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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/ |
5.12.2.2 Fiscal Test Group ( FTG )
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. was automated in CARES Client Assistance for Re-employment & Economic Support in January 2002. Use CARES to determine and certify eligibility for MAPP.
For months prior to January 2002, use CARES to determine if a client is eligible for a higher subprogram of MA. If not, use the manual worksheet process to determine and certify eligibility for MAPP and to establish a monthly premium (if applicable).
Certify applicants for MAPP retroactively for any or all, up to three prior months, if s/he met all of the eligibility criteria at that time. The client is responsible for any premium due for the previous months in which s/he elects coverage.
Clients can also choose to begin MAPP eligibility during any future month that can be processed in CARES.
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Example: Jack applies for MAPP on September 30th and requests a retroactive determination of eligibility. His application is processed on October 21st. He meets all eligibility requirements as of June. Jack can choose to begin MAPP eligibility in June, July, August, September, October, November or December. |
When both members of a married couple (living together) apply for MAPP, each person must be in a separate Assistance Group ( AG ). Enter them in CARES on the same application. The client’s spouse is a countable member of the FTG. A separate financial test is done for each spouse’s AG. The married couple is entered on the same case, but they are in two separate AGs.
If a spouse of a MAPP applicant chooses not to disclose or verify assets, a case may fail for a higher MA eligibility and still cascade The MA cascade is the hierarchy of eligibility. to MAPP eligibility.
If both members of a married couple (living apart) apply for MAPP, determine eligibility as two separate cases.
Include the client’s spouse and test children in the FTG. Test children include the client’s minor natural or adoptive children. Do not include the client’s stepchildren in the FTG. Do not count the income Income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing, and shelter. or assets of the test children.
This page last updated in Release Number: 03-02
Release Date: 04/01/03
Effective Date: 04/01/03