5.10 Medicaid Purchase Plan Disability

5.10.1 MAPP Introduction

When a disabilityThe law defines disability for Medicaid as "The inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." determination for the MAPPMedicaid Purchase Plan is required, complete the application process in Section 5.3 Disability Application Process.

Sections 12 and 13 of the Application for Medicaid Disability form (F-10112) must be completed in full detail in all MAPP disability determination requests. The Disability page in CWWCARES Worker Web should be coded to indicate whether the request is for a MAPP disability determination or both a regular Medicaid disability determination and a MAPP disability. It is advisable to have both determinations completed if an applicantA person who has submitted a request for coverage for whom no decision has been made regarding eligibility may move from regular Medicaid disability to MAPP disability.

A determination of disability for MAPP excludes consideration of Substantial Gainful Activity (SGA), while a regular Medicaid disability determination does not.

5.10.2 MAPP Recipients Over Age 65

A MAPP member who loses SSDISocial Security Disability Insurance. A benefit to disabled or blind individuals who have contributed to the Federal Insurance Contribution Act (FICA). benefits solely because he or she turns 65 does not need a disability re-determination until the next scheduled diary date. If there is no scheduled diary date, a MAPP disability determination must be done, and MAPP eligibility continued until the MAPP disability determination is made by the DDBDisability Determination Bureau.

For more information on MAPP, see Section. 26.1 Medicaid Purchase Plan Introduction.

This page last updated in Release Number: 10-02

Release Date: 06/22/10

Effective Date: 06/22/10

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