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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 58 Chapter 23 Specific Medicaid Requirements

23.12.4 QUALIFIED DISABLED WORKING INDIVIDUALS (QDWI) Income Assets 200% FPL $4,000 Individual $6,000 Couple Medicaid coverage is limited to payment of the Medicare, Part A, premium when the client is not eligible for premium free Part A. An individual is eligible for this limited Medicaid Coverage when all of the following conditions are met: • He is under age 65; • He is disabled and no longer entitled to Social Security disability benefits and Medicare because he is employed full time and his earnings exceed the SSA limits. Disability is established by verification of the reason for RSDI and Medicare termination; • He is eligible to purchase Medicare, Part A, as determined by SSA; • His income meets the limits detailed in Chapter 4; • His assets meet the limit detailed in Chapter 5; and, • He is not eligible under any other full-coverage Medicaid group. The Buy-In Unit is responsible for payment of the Medicare, Part A, and premium amount. To begin this process the Worker must forward to the Supervisor, Buy-In Unit, BMS, the following items: • A copy of the application with "QDWI" written at the top of the form. A copy must be retained in the case record. • A copy of the Medicare termination notice. The original must be retained in the case record. • A copy of the client's Medicare card, whether or not Medicare entitlement has expired. A copy must also be retained for the case record. Once the Buy-In Unit completes the buy-in process and the client is accepted by SSA, SSA will notify the individual that the State is now paying his Medicare premium.