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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 33 Chapter 23 Specific Medicaid Requirements

23.10.9.A.7 Special Agency Notification Requirements During the fourth month of Phase I eligibility, the client is notified of the availability of Phase II coverage and what he must do to continue coverage. 23.10.9.B Phase II Coverage When all eligibility factors for Phase II coverage are met, eligibility continues, without interruption, from Phase I to Phase II, unless the client has indicated he does not wish to continue such coverage. 23.10.9.B.1 Eligibility Requirements In order to be eligible for Phase II coverage, all of the following conditions must be met: • The AG received Phase I coverage for the entire six-month Phase I period. The six- month period includes months for which the client was dually eligible for Phase I and Parents/Caretaker Relatives Medicaid, if applicable; • The client completed and returned, in a timely manner, the periodic review letters sent to him, or had good cause for not returning it. The form is considered to be returned in a timely manner when it is received within the advance notice period; • The family has a dependent child living in the home; • The earned income amount meets the financial test as described in Chapter 4. For Phase II coverage, information from the PRL3 is used. Information from the PRL3 determines eligibility for months 7 – 12 of Phase II TM coverage. Information from the PRL8 determines continued eligibility for months 9 – 12 of Phase II and the PRL9 determines eligibility for month 12 of TM; • The client continues to have earnings, unless the lack of earnings is due to involuntary loss of employment, illness, or unless good cause is established; and, • The client applies for and maintains enrollment in his employer's health plan, provided such coverage is free to the client.