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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/ |
Forward cards are issued to MA clients. These cards are blue, permanent, plastic, and display the word “Forward” on them. Clients use the same Forward card each month. Monthly cards are not issued.
Each person in the family who is eligible for MA receives his/her own card. The cards do not display eligibility dates. All MA services are paid for under the MA ID number on the card. For newborns that do not have a MA ID, MA pays for all services within the first ten days of the baby's birth under the mother's MA ID number. The baby need not be determined eligible for the claims to be paid. If the baby has a MA ID, services are billed under that number. If the baby does not have a MA ID, CARES Client Assistance for Re-employment & Economic Support will assign a pseudo ID number. EDS assigns a pseudo ID if the newborn is reported to them by a MA HMO or hospital, and the newborn has not yet received an SSN.
Clients will know if they are eligible based on positive and negative notices sent from the IM agency. Clients who receive a notice that they are no longer eligible for MA should keep their Forward cards. Cards should not be thrown away. If a client becomes eligible again, they will use the same Forward card originally issued. If they have questions regarding their eligibility status, they can call you or Recipient Services at 1-800-362-3002.
Keep an MA case in appeal status open if the client makes a request prior to the closure date. The client can continue to use their Forward card until a decision is made regarding his/her eligibility.
Make ID cards available to homeless MA clients who have no fixed address or mailing address. Use your agency address or some other fixed address for delivery.
A program called ‘Lock-in’ is available in cases of benefit misuse. The client is assigned to a particular provider for services. When a client receives health care, the providers are told of the client’s restriction(s) when verifying eligibility. If you have information that your client may be misusing benefits or his/her Forward card, send the client’s name, address, card number, and a summary of the facts and any documentation to:
Division of Health Care Financing
Bureau of Health Care Program Integrity
P.O. Box 309
Madison, WI 53701-0309
Or call providers services at (800) 947-9627 or (608)221-9883 .
The following cards are the only paper MA cards:
Green Cards
Tan Cards
EDS does not issue temporary cards. The IMAgency issues them. Each agency must issue a temporary card if the client does not already have a Forward card and needs health care within the two to three days before s/he receives one in the mail. The green temporary card is the only way the client may be able to receive services without having to pay out-of-pocket, since eligibility is not on MMIS yet for the provider to verify.
Order the green temporary MA ID card stock from:
Medicaid Eligibility Maintenance
P.O. Box 7636
Madison, WI 53707-7636
Phone: (608) 221-4746
Fax: (608) 221-0885
When ordering, indicate the agency, contact person, and number of blank cards desired.
Include the following on each temporary ID card you issue:
MA ID number.
Agency code.
Medical status code.
Client’s full name.
Client’s date of birth.
Client’s sex (M or F).
Client’s address.
Valid dates: Do not use future dates beyond the current benefit month.
Other insurance coverage. If private insurance, include the name. If Medicare, include the Medicare number as it appears on the client’s Medicare card with “A” for Part A and/or “B” for Part B.
Do not issue a temporary card to clients who would not normally receive a Forward card. Clients in the following categories do not get a Forward card, so should not be issued temporary cards:
AE – Alien Emergency services. No card is necessary because only services directly related to the emergency are reimbursable by MA.
FC - Family Care Non-MA. MA does not cover services provided to clients in this category. If the client is enrolled in a Family Care CMO, limited services are provided entirely by that CMO.
Medicare Premium Assistance Programs
SB – SLMB only
SLMB+ – Qualified individual, group 1
ALMB – Qualified individual, group 2
QW – QDWI
MA pays for these clients’ Part A and/or Part B Medicare premiums. No health care services are payable by MA.
Temporary tan cards are provided to the client from the PE provider after having completed a presumptive eligibility application and the provider has found the client eligible for PE. The provider sends the completed PE application to EDS. Once EDS receives the PE application from the provider and applies the PE eligibility to MMIS, a Forward card is sent to the client.
If a client needs a replacement card, s/he or an authorized representative, including the IM worker, should call Recipient Services at 1-800-362-3002. A new Forward card will be issued and will be sent out the following business day. The 16-digit number on the card is unique to each card. If a new card is issued, it will have a new card number to help prevent fraud and monitor card stock.
Replacement cards are issued automatically when:
The client’s name changes.
The card was returned as undeliverable and the client’s address changes.
A replacement for any other reason must be requested through Recipient Services, 1-800-362-3002.
You cannot request replacement cards using a HCF 10110 (formerly DES 3070) or CARES.
This page last updated in Release Number : 03-02
Release Date: 04/01/03
Effective Date: 04/01/03
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