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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/ |
Follow these steps when determining FFU eligibility. See the FFU Income Income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing, and shelter. Worksheet (WKST 13).
Gather income information for each member of the AG, and apply the appropriate disregards.
Prorate each person’s income by the number of people each person is legally responsible for (including themselves).
Allocate the prorated income amount to each person that the target person has legal responsibility for (including themselves)
Add up the total income of the person including the prorated share of his/her own income and the income allocated to him/her from persons legally responsible for him/her. This is the income test amount.
Determine the FFU size. Exclude SSI recipients when determining group size. You may allocate to the SSI recipient, but you cannot allocate from the SSI recipient.
Determine FFU size based on legal responsibility. Include the person you are testing and anyone who is legally responsible for him/her. Increase a pregnant woman’s FFU size by the number of fetuses she is carrying. The fetuses only increase the FFU size of the pregnant woman and not anyone else in the household. Test each person individually. This may result in different FFU sizes for each FFU test.
To make the manual process of determining eligibility based on Family Fiscal Unit easier, we use the term “FFU size” in 4.8.4 to mean the person you are testing and all those who are legally responsible for that person, without including the fetuses. Follow the FFU size across to the columns on the left to include the fetuses. For example, the income limit for a pregnant mom (one fetus) with one child would be found by looking under the row for FFU size one, and then moving over to the column for "number of fetuses" equal to one.
Example 1: Mom has two children, Molly and Mindy. Mindy has income of her own. The case failed Healthy Start fiscal group testing so is in FFU. Mom’s FFU size is one since she is legally responsible for herself, no one is legally responsible for her, and she is not pregnant. Mindy’s group size is two (herself and mom, who is legally responsible for her), and Molly’s group size is also two.
Mom remarries. Now, mom’s group size is two, herself and her husband. The children’s group size remains the same. The step-dad’s group size is two. He is only legally responsible for his wife and himself. |
Compare the income test amount to the first appropriate individual income limit (4.8.4) that corresponds to his/her FFU size (from top to bottom). If the person’s test amount is equal to or less than his/her income limit, s/he is eligible for that category if all non-financial requirements are met for that category.
If the client you are testing is pregnant, follow the row with her FFU size across until it meets the column with the number of fetuses she is carrying.
Example 2 : Helen is pregnant with twins. She is 17 years old and lives with her mom.
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Caretakers are not eligible if they fail categorically needy income tests. Do not test them for medically needy.
If s/he fails at this income level, continue to test his/her income against the next appropriate income limits that corresponds to his/her FFU size.
Determine a deductible (4.9), if s/he fails all appropriate categories of MA.
This page last updated in Release Number : 04-01
Release Date: 02/27/04
Effective Date: 02/27/04