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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 17 Chapter 24 Long Term Care

24.6 ELIGIBILTY DETERMINATION GROUPS Eligibility may be determined under any full Medicaid coverage group using the eligibility determination groups for the appropriate coverage group. See Section 24.7.2 and Chapter 3. If the client is not eligible for a full Medicaid coverage group, the client is assessed for eligibility under the Nursing Facility coverage group and the SSI-Related/Monthly Spenddown group using the following guidance. 24.6.1 THE ASSISTANCE GROUP (AG) Only the institutionalized individual is included. A Medicaid-eligible spouse must be in his own AG, whether he is also institutionalized or not. 24.6.2 THE INCOME GROUP (IG) Only the countable income of the institutionalized individual is used to determine his eligibility. 24.6.3 THE NEEDS GROUP (NG) The NG is composed only of the institutionalized individual. See Section 24.7 for applicable income standards. 24.6.4 CASE COMPOSITION The case is composed of the institutionalized individual, a spouse living in the community, and any of the individual’s dependents. A Medicaid-eligible spouse receives benefits in his own case, whether he is also institutionalized or not.

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Page 1942

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 17 Chapter 24 Long Term Care

24.6 ELIGIBILTY DETERMINATION GROUPS Eligibility may be determined under any full Medicaid coverage group using the eligibility determination groups for the appropriate coverage group. See Section 24.7.2 and Chapter 3. If the client is not eligible for a full Medicaid coverage group, the client is assessed for eligibility under the Nursing Facility coverage group and the SSI-Related/Monthly Spenddown group using the following guidance. 24.6.1 THE ASSISTANCE GROUP (AG) Only the institutionalized individual is included. A Medicaid-eligible spouse must be in his own AG, whether he is also institutionalized or not. 24.6.2 THE INCOME GROUP (IG) Only the countable income of the institutionalized individual is used to determine his eligibility. 24.6.3 THE NEEDS GROUP (NG) The NG is composed only of the institutionalized individual. See Section 24.7 for applicable income standards. 24.6.4 CASE COMPOSITION The case is composed of the institutionalized individual, a spouse living in the community, and any of the individual’s dependents. A Medicaid-eligible spouse receives benefits in his own case, whether he is also institutionalized or not.