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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 56 Chapter 23 Specific Medicaid Requirements

23.12.2.E Nursing Facility Services Eligibility for SLIMB alone does not cover the Medicare co-insurance and/or deductibles associated with nursing facility services. However, the client may be dually eligible for SLIMB and Medicaid nursing facility services as described in Chapter 24. 23.12.3 QUALIFIED INDIVIDUAL (QI) Income Assets 121 –135% FPL $9,950 – Individual $14,910 – Couple Medicaid coverage is limited to payment of the Medicare Part B premium. An individual or couple (spouses) is eligible for limited* Medicaid coverage when all the following conditions are met: • The individual must be enrolled in Medicare, Part A. He must be entitled in any of the following three ways: o By being age 64 years and 9 months old or older; o By having been totally and continuously disabled and receiving RSDI or Railroad Retirement benefits for 24 months or longer; or, o By having end-stage renal disease; • The individual or couple must meet the income test detailed in Chapter 4; • The individual or couple must meet the asset test detailed in Chapter 5; and • The individual or couple is not eligible for any full-coverage Medicaid group Medicaid coverage is limited to payment of the Medicare, Part B premium. The Buy-In Unit pays the Medicare premium. Refer to Chapter 25 for details.