Policy History for 5.12.4 Financial Requirements

Release 04-03

Follow EBD rules in Chapters  4.1 and 4.5 to determine countable assets and income  The following are MAPP The Medicaid Purchase Plan (MAPP) offers people with disabilities who are working or interested in working the opportunity to obtain health care coverage through the Wisconsin Medicaid Program. financial eligibility requirements.

5.12.4.1 Assets

Total countable assets of the client must be $15,000 or less.  

5.12.4.1.1 Independence Accounts

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.

 

Example:  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:

 

  1. Registered with the ESA.

  1. A separate financial account owned solely by the MAPP client.

  1. Established after MAPP eligibility is confirmed, with the exception of pension and retirement accounts (5.12.4.1.3).
     

A client’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 client’s deposits, from actual (earned or unearned income), exceed 50% of his/her actual gross earnings over the same twelve-month period, a penalty is assessed (5.12.5.1.1).

5.12.4.1.2 Independence Account Exemption Status

If a client 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 MA subprograms.

5.12.4.1.3 Pension or Retirement Accounts

A client who has a pension or retirement account can designate that account as an Independence Account.  The initial balance is a countable asset (4.5.7.21).  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.

5.12.4.2 Income

The spouse and client’s net income must not exceed 250% of the FPL 8.1.6 for appropriate fiscal test group size.  To determine this, do the following:

 

  1. Determine family earned income.  Count the client and his/her spouse’s income if residing together.
     

  2. Deduct the $65 and ½ of the earned income disregard from the spouse and client’s earnings (4.1.3.6).
     

  3. Deduct the client’s IRWEs (4.1.3.4).  The result is the adjusted earned income.
     

  4. Determine unearned income.  Count the client and his/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 (4.1.3.2).
     

  8. If a MAPP client receives Social Security payments, subtract the current COLA disregard between January 1st and the date the FPL is effective in CARES Client Assistance for Re-employment & Economic Support for that year.

     

    Example:  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.

 

  1. Subtract the historical COLA Disregard Amount (4.1.7) for MAPP clients who are also determined to be a 503 (5.11.1) or Disabled Adult Child ( DAC ) (5.11.2).  Do not allow the historical COLA disregard amount (8.1.7) in the premium calculation for MAPP clients who are also determined to be a 503 (5.11.1) or a DAC (5.11.2).
     

  2. Compare the result to 250% of the FPL (8.1.6).  Include the client’s minor dependent children (natural or adoptive) when determining fiscal test group size.  Do not include the client’s stepchildren in the fiscal test group size.

 

This page last updated in Release Number : 03-02

Release Date: 04/01/03

Effective Date: 04/01/03