligibility. For example, a referral for long-term care services from a community agency. 23.8.2.A Eligible for Non-MAGI Group If the client is determined eligible for a non-MAGI coverage group, they are enrolled into this coverage group and the MAGI group is closed. 23.8.2.B Ineligible for Non-MAGI Group If the client is ineligible for a non-MAGI coverage group, or a determination cannot be made because all necessary information was not provided, the client remains enrolled in the MAGI coverage group. The client is not required to provide any additional information needed to make a full eligibility determination for the non-MAGI coverage group. 23.8.2.C Notification Information regarding potential eligibility for non-MAGI coverage groups, and the benefits and services afforded to the applicant in the non-MAGI coverage groups, will be provided to the applicant in the MAGI notice. Information regarding additional information needed to determine eligibility and how to apply will be provided to the applicant. The information should be sufficient to enable the applicant to make an informed choice.