Wisconsin Medical Assistance Eligibility Requirements

You may be eligible for Wisconsin medical assistance if you are a Wisconsin resident and meet certain financial and non-financial eligibility requirements.

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What is Wisconsin Medical Assistance?

Wisconsin Medical Assistance is a government-funded health care program that provides health care coverage for low-income residents of Wisconsin. The program is jointly administered by the Wisconsin Department of Health Services and the Centers for Medicare and Medicaid Services.

Wisconsin Medical Assistance is available to residents of Wisconsin who meet certain income and asset eligibility requirements. In order to be eligible for the program, applicants must have an annual income that does not exceed 200% of the federal poverty level. In addition, applicants must be U.S. citizens or legal residents of the United States and they must be residents of Wisconsin.

The program provides health care coverage for a wide range of medical services, including physician services, hospitalization, prescription drugs, mental health services, and more. Coverage is available for both children and adults.

Who is eligible for Wisconsin Medical Assistance?

Children
In order for a child to be eligible for Wisconsin Medical Assistance, the child must be under 19 years of age and a resident of Wisconsin. The child must also meet one of the following criteria:

-Be a U.S. citizen or have qualified alien status
-Be enrolled in an approved Medicaid program
-Have incomes at or below certain levels

Pregnant Women
To be eligible for Wisconsin Medical Assistance as a pregnant woman, you must be a resident of Wisconsin and either a U.S. citizen or have qualified alien status. You must also have an income at or below certain levels. In addition, you must be either:
-Pregnant
-A parent or caretaker relative of a dependent child under 19 years of age
-Under 21 years of age and pregnant with your first child
-A parent or caretaker relative of a disabled child under 18 years of age

How do I apply for Wisconsin Medical Assistance?

You can apply for Wisconsin Medical Assistance online, in person, or over the phone. You will need to provide information about yourself and your family, including your income and assets. Once you have applied, a case worker will determine if you are eligible for benefits.

What are the income guidelines for Wisconsin Medical Assistance?

In order to be eligible for Wisconsin Medical Assistance, your income must not exceed a certain level. The income guidelines are different for each state, and they are based on the Federal Poverty Level (FPL).

In Wisconsin, the income guidelines for Medical Assistance are as follows:

· If you are an individual with no dependents, your income must not exceed $1,012 per month.

· If you are a family of two (with or without children), your income must not exceed $1,372 per month.

· If you are a family of three (with or without children), your income must not exceed $1,732 per month.

· If you are a family of four (with or without children), your income must not exceed $2,092 per month.

· If you have more than four family members, your income must not exceed $2,452 per month.

What assets are considered when determining Wisconsin Medical Assistance eligibility?

Wisconsin Medical Assistance (Medicaid) helps pay for medical and long-term care services for low-income adults, children, pregnant women, elderly adults and people with disabilities.

In order to be eligible for Wisconsin Medicaid, applicants must meet certain requirements regarding their income, resources, citizenship status and residency.

Income: Income limits vary depending on the size of the household and the program for which you are applying. For example, as of 2018, a single person could have an annual income of no more than $16,754 to qualify for Medicaid benefits.
Resources: When determining eligibility for Medicaid, countable resources include cash, checking and savings accounts, investments and real property. Some resources are not counted when determining Medicaid eligibility, including the applicant’s home (up to $552,000 in equity value), personal belongings and one vehicle per licensed driver in the household.
Citizenship status: To qualify for Medicaid in Wisconsin, applicants must be U.S. citizens or legal aliens who have been lawfully admitted for permanent residency in the United States.
Residency: In order to receive Wisconsin Medicaid benefits, applicants must reside in the state of Wisconsin.

How often is Wisconsin Medical Assistance eligibility redetermined?

Eligibility for Wisconsin Medical Assistance is determined once every 12 months for families, children, pregnant women, parents and caretaker relatives, and disabled adults age 21 and over. Wisconsin Medical Assistance eligibility is redetermined every 6 months for aged, blind or disabled individuals who live in a nursing home or other long-term care facility.

What changes in circumstances must be reported to the Wisconsin Medical Assistance program?

There are several types of changes in circumstances that must be reported to the Wisconsin Medical Assistance program. These include changes in income, assets, health insurance coverage, and living arrangements. If you have any questions about whether or not a change needs to be reported, you can contact your county’s Medical Assistance office.

Income changes:
If your income goes up or down, you must report this change to the Medical Assistance program. This includes changes in wages, tips, self-employment income, interest and dividends, alimony payments, pensions, annuities, and other types of income. In general, any increase in income that is expected to last for more than one month should be reported.

Asset changes:
If your assets go up or down by more than $5,000 (or $10,000 for a married couple), you must report this change to the Medical Assistance program. This includes changes in savings accounts, checking accounts, stocks, bonds, and other types of assets.

Health insurance coverage changes:
If your health insurance coverage goes up or down (for example, if you get a new job with health insurance benefits), you must report this change to the Medical Assistance program. This also includes changes in Medicare coverage.

Living arrangement changes:
If you move to a new address or if anyone moves into or out of your household (including a new baby), you must report this change to the Medical Assistance program.

What are the consequences of failing to report changes in circumstances to the Wisconsin Medical Assistance program?

If you do not report changes in your circumstances to the Wisconsin Medical Assistance program, you may be subject to penalties. These can include a loss of benefits, and in some cases, prosecution.

Can I appeal a decision about my Wisconsin Medical Assistance eligibility?

Wisconsin Medical Assistance (Medicaid) is a program that provides health care benefits to low-income adults, children, pregnant women, and people with disabilities. If you are found ineligible for Wisconsin Medical Assistance, you may be able to appeal the decision.

To appeal a decision about your Wisconsin Medical Assistance eligibility, you will need to request a hearing within 60 days of the date on the notice of ineligibility. To do this, you can contact the Department of Health Services Office of Hearings and Appeals by phone at 1-800-999-1118 or by mail at P.O. Box 309, Madison, WI 53701-0309.

At the hearing, you will have the opportunity to present evidence and testimony about your eligibility for Wisconsin Medical Assistance. An administrative law judge will then make a decision about your eligibility for Medicaid benefits.

If you are still found ineligible for Medicaid benefits after appealing the decision, you may be able to file a lawsuit in circuit court.

Where can I get more information about Wisconsin Medical Assistance?

Wisconsin provides medical assistance through a program called Wisconsin Medicaid. Medicaid is a federally and state-funded program that provides health insurance to low-income individuals and families. In order to be eligible for Wisconsin Medicaid, you must meet certain income and asset limits.

Medicaid is administered by the Wisconsin Department of Health Services. If you think you might be eligible for Medicaid, you can contact the Department of Health Services for more information.