Policy History for  1.1.1 DEFINITIONS

Release 07-04

 

1.1.1 DEFINITIONS

Medicaid, also known as Medical Assistance, MA, and Title 19, is a state/federal program that helps low income Income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing, and shelter. people pay their medical bills.  A person is eligible if s/he meets all non-financial and financial requirements.

Note: An individual could be both AFDC related and EBD related.  An example would be a disabled child or disabled caretaker.  This type of individual would usually first be tested for AFDC related ( Family ) Medicaid and if they failed the family Medicaid tests, they would then be tested for EBD MA (1.1.1.2).

 

1.1.1.1  Family MA

Family MA is for:
 

  1. Individuals under age 19.

  2. Pregnant women.

  3. Parents and caretaker relatives of children under age 19.  
     

The following are types of Family MA:

  1. AFDC-MA.

  2. AFDC-Related MA.

  3. Healthy Start (5.2).

  4. BadgerCare (5.7).

  5. Foster Care (5.3).

 

1.1.1.2 EBD MA
 

EBD MA is elderly, blind, disabled MA.  The client must be:
 

  1. 65 or older, or

  2. Blind or disabled as determined by the Disability Determination Bureau ( DDB ).
     

There are special rules for residents of an institution for mental disease ( IMD Institute for Mental Disease ) under age 21 (5.8.1.1).

The following are types of EBD MA:
 

  1. Institutional MA (5.8).

  2. Non-institutional EBD MA.

  3. Community Waivers (5.9).

  4. Medicaid Purchase Plan ( 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. ) (5.12).

  5. 1619 (5.11.5).

  6. Katie Beckett (5.11.6).

  7. Medicare beneficiaries (5.14).

  8. SSI.

 

1.1.1.3 Special Status MA
 

Several categories of MA do not fit into either the Family or EBD categories of MA.  Qualifications are unique for each category of MA, and the amount of benefits may vary.  The following are types of Special Status MA:

  1. TB-Related (5.11.7).

  2. Adoption Assistance.

  3. Wisconsin Well Woman Medicaid (5.17).

  4. Emergency Services (3.2.3).

  5. Family Planning Waiver (5.15).

 

This page last updated in Release Number: 04-03

Release Date: 08/02/04

Effective Date: 08/02/04