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State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
Follow EBD rules in Chapters 15.1 Income Introduction and 16.1 Assets Introduction to determine countable assets and income. The following are MAPP financial eligibility requirements.
Total countable assets of the member must be $15,000 or less. Only count the assets of the MAPP applicant for the MAPP asset eligibility test.
Someone who has been determined eligible for MAPP can establish an Independence Account. These accounts are an exempt asset. There is no limit to the number of accounts, and no restriction on what the money can be used for.
Only assets deposited while MAPP eligible may be exempted. Deposits made between periods of MAPP eligibility are not exempt.
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Example 1: Freda creates an Independence Account out of an existing pension account in January with a pre-existing $5,000 when she becomes MAPP eligible. In March, while MAPP eligible Freda deposits another $2,000 in her Independence Account. Freda became MAPP ineligible in April and deposited another $1,200 in her Independence Account. Freda became MAPP eligible again in July. In the second period of MAPP eligibility the Independence Account pre-amount would change from $5,000 to $6,200. The only assets that can be exempted are the deposits made while MAPP eligible. In this case $2,000 would be exempt and $6,200 would be counted as an asset. |
To qualify as an Independence Account, it must be:
Registered with the IM Agency. Completing the F-10121 Medicaid Purchase Plan (MAPP) Independence Account Registration form registers the Independence Account with the IM agency. Place the completed F-10121 in the member case file and provide a copy to the member.
A separate financial account owned solely by the MAPP member.
Established after MAPP eligibility is confirmed, with the exception of pension and retirement accounts (See 26.4.1.3 Pension or Retirement Accounts)
A member’s deposits (earned or unearned) in an independence account may total up to 50% of gross earning over a 12-month period, without penalty. If the member’s deposits, from actual (earned or unearned income), exceed 50% of his or her actual gross earnings over the same twelve-month period, a penalty is assessed (See 26.5.1.1 Penalty). Amounts withdrawn from a MAPP Independence Account during a twelve month period do not affect the limit on the gross amount that may be deposited during the same period without penalty.
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Example 2: Fred earns $5000 gross from January - December. Total deposits into the independence account were $3000 for the same period. A $500 withdrawal was made in December of that same year to pay for car repairs. The $500 withdrawal is ignored when determining the penalty. The penalty is based solely on total deposits which exceeded 50% of gross earnings over a twelve month period. The result in this example would be a $500 penalty. (See 26.4.1.3 Pension or Retirement Accounts) |
If a member with an approved Independence Account loses MAPP eligibility, the exempt portion of the account (on the date eligibility ends) is exempt for future MAPP application(s). The entire balance is a countable asset for all other Medicaid subprograms.
A member who has a pension or retirement account can designate that account as an Independence Account. The initial balance is a countable asset (16.7.21 Retirement Benefits). Any dividends, interest, and deposits to the account are exempt from the date the Independence Account is approved. Continue to count the initial balance as an asset.
The spouse and member’s net income must not exceed 250% of the FPL (See 39.5 FPL) for appropriate fiscal test group size. To determine this, do the following:
1. Determine family earned income. Count the member and his or her spouse’s income if residing together.
2. Deduct the $65 and ½ of the earned income disregard from the spouse and member’s earnings (15.7.5 $65 and ½ Earned Income Deduction).
3. Deduct the member’s IRWEs (15.7.4 Impairment Related Work Expenses (IRWE)). The result is the adjusted earned income.
4. Determine unearned income. Count the member and his or her spouse’s income if residing together.
5. Add the adjusted earned and unearned income together.
6. Deduct $20 from the combined income.
7. Deduct special exempt income (15.7.2 Special Exempt Income).
8. If a MAPP member receives Social Security payments, subtract the current COLA disregard between January 1st and the date the FPL is effective in CARES for that year.
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Example 3: Ed’s Social Security payment amounts were $875 a month for the previous year and $900 for the current year. Calculate the current COLA disregard by subtracting the Ed’s previous Social Security payment amounts from the current payments. Allow $25 as the current COLA disregard. |
9. Subtract the historical COLA Disregard Amount (39.6 COLA) for MAPP members who are also determined to be a 503 (25.1 503 Eligibility) or Disabled Adult Child (DAC) (25.2 DAC).
10. Compare the result to 250% of the FPL (39.5 FPL Table). Include the member’s minor dependent children (natural or adoptive) when determining fiscal test group size. Do not include the member’s stepchildren in the fiscal test group size.
This page last updated in Release Number: 15-01
Release Date: 06/10/2015
Effective Date: 06/10/2015
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