Policy History for 5.17.2 NON-FINANCIAL REQUIREMENTS

Release 04-03

The following are Wisconsin Well Woman Medicaid specific non-financial requirements:

1. Meet general MA non-financial requirements (1.1.2).
    

2. Be at least 35 years old but under age 65.
    

3. Have been screened for breast or cervical cancer by WWWP
    

4. Be diagnosed for breast or cervical cancer, or certain pre-cancerous conditions of the cervix, as identified by the screener.
    

5. Require treatment for the breast or cervical cancer, or certain pre-cancerous conditions of the cervix, as identified by the screener.
    

6. Not be eligible for any other subprogram of MA, including BadgerCare.
    

7. Meet the insurance coverage requirements listed below in 5.17.2.1.

5.17.2.1 Disqualifying Insurance Coverage

A woman is ineligible for Wisconsin Well Woman Medicaid if she is covered by any one of the following:

1. Group health plans.

2. Health insurance.

3. Medicare Parts A or B.

4. Any other category of MA.

5. Veteran’s benefits/CHAMPUS.

6. HIRSP.

7. Federal employee health plans.

8. Peace Corps health plans.

9. Other private or public health care plans.

5.17.2.2 Non-Disqualifying Insurance Coverage

1. The following health care benefits do not disqualify a client from Wisconsin Well Woman Medicaid:

1. Coverage only for accident, or disability income insurance, or any combination thereof.
    

2. Liability insurance, including general liability insurance and automobile liability insurance.
    

3. Workers’ compensation or similar insurance, credit-only insurance.
    

4. Coverage for on-site medical clinics.
    

5. Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.
    

6. Indian Health Services.

2. Separate health insurance benefits that are not considered health insurance if offered separately are:

1. Limited scope dental or vision benefits.
    

2. Benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof.
    

3. Independent uncoordinated benefits are not considered health care insurance if offered as independent and/or uncoordinated benefits (e.g., coverage only for specified disease or illness, hospital indemnity or other fixed indemnity insurance.
    

4. Separate insurance policies are not considered health insurance if offered as a separate insurance policy:

1. Medicare supplemental health insurance.

2. Coverage supplemental to the coverage provided under Chapter 55 of Title 10.

3. Similar supplemental coverage under a group health plan.  

However, Medicare Parts A or B disqualify a client from Wisconsin Well Woman Medicaid eligibility.

This page last updated in Release Number : 02-03

Release Date: 07-01-02

Effective Date: 07/01/02