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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 121 Chapter 24 Long Term Care

24.37.1.H The Benefit Effective December 21, 2017 there was a change in the way Medical ID cards are issued. Instead of the separate blue paper card, the Medical ID card is now included in all Medicaid approval notices. The Medical ID card does not include any date parameters since eligibility may terminate. Medicaid recipients will receive one Medical ID card per case each time there is an approval or renewal for Medicaid for any household member. In situations where retroactive eligibility is established, the Medicaid coverage will be validated appropriately for each back-dated month. ADW services will only be paid on or after the ADW approval date. 24.37.2 STEPS IN THE APPLICATION PROCESS Steps in the application process are as follows. 24.37.2.A Step One: Receipt of the DOHS Referral Form for Medicaid Aged and Disabled Waiver Program, Initiate Financial Eligibility (DHS-2.FRM) YELLOW FORM The yellow DHS-2.FRM will originate from the ADW Utilization Management Contractor (UMC). The current UMC contact information is found in Appendix E. The yellow DHS-2.FRM may be submitted by the client or a case management agency and instructs the worker to determine financial eligibility. The client must also submit an appropriate Medicaid application form. General application procedures above must be followed. 24.37.2.A.1 Expired Yellow DHS-2.FRM If the yellow DHS-2.FRM is expired, the Worker checks the box indicating it is expired and faxes the form back to the ADW UMC.

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Page 2046

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 121 Chapter 24 Long Term Care

24.37.1.H The Benefit Effective December 21, 2017 there was a change in the way Medical ID cards are issued. Instead of the separate blue paper card, the Medical ID card is now included in all Medicaid approval notices. The Medical ID card does not include any date parameters since eligibility may terminate. Medicaid recipients will receive one Medical ID card per case each time there is an approval or renewal for Medicaid for any household member. In situations where retroactive eligibility is established, the Medicaid coverage will be validated appropriately for each back-dated month. ADW services will only be paid on or after the ADW approval date. 24.37.2 STEPS IN THE APPLICATION PROCESS Steps in the application process are as follows. 24.37.2.A Step One: Receipt of the DOHS Referral Form for Medicaid Aged and Disabled Waiver Program, Initiate Financial Eligibility (DHS-2.FRM) YELLOW FORM The yellow DHS-2.FRM will originate from the ADW Utilization Management Contractor (UMC). The current UMC contact information is found in Appendix E. The yellow DHS-2.FRM may be submitted by the client or a case management agency and instructs the worker to determine financial eligibility. The client must also submit an appropriate Medicaid application form. General application procedures above must be followed. 24.37.2.A.1 Expired Yellow DHS-2.FRM If the yellow DHS-2.FRM is expired, the Worker checks the box indicating it is expired and faxes the form back to the ADW UMC.