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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 60 Chapter 23 Specific Medicaid Requirements

23.14 NON-MEDICAID HEALTH PROGRAMS 23.14.1 WV CHILDREN’S HEALTH INSURANCE PROGRAM (WVCHIP) WVCHIP is not Medicaid. See Chapter 22 for WVCHIP policy, including deemed newborns. 23.14.2 PHARMACY PROGRAMS 23.14.2.A AIDS DRUG ASSISTANCE PROGRAM (ADAP) Income Assets 500% FPL N/A The ADAP is also referred to as the AIDS Special Pharmacy Program or the ADAP WV Special Pharmacy Program. Medicaid coverage is limited to payment for medications listed on the current WV ADAP Formulary for HIV/AIDS treatment. An individual is eligible for this limited Medicaid coverage when all the following conditions are met: • The individual must have been diagnosed as HIV positive; • The income of the individual, his spouse, and his dependent children who live with him must meet the income limits detailed in Chapter 4; and, • He must be ineligible for any other Medicaid full-coverage group or be eligible as a Medically Needy client who has not met his spenddown. Except for acceptance of the initial DFA-2 Medicaid and the two-page ADAP applications, eligibility determination for this coverage group is administered by BMS. Potential eligibility for or receipt of Medicare, Part D, does not affect the application or referral process for ADAP eligibility determination. The resource development policies in Chapter 8 do not apply to ADAP. For information related to special communication between the Worker and BMS, refer to Chapter 1. If the client becomes eligible under any other coverage group or meets his spenddown, the Worker must notify BMS immediately and must specify the beginning date of Medicaid eligibility.