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Wisconsin Department of Health and Family Services Obsolete Medicaid Eligibility Handbook For the current MEH, see http://www.emhandbooks.wi.gov/meh-ebd/ For the current BC Plus Handbook, see http://www.emhandbooks.wi.gov/bcplus/ |
1.2.7.1 Application and Review
Verify mandatory and questionable items at application, review, person addition or deletion, or when there is a change in circumstance that affects eligibility or benefit level. Do not reverify one time only verification items.
Application
The time period for processing an application for MA is 30 days. Advise the applicant of the specific verifications required within the 30 day processing time. Give the applicant a minimum of ten calendar days to provide any necessary verification.
Do not deny eligibility for failure to provide the required verification until the later of::
11th day after requesting verification, or
31st day after the application filing date. .
If you request verification more than ten days prior to the 30th day you must still allow the applicant 30 days from the application filing date to provide the required verification.
Eligibility Reviews
Do not deny the group's eligibility for failure to provide the required verification until the 11th day after requesting verification or the end of the review month, whichever is later.
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Example 1: Fred’s eligibility review is due in April. He submits a mail-in review form on April 10th. The eligibility worker requests verification of his income on April 11th. If the verification is not submitted by April 30th, his eligibility will end on April 30th. |
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Example 2: Shannon’s eligibility review was due in June. At Adverse Action in June a notice was sent to Shannon to let her know her Medicaid eligibility would end June 30th because she had not yet completed her review. A telephone interview was conducted on June 30th. A request for verification, with a July 10th due date, was sent to Shannon. Because the required verification (including signature) was not submitted by July 11th, her eligibility beginning July 1st was denied. |
Advise the recipient of the specific verification required and allow a minimum of ten days to provide it.
This page last updated in Release Number: 07-06
Release Date: 07/16/07
Effective Date: 07/16/07