3.6 Inmates

3.6.1 Huber Law

An inmate is residing in a public institution on an involuntary basis. For example, a prisoner in a jail, prison, or other correctional facility is considered an inmate. A staff person voluntarily residing in a public institution is not considered an inmate. An individual voluntarily residing in an institution while waiting for other living arrangements to be made which are appropriate to the person’s needs is not considered an inmate. An individual who is legally confined to his or her home by a monitoring device, such as an ankle bracelet, is not considered in inmate for purposes of BadgerCare Plus. Individuals who are inmates of a public institution are not eligible for BadgerCare Plus unless they meet the Huber criteria or the following two exceptions:

Prenatal Exception: Pregnant women may apply for and enroll in the BadgerCare Plus Prenatal Program (Chapter 41) while they are inmates.
Inpatient Exception: If an inmate resides outside of a public correctional institution for more than 24 hours at any one time, he or she can qualify for BadgerCare Plus during that time period if he or she meets all other eligibility criteria. For example, if an inmate of a public institution is admitted as an inpatient to a medical institution for 24 hours or more and is otherwise eligible, manually certify him or her for BadgerCare Plus from the admission date through the discharge date.

Use the following process for inmates of state correctional institutions:

Department of Corrections (DOC) staff submits an ACCESS application, which will be systematically routed to EM CAPO. Superintendents of state correctional facilities (Wardens) or their designee may sign the application for the inmate. Refer to MEH 6.9.4 State Correctional Institutions for the list of state correctional facilities at which the Warden may sign the application.
Process the inmate as a one-person household with a living arrangement of “01- Independent (Home/Apt/Trlr)” on the demographics page.
If the individual is eligible, close the case in CARES by changing the Healthcare Request page to “N”. Suppress CARES generated notices for Medicaid and any program the Individual has not requested. Manually certify the Individual with the appropriate medical status code (see below), from the hospital admission date through the date of discharge. If the individual has not yet been discharged, certify the individual from the date of admission through the estimated discharge date. Send a manual positive notice to DOC indicating the dates of eligibility. Also if the individual had not been discharged when you sent the initial positive notice, send a manual negative notice with the eligibility end date as soon as that is known. If you issue the notice after the discharge date, the effective date of the termination and the notice should be the date you mail out the notice. The reason for the termination should be shown as, “Individual is incarcerated”. The legal citation should read, “DHS 103.03(6)”.

Note: It is not necessary to provide a ten-day notice of termination for Medicaid when the reason for termination is the return of the individual to prison. The notice is considered timely if it is mailed no later than the termination effective date.
If the individual is ineligible, confirm the denial on CARES, and allow CARES generated notices to be sent to the designated DOC staff person.

For a list of Med Stat Codes, see Process Help 81.5.

3.6.1 Huber Law

Huber Law prisoners who are released from jail for the purpose of attending to the needs of their families can become eligible for BadgerCare Plus if the prisoner.

Intends to return to the home, and

Continues to be involved in the planning for the support and care of the minor children.

Huber Law prisoners who are released for a purpose other than attending to the needs of their families are not eligible for BadgerCare Plus. Consider them to be absent parents.

This page last updated in Release Number: 14-02

Release Date: 05/14/14

Effective Date: 04/01/14