State of Wisconsin Department of Health Services

HISTORY

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

17-01 Version of 31.2 Simplified Application

Migrant workers and their families can have their eligibility for Medicaid determined using a simplified application process if they:

• Have current Medicaid eligibility from another state (“Current Medicaid eligibility” means eligibility that includes at least months one and two of the application process.) or had Medicaid eligibility in Wisconsin that was certified through months one and two of the application and that ended only because the family left Wisconsin.
• Have the same members, or fewer, in the case as there were when the case had eligibility in the other state.

The simplified application procedure is as follows:

1. For members with current Medicaid eligibility from another state, verify the eligibility and the end date. Accomplish the verification by copying the out-of-state Medicaid card or by contacting the other state.
2. For members previously eligible in Wisconsin find the CARES Member Assistance for Re-employment & Economic Support closure code and review date.
3. Ask if the same members, or fewer, are in the case compared to when the group was eligible in the other state.
4. Collect all nonfinancial information.
5. Do not collect any financial information.
6. Certify Medicaid benefits for the migrant family.

Example 1:

A migrant family consisting of dad, mom, and their three children comes to Wisconsin. On September 3, dad applies for Medicaid in Wisconsin for himself and his family. The family has current Medicaid eligibility from Texas. That is, eligibility extends beyond application months one and two. The household composition of five members is the same as listed on the Medicaid card. The fulfillment of these two conditions indicates that the case should be processed with the simplified application procedure. The IM worker enters nonfinancial information into CARES, and completes the asset and income screens by answering “N” to all of the financial questions. He or she also makes sure to answer “Y” to the migrant question on ANDC for all family members. CARES passes the case for MAOU eligibility with $0 assets and $0 income. The eligibility end date from Texas is November 30. The IM worker changes the review date on AGEC to November 30 to coincide with the end date from Texas.

 

Example 2:

The same migrant family comes in for the November review. Verify all mandatory and questionable verification items. The family is determined eligible through October 31 of the following year. The family leaves Wisconsin in December. Medicaid closes for failure to reside in the state. In March the family returns. There have been no non-financial changes and no changes in household composition. The family should be processed with the simplified application procedure because their case closed only for failure to reside in Wisconsin.

This page last updated in Release Number: 17-01
Release Date: 05/05/2017
Effective Date: 05/05/2017

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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