Page 1867

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 25 Chapter 23 Specific Medicaid Requirements

23.10.6.A Eligibility Criteria A CEN (birth –12 months) is eligible for Medicaid until he reaches age 1, when all the following conditions are met: • The child is not eligible for SSI Medicaid; • If the child's mother was eligible for and receiving Medicaid from West Virginia in the month the child was born, an application is considered to have been made for the child. The application may be made up to three months after the child's birth; and, • The child resides continuously in West Virginia during the entire CEN period. If the child leaves WV and returns, CEN coverage cannot be reinstated. 23.10.6.B Special Conditions • Under SSI, a child born to an institutionalized woman is eligible on the date of birth only. Eligibility under all other Medicaid coverage groups must be explored immediately for these children. • CENs must not be required to live with a specified relative. • The child is not required to have a social security number (no enumeration requirement). • There is no requirement that the CEN be evaluated for the Children Under Age 19 group. He must remain a CEN until he reaches age 1, as long as all CEN eligibility requirements are met. • If a child is receiving inpatient services on the date he would lose eligibility due to attainment of age 1, eligibility must continue until the end of that inpatient stay.

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Page 1867

Official source

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 25 Chapter 23 Specific Medicaid Requirements

23.10.6.A Eligibility Criteria A CEN (birth –12 months) is eligible for Medicaid until he reaches age 1, when all the following conditions are met: • The child is not eligible for SSI Medicaid; • If the child's mother was eligible for and receiving Medicaid from West Virginia in the month the child was born, an application is considered to have been made for the child. The application may be made up to three months after the child's birth; and, • The child resides continuously in West Virginia during the entire CEN period. If the child leaves WV and returns, CEN coverage cannot be reinstated. 23.10.6.B Special Conditions • Under SSI, a child born to an institutionalized woman is eligible on the date of birth only. Eligibility under all other Medicaid coverage groups must be explored immediately for these children. • CENs must not be required to live with a specified relative. • The child is not required to have a social security number (no enumeration requirement). • There is no requirement that the CEN be evaluated for the Children Under Age 19 group. He must remain a CEN until he reaches age 1, as long as all CEN eligibility requirements are met. • If a child is receiving inpatient services on the date he would lose eligibility due to attainment of age 1, eligibility must continue until the end of that inpatient stay.