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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 42 Chapter 23 Specific Medicaid Requirements

23.11.2.C Essential Spouse of SSI Recipients Income Assets N/A N/A Under West Virginia's former Old Age Assistance (OAA), Aid to the Disabled (AD), and Aid to the Blind (AB) Programs, Essential Spouses are spouses of the aged, disabled, or blind person, who were not themselves aged, disabled, or blind. Essential Spouses were “grandfathered” into the SSI program based on eligibility for benefit categories that no longer exist. This means that the SSI benefit received by the eligible individual is based on the payment level of eligible spouses and is intended to meet the needs of husband and wife. Essential Spouses are included in the SSI Medicaid case with their eligible spouses as long as they are included in the SSI payment. Individuals continue to qualify as Essential Spouses until one of the following occurs: • The eligible spouse becomes ineligible for SSI. Once the eligible spouse goes into a non-payment or terminated status, his spouse can never again qualify for SSI or Medicaid as an Essential Spouse of an SSI recipient. • The eligible spouse and the Essential Spouse are no longer living together. The Essential Spouse becomes ineligible when SSA determines that the separation is not temporary or after 90 days, whichever occurs first. The Essential Spouse status cannot be regained if the couple begins living together again. • The Essential Spouse becomes eligible for SSI in his own right. Eligibility for this coverage group is determined by SSA. There are no special procedures for this coverage group and the client is not required to apply for Medicaid.