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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 29 Chapter 23 Specific Medicaid Requirements

• The AG received Parents/Caretaker Relatives Medicaid in any three or more months during the six-month period immediately preceding the first month of ineligibility for Parents/Caretaker Relatives Medicaid; • The AG did not receive Parents/Caretaker Relatives Medicaid fraudulently during any of the six months prior to the first month of Parents/Caretaker Relatives Medicaid ineligibility; and, • The family has a dependent child who would be included in the Parents/Caretaker Relatives Medicaid AG, if the family were eligible. When the AG becomes ineligible for Medicaid for a combination of reasons, the Worker must determine if the amount of earned income (or the addition of an individual with earnings who has received Parents/Caretaker Relatives Medicaid in three of the past six months) had an effect on the ineligibility. Only when this is the case is the AG eligible for TM. The steps below are to be followed to determine if such factors had an effect on ineligibility for Parents/Caretaker Relatives Medicaid: STEP 1: Determine if the increase in earned income would have resulted in loss of Parents/Caretaker Relatives Medicaid if all other factors in the case remained the same (i.e., there was no other change in income, no change in family composition, no change in Parents/Caretaker Relatives Medicaid standards.). IF YES: The AG meets the requirement. IF NO: Go to STEP 2. STEP 2: Determine if events other than the increase in earned income would have resulted in loss of Parents/Caretaker Relatives Medicaid if earned income had stayed the same. IF YES: The AG does not meet the requirement. IF NO: Go to STEP 3. STEP 3: Determine if the AG is ineligible for Parents/Caretaker Relatives Medicaid when all changes are considered. IF YES: The AG meets the requirement. The increase in earnings was essential to the loss of Parents/Caretaker Relatives Medicaid eligibility. Without that increase, the AG would not have lost eligibility.