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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 35 Chapter 23 Specific Medicaid Requirements

At the end of the TM Phase II, the eligibility system will automatically terminate coverage. 23.10.9.C Return to Parents/Caretaker Relatives Medicaid, Phase I and II If an AG returns to Parents/Caretaker Relatives Medicaid during Phase I or Phase II, but otherwise meets the requirements for TM, the AG is dually eligible for Parents/Caretaker Relatives Medicaid and TM. If the AG again becomes ineligible for Parents/Caretaker Relatives Medicaid, Worker action depends upon the case circumstances at the time of the subsequent case closure as follows: 23.10.9.C.1 Otherwise Eligible for TM If the AG meets all of the eligibility requirements listed in Section 16.10.9.A.1 above, the family is eligible for a new TM period, beginning with Phase I for six months and continuing through Phase II, if the Phase II requirements are met. 23.10.9.C.2 Not Otherwise Eligible for TM When either of the two following conditions is met at the time of the subsequent case closure, the AG is eligible only for the remainder of the original TM period. • The AG loses eligibility for a reason not related to employment. • The AG loses eligibility for a reason related to employment but does not meet the requirement of having received Parents/Caretaker Relatives Medicaid in three of the preceding six months. Dual Eligibility Example: A Parents/Caretaker Relatives Medicaid AG becomes ineligible when the parent obtains full-time employment. The family receives TM for seven months, from March through September, but returns to Parents/ Caretaker Relatives Medicaid for two months, October and November. At the time the parent’s job starts again, at the end of November, he has no longer NOTE: When TM eligibility ends for any reason other than expiration of the time period, the Worker must evaluate eligibility of the AG for all other Medicaid coverage groups.