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VA MEDICAID WORKS - Good Cause Exceptions

You may remain eligible for Virginia's MEDICAID WORKS program after enrollment if one of the following good cause exceptions is met:

·               If you are unable to maintain employment due to illness or unavoidable job loss, you may remain in MEDICAID WORKS for up to six months as long as any required premium payments continue to be made (the monthly premium is currently waived). The six-month period begins the first day of the month following the month in which the job loss occurred. You should be asked to provide documentation that you unable to work from a medical or mental health practitioner or employer. However, your eligibility under MEDICAID WORKS due will not be cancelled due to the lack of documentation if you indicate that you are still seeking employment.

·               The Department of Medical Assistance Services (DMAS) may establish other good cause reasons. Requests for good cause other than the temporary loss of employment due to illness or unavoidable job loss must be submitted to DMAS on the enrollee's behalf by the local department of social services.

Also See:

Virginia MEDICAID WORKS - Overview

Virginia MEDICAID WORKS - Agreement

Virginia MEDICAID WORKS - Blindness and Disability

Virginia MEDICAID WORKS - Cost Sharing and Premium Payment

Virginia MEDICAID WORKS - Employment Considerations

Virginia MEDICAID WORKS - Entitlement and Enrollment

Virginia MEDICAID WORKS - Financial Eligibility

Virginia MEDICAID WORKS - Non-Financial Eligibility

Virginia MEDICAID WORKS - Safety Net

VA MEDICAID WORKS - Work Incentive (WIN) Account

Source

Some information for this topic was drawn from the DMAS website at:
http://www.dmas.virginia.gov/downloads/pdfs/mb-FactSheet_Medicaid.pdf
http://www.dmas.virginia.gov/downloads/pdfs/rcp-medicaid_applicant_handbook.pdf

Additional information was drawn from Section M0320.211 of the Department of Social Services (DSS) Medicaid Manual.

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