Page 249

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 5 Chapter 1 Application/Redetermination Process

Program and Form ID Name of Form When to Use Due Date of Additional Information Agency Time Limits Continuously Eligible Newborn (CEN) Children N/A N/A No application required for CEN children who are born to Medicaid eligible women.

Deemed Parents/Caretaker Relatives N/A N/A No application required.

Deemed SSI Recipients N/A N/A No application required. State Data Exchange (SDX) codes indicate potential eligibility.

Former West Virginia Foster Children DFA-2

WV PATH Application for All Programs of Assistance Applicant is being considered for all programs. The client and the Worker agree on the date by which additional verification must be obtained. Eligibility system action must be taken to approve, deny or withdraw the application within 30 days of the date of application.

DFA-SLA-1 Application for Healthcare Coverage For a family or when there is more than one individual in the household applying for health care coverage only.

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Page 249

Official source

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 5 Chapter 1 Application/Redetermination Process

Program and Form ID Name of Form When to Use Due Date of Additional Information Agency Time Limits Continuously Eligible Newborn (CEN) Children N/A N/A No application required for CEN children who are born to Medicaid eligible women.

Deemed Parents/Caretaker Relatives N/A N/A No application required.

Deemed SSI Recipients N/A N/A No application required. State Data Exchange (SDX) codes indicate potential eligibility.

Former West Virginia Foster Children DFA-2

WV PATH Application for All Programs of Assistance Applicant is being considered for all programs. The client and the Worker agree on the date by which additional verification must be obtained. Eligibility system action must be taken to approve, deny or withdraw the application within 30 days of the date of application.

DFA-SLA-1 Application for Healthcare Coverage For a family or when there is more than one individual in the household applying for health care coverage only.