13-02 Version of 25.9 Denials and Terminations

25.9 Denials and Terminations

25.9.1 Termination

If less than a calendar month has passed since a member’s enrollment has been terminated, the applicantA request for BadgerCare Plus coverage. The request must be on the Department's or Federally-facilitated Marketplace’s application, registration form or account transfer (from Federally-facilitated Marketplace) and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. can provide the necessary information to reopen BadgerCare Plus without filing a new applicationA request for BadgerCare Plus coverage. The request must be on the Department's application or registration form and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. .

If more than a calendar month has passed since a member’s enrollment was terminated, the applicant must file a new application to reopen his or her BadgerCare Plus.

Starting with renewals due March 31, 2014, if a case is determined under MAGIModified Adjusted Gross Income. MAGI rules are used to determine BadgerCare Plus eligibility for new applicants beginning in 2014 and for existing members as of March 31, 2014, or their next regularly scheduled renewal, whichever is later. MAGI rules are based on tax relationships and family relationships, and they consider taxable income and whether children and tax dependents are required to file. rules and is closed at renewal due to failure to complete the renewal, including providing verification for that renewal, the individual can be reopened for BadgerCare Plus without filing a new application if he or she provides the necessary information within 90 days of the renewal date.

25.9.2 Denial

If less than 30 days has passed since the client's eligibility was denied, allow the client to re-sign and date the application or page one of the CAF to set a new filing date .

If more than 30 days has passed since a client's eligibility was denied and the client is not open for any other program, the client must file a new application to reopen his or her Medicaid.

If the client is open for any other program of assistance, do not require him or her to re-sign his or her application or sign a new application.

This page last updated in Release Number: 13-02

Release Date: 10/25/13

Effective Date: 10/01/13