Wisconsin Administrative Code › Department of Health Services › DHS 101-109 - Medical Assistance › Chapter DHS 103 - Eligibility › Section DHS 103.09 - Termination of medical assistance

Current through June 24, 2024
(1) FINAL MONTH
				COVERAGE. When eligibility ends, except in the case of death of the recipient,
				the MA benefits shall continue until the end of the calendar month.
(2) FOUR-MONTH CONTINUATION OF ELIGIBILITY.
(a) When a parent, caretaker, or pregnant
				person eligible for BadgerCare Plus has an increase in MAGI-based countable
				monthly income under s.
				DHS 103.04 (7)
				(d) that exceeds 100% of the federal poverty
				line, BadgerCare Plus eligibility for the persons identified in par. (c) will
				continue for four months when the conditions in par. (b) are met. Eligibility
				shall be discontinued when the person is no longer a resident of
				Wisconsin.
(b) To receive a
				four-month continuation of BadgerCare Plus eligibility, all of the following
				conditions must be met by the parent, caretaker or pregnant person:
1. The monthly income increase which caused
				the countable income to exceed 100% of the poverty line must be due solely to
				one of the following:
a. Increased spousal
				support income.
b. Increased
				spousal support income along with other unearned income.
2. There has been no increase in earned
				income.
3. The person receiving the
				spousal support is eligible for BadgerCare Plus with monthly income at or below
				100% of the poverty line at the time the income increased to over 100% of the
				poverty line.
4. The person must
				have been enrolled in BadgerCare Plus with monthly income that was at or below
				100% of the poverty line for at least three of the six months immediately
				preceding the month in which the monthly income went above 100% of the poverty
				line.
5. The person must otherwise
				meet the BadgerCare Plus eligibility criteria for persons with monthly income
				below 100% of the poverty line.
(c) When a parent, caretaker, or pregnant
				person eligible for BadgerCare Plus meets the condition in par. (b), any of the
				following persons in the home, who otherwise meet the BadgerCare Plus
				eligibility criteria are eligible for BadgerCare Plus for four months past the
				month in which income exceeded 100% of the poverty line:
1. The parent, caretaker or pregnant person
				who received the spousal support.
2. All children whose parent or caretaker
				relative qualify for four months of continued eligibility under this subsection
				is eligible for the same four months of continued eligibility, provided that
				they are eligible for BadgerCare Plus in the month prior to the increase in
				countable income and one of the following applies:
a. The child is under age one, and the parent
				or caretaker had MAGI-based countable income at or below 306% of the poverty
				line and is not eligible under ss.
				49.471 (4) (a)
				2 or 2m, Stats.
b. The child is age one through five and the
				parent or caretaker had MAGI-based countable income at or below 191% of the
				poverty line.
c. The child is age
				six through 18 and the parent or caretaker had MAGI-based countable income at
				or below 156% of the poverty line.