Page 45

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 12 Chapter 1 Application/Redetermination Process

1.2.2.B Redetermination Process Periodic reviews of total eligibility for recipients are mandated by federal law. These are redeterminations and take place at specific intervals, depending on the program or Medicaid coverage group. Failure by the client to complete a redetermination will result in termination of benefits. If the client completes the redetermination process by the specified program deadline(s) and remains eligible, benefits must be uninterrupted and received at approximately the same time. The redetermination process involves basically the same activities described in the Application Process above. Eligibility system changes and client notification of any changes resulting from the redetermination conclude the process. 1.2.2.C Case Reviews and Case Maintenance While a redetermination is a required periodic review of total eligibility, a review may be conducted at any time on a single or combination of questionable eligibility factor(s). The case maintenance process may involve a review or activities that update the Department's information about the client's circumstances between the application and first redetermination and between redeterminations. Changes in eligibility or the benefit amount may occur. If so, eligibility system action and client notification of any changes are required. Some special situations may require a more formal review process. This may be a special procedure to target an error problem. 1.2.2.D Resource Development SNAP clients must be encouraged to take advantage of any potential resources that may be available, but failure to apply for or accept such benefits does not affect SNAP eligibility. WV WORKS clients are responsible for taking necessary steps to apply for alternate available resources. This resource development is part of the Personal Responsibility Contract (PRC). See Section 8.2 for details and exceptions. Medicaid applicants and clients who qualify for Medicare Buy-In must enroll in Medicare Parts A and B as a condition of eligibility; See Section 8.2.2 for details and exemptions. All other