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Wisconsin Department of Health and Family Services |
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Wisconsin Department of Health and Family Services |
These requirements apply to all types of MA, unless specifically stated
otherwise. The
client must:
Provide a Social Security Number ( SSN ) or be
willing to apply for one.
If the caretaker is unwilling to provide
or apply for the SSN of a minor or dependent 18-year-old, the person who
does not have the SSN is ineligible.
Do not require an SSN for:
Continuously eligible newborns.
Pre-adoptive infants living in a foster home.
Unqualified aliens receiving emergency services.
Women applying for BadgerCare Prenatal Program (BCPP).
Be a Wisconsin resident (3.1).
Be a U.S. citizen or qualified alien (3.2).
This does
not apply to aliens receiving emergency services (3.2.3)
or women applying for the BCPP (5.7.11).
Be living in the household.
A household is all the people living in or temporarily absent (3.5.6) from the same residence. In addition to regular household members, include:
Huber law prisoners who are released from
jail to attend to the needs of their families.
People in a community residential confinement program. The Department of Corrections ( DOC ) electronically monitors them.
Do not include the following in the household:
Inmates of a public institution, even if they are temporarily absent from the home.
SSI recipients.
SSI recipients are actually receiving SSI benefits, including MA, or would be receiving benefits except for recoupment.
A client is not an SSI recipient if s/he is eligible for SSI but has not received benefits.
Provide information on health insurance coverage
(6.3.3.2).
Sign over to the state their rights to payments
from a third party for their medical expenses
(3.3.1).
Cooperate with Medical Support Liability ( MSL ) (3.3)
Deny or terminate eligibility for caretakers who refuse to cooperate, unless there is good cause. This is applicable to anyone who is applying for Family MA or EBD MA. The Child Support Agency ( CSA ) will inform you in writing of those who are not cooperating.
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Example: Liz, a disabled parent, is applying for MA for her and her son, Steve. She refuses to cooperate with the child support agency in the pursuit of medical support liability. Liz meets all other non-financial and financial criteria for Family MA and EBD MA.
Liz is not eligible for EBD MA or Family MA, because she will not cooperate with obtaining medical support. Even though Liz refuses to cooperate with obtaining medical support, Steve remains eligible for MA. |
Do not sanction minors, dependent 18 year olds, and pregnant women until two months after the pregnancy ends.
Cooperate with verification requests when information
is deemed questionable (1.2).
Meet any additional criteria that is specific
to the subprogram of MA that s/he is being tested for. Any
non-financial criteria specific to a particular subprogram of MA will
be listed in the chapter relating to that subprogram.
Not be an inmate of a public institution (see
3.1.9),
with
the following exceptions:
Pregnant inmates
applying for the BCPP.
If an inmate resides
outside of a public correctional institution for more than 24 hours at
any one time, s/he can qualify for MA during that time period if s/he
meets all other eligibility criteria. For
example, if an inmate is admitted as an inpatient to a non-prison hospital
for 24 hours, that inmate could qualify for Medicaid for that day, if
otherwise eligible
In addition to the non-financial requirements listed in 1.1.2, a client applying for Family MA must not be on strike (3.4). Do not sanction anyone on strike who is pregnant, a minor, over age 65, blind or disabled, on a MA extension or a Family Planning Waiver applicant/recipient.
This page last updated in Release Number: 06-03
Release Date: 09/15/06
Effective Date: 01/01/06
