West Virginia Code 9-4D-4 – Eligibility guidelines
(a) To be eligible to participate in the buy-in program beginning July 1, 2003, an individual shall:
Terms Used In West Virginia Code 9-4D-4
- Countable income: means income that does not exceed two hundred fifty percent of the federal poverty level: Provided, That for purposes of this article, countable income does not include:
(A) The income of the individual'. See West Virginia Code 9-4D-2
- Countable resources: includes earned and unearned income: Provided, That countable resources do not include:
(A) Liquid assets of up to $5,000 for an individual. See West Virginia Code 9-4D-2
- Department: means the Department of Health and Human Resources. See West Virginia Code 9-4D-2
- Disability: means a medically determinable physical or mental condition that:
(A) Can be expected to result in death or has lasted, or can be expected to last, for a continuous period of not less than twelve months. See West Virginia Code 9-4D-2
- Federal poverty level: means the level of personal or family income below which one is classified as poor according to federal governmental standards, commonly referred to as the federal poverty guidelines which are issued and printed each year in the federal register. See West Virginia Code 9-4D-2
- Income: means money earned from employment wages or self-employment earnings and unearned money received from any other source. See West Virginia Code 9-4D-2
- Premium: is a monthly fee paid by an eligible buy-in participant to continue participation in the program. See West Virginia Code 9-4D-2
- Secretary: means the secretary of the Department of Health and Human Resources: Provided, That beginning January 1, 2024, "secretary" means the secretary of the Department of Human Services. See West Virginia Code 9-1-2
- State: when applied to a part of the United States and not restricted by the context, includes the District of Columbia and the several territories, and the words "United States" also include the said district and territories. See West Virginia Code 2-2-10
(1) Be a resident of the State of West Virginia;
(2) Have a disability that is defined and determined by the social security administration or the department;
(3) Be at least sixteen years of age but not more than sixty-four years of age;
(4) Be engaged in competitive employment, including self-employment or nontraditional work that results in remuneration at or above minimum wage in an integrated setting;
(5) Have countable resources that do not exceed the resource limit for the supplemental security income program;
(6) Have countable income that does not exceed two hundred fifty percent of the federal poverty level;
(7) Have total countable unearned income, using the social security income program methodology, that does not exceed the federal benefit rate plus the general income exclusion; and
(8) Except as provided in section five of this article, not have countable resources that exceed the resource limits for the federal supplemental security income program.
(b) The secretary shall establish a method of providing notice of the availability of participation in the Medicaid buy-in program. The secretary shall develop all forms and notices necessary to implement the provisions of this article, including forms for application to the program, determination of eligibility and continued participation and notices that advise all eligible buy-in participants of the rights, benefits, obligations and participation requirements of the program, including, but not limited to, notice of fees, premiums, premium adjustments, periodic review, length of time for which benefits may be paid and disqualifying factors.