Page 1868

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 26 Chapter 23 Specific Medicaid Requirements

23.10.7 AFDC-RELATED MEDICAID Income Assets Medically Needy Income Level (MNIL) Possible Spenddown $2,000 – 1 person $3,000 – 2 people Increases $50 for each additional coverage group member Only children under 19, who would be eligible for Medicaid except that countable income/assets are too high, are required to be covered under AFDC-Related Medicaid. However, West Virginia has elected to cover caretaker relatives of such children. The caretaker relative(s) and the dependent children for whom they care are treated as a family unit. Parents or Other Caretaker Relatives and dependent children and pregnant women are eligible for Medicaid when all the AFDC-Related Medicaid eligibility requirements are met, except as follows: • No AFDC-Related case is denied due only to excess income. Instead, incurred medical bills are deducted from the family's income for the six-month Period of Consideration. This process is called spenddown and details of this procedure are in Chapter 4. • Eligibility and the amount of the spenddown, if any, are determined using the MNIL, not the cash assistance payment level. The level of the MNIL is determined by each state, according to federal guidelines. By law, the MNIL cannot exceed 133% of the State's cash assistance payment level, rounded to the nearest $100 for a family of the same size. Individual family members may be eligible for SSI-Related Medicaid as aged, blind, or disabled. Refer to Chapter 13. The Worker must take the action that will most benefit the client.

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Page 1868

Official source

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 26 Chapter 23 Specific Medicaid Requirements

23.10.7 AFDC-RELATED MEDICAID Income Assets Medically Needy Income Level (MNIL) Possible Spenddown $2,000 – 1 person $3,000 – 2 people Increases $50 for each additional coverage group member Only children under 19, who would be eligible for Medicaid except that countable income/assets are too high, are required to be covered under AFDC-Related Medicaid. However, West Virginia has elected to cover caretaker relatives of such children. The caretaker relative(s) and the dependent children for whom they care are treated as a family unit. Parents or Other Caretaker Relatives and dependent children and pregnant women are eligible for Medicaid when all the AFDC-Related Medicaid eligibility requirements are met, except as follows: • No AFDC-Related case is denied due only to excess income. Instead, incurred medical bills are deducted from the family's income for the six-month Period of Consideration. This process is called spenddown and details of this procedure are in Chapter 4. • Eligibility and the amount of the spenddown, if any, are determined using the MNIL, not the cash assistance payment level. The level of the MNIL is determined by each state, according to federal guidelines. By law, the MNIL cannot exceed 133% of the State's cash assistance payment level, rounded to the nearest $100 for a family of the same size. Individual family members may be eligible for SSI-Related Medicaid as aged, blind, or disabled. Refer to Chapter 13. The Worker must take the action that will most benefit the client.