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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 28 Chapter 23 Specific Medicaid Requirements

• When the assistance is provided by another state, coverage is provided as an SSI recipient. 23.10.9 TRANSITIONAL MEDICAID (TM) Income Assets Phase I – N/A Phase II – 185% FPL N/A This coverage group consists of families losing eligibility for Parents/Caretaker Relatives Medicaid because of earned income. When a child loses eligibility as a Child Under Age 19 and his family is receiving TM, he is included in the AG, if otherwise eligible. TM provides continuing medical coverage after Parents/Caretaker Relatives Medicaid eligibility ends and occurs in two phases, as described below. There is no application required for Transitional Medicaid. When a Parents/Caretaker Relatives Medicaid case becomes ineligible, the Worker must automatically determine eligibility for TM. If the case is closed in error instead of being converted to a TM case, the case must be reopened without reapplication by the client. Clients of TM are not referred or required to cooperate with BCSE. 23.10.9.A Phase I Coverage 23.10.9.A.1 Eligibility Requirements To be eligible for Phase I coverage, all the following conditions must be met: • The AG became ineligible for Parents/Caretaker Relatives Medicaid due to the amount of income from employment; • In determining ineligibility for Parents/Caretaker Relatives Medicaid, the Worker must consider income of the AG and any individual who would normally be included in the AG, but who has been penalized;