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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/ |
A woman applying for both MA and FPW will not be given a choice at the time of confirmation if she meets the eligibility requirement for another subprogram of MA in addition to FPW.
Confirm eligibility for any full-benefit MA subprogram, including BadgerCare (BC), that a woman requesting both MA and FPW is eligible for. All the eligibility requirements for that subprogram of MA apply, including restrictive reenrollment periods (5.7.9)., (5.12.6). A woman may request, at any time, that she does not want to receive full-benefit MA or BC in order to receive only FPW. Change the request switch on ACPA for MA or BC to “N” in order to receive the FPW.
A woman who is found to be eligible for a deductible may also be eligible for FPW benefits during the deductible period. She may receive FPW benefits until she has met her deductible. The client can report any out-of-pocket medical bills incurred while she is receiving services through FPW in order to meet her deductible. Once her deductible has been met, she is receiving full-benefit MA, so she is no longer eligible for FPW but will continue to receive the same services through full-benefit MA.
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Example: Theresa is an 18-year-old woman applying for MA, BC, and FPW for her and her daughter Sara (age six). She is found to be eligible for BC with a premium or a deductible.
If Theresa chooses BC, she would need to pay a premium but would be able to receive family planning services through BC as well as having coverage for her whole family. If she chooses the deductible, she can receive family planning related services through FPW until her deductible has been met. |
This page last updated in Release Number: 03-02
Release Date: 04/01/03
Effective Date: 04/01/03