Page 645

West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 173 Chapter 4 Income

TRANSITIONAL MEDICAID (TM) (Categorically Needy, Mandatory) This coverage group consists of families that lose eligibility for Parents/Caretaker Relatives Medicaid because of earned income. TM provides continuing medical coverage after Parents/Caretaker Relatives Medicaid eligibility ends and occurs in two phases. 4.9.1 FINANCIAL REQUIREMENTS FOR PHASE I TM There is no maximum income test for Phase I TM. The onset or increase of earned income must cause Parents/Caretaker Relatives Medicaid ineligibility. See Section 23.10.1. 4.9.2 DETERMINING ELIGIBILITY FOR PHASE II TM In order to be eligible for Phase II TM, the income must not exceed 185% of the Federal Poverty Level (FPL) based on the steps below. To determine eligibility for Phase II coverage, the following procedure is used: Step 1: Determine the total countable income of all assistance group (AG) members. Step 2: Deduct the Dependent Care Deduction. See Section 4.16. Step 3: Compare the remaining amount to the 185% of the FPL amount for the Needs Group found in Appendix A.

NOTE: The spenddown provision does not apply to TM. NOTE: Self-employment income and Annual Contract Employment income is determined using the same methodology outlined in Section 4.7.5.

loading…

Page 645

Official source

West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 173 Chapter 4 Income

TRANSITIONAL MEDICAID (TM) (Categorically Needy, Mandatory) This coverage group consists of families that lose eligibility for Parents/Caretaker Relatives Medicaid because of earned income. TM provides continuing medical coverage after Parents/Caretaker Relatives Medicaid eligibility ends and occurs in two phases. 4.9.1 FINANCIAL REQUIREMENTS FOR PHASE I TM There is no maximum income test for Phase I TM. The onset or increase of earned income must cause Parents/Caretaker Relatives Medicaid ineligibility. See Section 23.10.1. 4.9.2 DETERMINING ELIGIBILITY FOR PHASE II TM In order to be eligible for Phase II TM, the income must not exceed 185% of the Federal Poverty Level (FPL) based on the steps below. To determine eligibility for Phase II coverage, the following procedure is used: Step 1: Determine the total countable income of all assistance group (AG) members. Step 2: Deduct the Dependent Care Deduction. See Section 4.16. Step 3: Compare the remaining amount to the 185% of the FPL amount for the Needs Group found in Appendix A.

NOTE: The spenddown provision does not apply to TM. NOTE: Self-employment income and Annual Contract Employment income is determined using the same methodology outlined in Section 4.7.5.