5.10 Medicaid Purchase Plan Disability

5.10.1 MAPP Introduction

When a disability determination for the MAPP is required, complete the application process in Section 5.3 Disability Application Process.

Section V – Work History of the Medicaid – Disability Application (F-10112) must be completed in full detail in all MAPP disability determination requests. The Disability page in CWW 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 applicant 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 Members Over Age 65

A MAPP member who loses SSDI 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, check with SSA to see if they still consider the person disabled. If not, a MAPP disability determination must be done, and MAPP eligibility must be continued until the MAPP disability determination is made by the DDB .

For more information on MAPP, see Section. 26.1 Introduction.

This page last updated in Release Number: 17-01

Release Date: 05/05/2017

Effective Date: 05/05/2017

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