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West Virginia Income Maintenance Manual Chapter 3

West Virginia Income Maintenance Manual Page 78 Chapter 3 Eligibility Determination Groups

3.18 AFDC-RELATED MEDICAID Eligibility must be determined for each individual separately. Income and asset eligibility is determined based on the circumstances of the income group (IG) and needs group (NG). When an individual, not related as a parent, a dependent minor child, or a minor sibling to a member of an AFDC-Related Medicaid assistance group (AG), lives in the household and applies for Medicaid, eligibility is determined separately. 3.18.1 THE ASSISTANCE GROUP (AG) The process of determining who must be included in the AG begins with the dependent child for whom AFDC-Related Medicaid is sought. The AFDC-Related Medicaid AG is composed of otherwise eligible dependent children and their parents or another specified relative. Otherwise eligible, for the purpose of this Section only, means the dependent child lives with a specified relative. See Section 3.3 for the definition of dependent child and for the definition of a specified relative. If any member of the AG is a striker, no member of the AG is eligible for AFDC-Related Medicaid. Eligibility under other coverage groups must be explored. Those individuals who are required to be included, or who choose to be included to receive AFDC-Related Medicaid, will be in an AG. However, they are not all in the same AG. The following rules apply. 3.18.1.A Parent(s) Otherwise eligible married parents who live together are in the same AG. However, unmarried, otherwise eligible parents must be in separate AGs. This is necessary to prevent illegal deeming from one unmarried parent to another.

NOTE: Supplemental Security Income (SSI) recipients, whether they are adults or children, are not included in the AG, IG, or NG.