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40.5 Financial Requirements

40.5.1 Financial Eligibility Requirements Specific to FPOS

40.5.2 Income

40.5.1 Financial Eligibility Requirements Specific to FPOS

The following specific financial eligibility requirements apply to FPOS members, regardless of the methodology used to determine his or her FPOS income:

 

  1. Countable income calculated in the application month is used to determine the member's financial eligibility for the entire 12-month eligibility period. Income changes do not need to be reported until the next review. This policy does not apply to backdated months. Backdated months are determined in addition to the 12-month certification period and are not used as the basis for whether someone’s eligibility will be maintained after an increase in income. As with other health care requests, the 12-month certification period will be set based on the filing month, not the first month of backdated eligibility.
  2. Any change in income or household size reported after confirmation for FPOS during the 12-month eligibility period is only applied if it results in enrollment in BadgerCare Plus with no premium or eligibility for other full benefit Medicaid.
  1. All changes in income or household composition that result in enrollment in BadgerCare Plus with no premium or eligibility for other full benefit Medicaid will result in FPOS closure prior to the 12th month.
  2. All changes in income will be applied at the 12-month FPOS eligibility renewal.

40.5.2 Income

Because FPOS eligibility is determined based on a group size of one, the applicant’s taxable earned and unearned income is the only income that should be used when calculating their income for purposes of FPOS eligibility (see Chapter 16 Income for information on taxable income). When a child under 19 is applying, their parents’ income is not included in his or her eligibility determination. If a married individual is applying for FPOS coverage, do not include the income of the spouse, even if he or she is living with his or her spouse.

 

 

This page last updated in Release Number: 18-03

Release Date: 12/14/2018

Effective Date: 06/23/2018