Page 1888

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 46 Chapter 23 Specific Medicaid Requirements

23.11.2.G Drug Addicts and Alcoholics (DA&A) Income Assets SSI Payment Level $2,000 Individual Drug addicts and alcoholics who meet one of the following conditions are eligible for Medicaid: • They were found by SSA to be disabled, and drug addiction or alcoholism was material to the disability determination; • They would be eligible for SSI except that they are suspended due to non-compliance with the treatment requirements or for the mandatory period for demonstrating compliance; or, • Their SSI benefits were terminated due to the 36-month limit for SSI benefits provided under the SSI drug addiction and alcoholism provisions. Potential eligibility is determined by SSA and communicated to the DOHS through data exchange. The client must not be required to apply for this coverage group. 23.11.3 SSI-RELATED Income Assets MNIL Subject to Spenddown $2,000 Individual $3,000 Couple Individuals who meet the SSI definition of aged, blind or disabled are eligible for Medicaid when all of the following conditions are met. Aged means 65 years or over. • Countable income is under the Medically Needy Income Limit (MNIL). The income eligibility requirement is detailed in Chapter 4. However, no SSI-Related case is denied due only to excess income. Instead, the Worker must deduct incurred medical bills from countable income for the six-month Period of Consideration. This process is called spenddown and details of this procedure are in Chapter 4.

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Page 1888

Official source

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 46 Chapter 23 Specific Medicaid Requirements

23.11.2.G Drug Addicts and Alcoholics (DA&A) Income Assets SSI Payment Level $2,000 Individual Drug addicts and alcoholics who meet one of the following conditions are eligible for Medicaid: • They were found by SSA to be disabled, and drug addiction or alcoholism was material to the disability determination; • They would be eligible for SSI except that they are suspended due to non-compliance with the treatment requirements or for the mandatory period for demonstrating compliance; or, • Their SSI benefits were terminated due to the 36-month limit for SSI benefits provided under the SSI drug addiction and alcoholism provisions. Potential eligibility is determined by SSA and communicated to the DOHS through data exchange. The client must not be required to apply for this coverage group. 23.11.3 SSI-RELATED Income Assets MNIL Subject to Spenddown $2,000 Individual $3,000 Couple Individuals who meet the SSI definition of aged, blind or disabled are eligible for Medicaid when all of the following conditions are met. Aged means 65 years or over. • Countable income is under the Medically Needy Income Limit (MNIL). The income eligibility requirement is detailed in Chapter 4. However, no SSI-Related case is denied due only to excess income. Instead, the Worker must deduct incurred medical bills from countable income for the six-month Period of Consideration. This process is called spenddown and details of this procedure are in Chapter 4.