Page 220

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 187 Chapter 1 Application/Redetermination Process

1.18.10 SPOUSES APPLY – ONE APPROVED, ONE PENDING When an application for an SSI-Related coverage group is made for a couple and one spouse is eligible, but the application for the other remains pending because disability has not been established, the procedure is as follows: • Approve the application for the eligible spouse. Deeming procedures in Chapter 4 apply. • Send an approval notice to the eligible individual and include an explanation that eligibility for the spouse has not been established and the reason. If the spouse is determined eligible at a later date, the procedures depend upon whether or not the previously ineligible spouse has income, whether or not such income was deemed to the client, and whether or not there is a spenddown. 1.18.10.A Income of Previously Ineligible Spouse Does Not Cause Spenddown When the income of the previously ineligible spouse equals $0, or has been deemed to the client spouse, or does not cause the AG to have a spenddown, the following procedures apply. • Take eligibility system action to add the spouse to the AG. The beginning period of consideration (POC) or period of eligibility (POE) for the spouse is the same as for the client; • Send an approval notice to the recipient to inform him that eligibility for the spouse has been established and the date on which his medical coverage begins. • If the individual is added after the deadline date in the sixth month of the POC, proper eligibility system procedures must be followed to insure issuance of a Medical ID card. 1.18.10.B Income of Previously Ineligible Spouse Causes Spenddown When the previously ineligible spouse has income, but it was not deemed to the client spouse, and it causes the AG to have a spenddown, the following procedures apply. If the eligible spouse did not previously have a spenddown, but the addition of the previously ineligible spouse and his income makes the AG subject to spenddown, the following actions are taken: