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West Virginia Income Maintenance Manual Chapter 3

West Virginia Income Maintenance Manual Page 63 Chapter 3 Eligibility Determination Groups

3.12 TRANSITIONAL MEDICAID (TM), PHASES I AND II This coverage group consists of families who lose eligibility for Parents/Caretaker Relatives Medicaid because of earned income. Transitional Medicaid (TM) provides continuing medical coverage and has two phases. 3.12.1 THE ASSISTANCE GROUP (AG) 3.12.1.A Who Must Be Included? The following persons must be included in the AG: • All individuals, regardless of WV WORKS receipt, who meet the requirement for TM Phase I or II. See Chapter 23. • An individual who joins the household during either TM Phase I or II, who is otherwise Parents/Caretaker Relatives Medicaid eligible. 3.12.1.B Who Cannot Be Included? The following persons cannot be included: • Supplemental Security Income (SSI) Recipients • Individuals who are otherwise ineligible for Parents/Caretaker Relatives Medicaid. See Section 3.10. 3.12.2 THE INCOME GROUP (IG) There is no income test for TM Phase I. For TM Phase II, the non-excluded income of the AG and sanctioned individuals is used when determining ineligibility for Parents/Caretaker Relatives Medicaid and, therefore, eligibility for TM. The income of the same individuals is used to determine if income exceeds 185% of the Federal Poverty Level (FPL).

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Page 374

Official source

West Virginia Income Maintenance Manual Chapter 3

West Virginia Income Maintenance Manual Page 63 Chapter 3 Eligibility Determination Groups

3.12 TRANSITIONAL MEDICAID (TM), PHASES I AND II This coverage group consists of families who lose eligibility for Parents/Caretaker Relatives Medicaid because of earned income. Transitional Medicaid (TM) provides continuing medical coverage and has two phases. 3.12.1 THE ASSISTANCE GROUP (AG) 3.12.1.A Who Must Be Included? The following persons must be included in the AG: • All individuals, regardless of WV WORKS receipt, who meet the requirement for TM Phase I or II. See Chapter 23. • An individual who joins the household during either TM Phase I or II, who is otherwise Parents/Caretaker Relatives Medicaid eligible. 3.12.1.B Who Cannot Be Included? The following persons cannot be included: • Supplemental Security Income (SSI) Recipients • Individuals who are otherwise ineligible for Parents/Caretaker Relatives Medicaid. See Section 3.10. 3.12.2 THE INCOME GROUP (IG) There is no income test for TM Phase I. For TM Phase II, the non-excluded income of the AG and sanctioned individuals is used when determining ineligibility for Parents/Caretaker Relatives Medicaid and, therefore, eligibility for TM. The income of the same individuals is used to determine if income exceeds 185% of the Federal Poverty Level (FPL).