State of Wisconsin Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

08-01 Version of 26.2 MAPP Application

26.2.1 Begin Month

Certify applicants for MAPPMedicaid Purchase Plan retroactively for any or all, up to three prior months, if he or she met all of the eligibility criteria at that time. The memberA recipient of Medicaid; formerly referred to as a "client." is responsible for any premium due for the previous months in which he or she elects coverage.

Clients can also choose to begin MAPP eligibility during any future month that can be processed in CARES.

Example 1:

Jack applies for MAPP on September 30th and requests a retroactive determination of eligibility.  His application is processed on October 21st.  He meets all eligibility requirements as of June.  Jack can choose to begin MAPP eligibility in June, July, August, September, October, November or December.

26.2.2 Fiscal Test Group

When both members of a married couple (living together) apply for MAPP, each person must be in a separate Assistance Group (AGassistance group). Enter them in CARES on the same application. The member’s spouseA spouse is that person recognized by Wisconsin law as another person's legal husband or wife. Wisconsin does not recognize common law marriage. is a countable member of the FTGfiscal test group . A separate financial test is done for each spouse’s AG. The married couple is entered on the same case, but they are in two separate AGs.

If a spouse of a MAPP applicantA person who has submitted a request for coverage for whom no decision has been made regarding eligibility chooses not to disclose or verify assets, a case may fail for a higher Medicaid eligibility and still cascade to MAPP eligibility.

If both members of a married couple (living apart) apply for MAPP, determine eligibility as two separate cases.

Include the member’s spouse and test children in the FTG.  Test children include the member’s minorA minor is a person less than age 18. natural or adoptive children. Do not include the member’s stepchildren in the FTG. Do not count the income or assets of the test children.

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The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030