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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 122 Chapter 24 Long Term Care

24.37.2.A.2 Yellow DHS-2.FRM with Missing Expiration Date If there is no expiration date on the yellow DHS-2.FRM, it should be faxed back to the UMC, noting there is no expiration date. 24.37.2.A.3 Current (Not Expired) Yellow DHS-2.FRM If the yellow DHS-2.FRM is not expired: • The Worker completes the financial eligibility determination following the general application procedures above. A Medicaid application must be received by the Worker prior to the DHS-2.FRM expiration date. However, the application process does not have to be completed prior to the expiration date. • If the client does not submit an appropriate Medicaid application form with the yellow DHS-2.FRM, the Worker must send an application to the client. • If the client does not submit the appropriate Medicaid application form prior to the yellow DHS-2.FRM expiration date, the Worker checks the box indicating the application was not completed and faxes the form back to the UMC. 24.37.2.A.4 Client Is Determined Financially Eligible If the client is determined financially eligible for the ADW: • The Worker confirms the pending ADW category. Financial eligibility for the ADW category is pended up to 90 days in the data system awaiting verification of medical eligibility and availability of a funded ADW slot. The client is notified by a system generated letter. • The Worker checks the box on the yellow DHS-2.FRM indicating the client is financially eligible and faxes the form back to the UMC. This will initiate medical eligibility to be determined by the UMC. 24.37.2.A.5 Client Is Determined Financially Ineligible