18.2 Increase in Earnings/Decrease in Group Size Extensions

18.2.1 Earned Income Extensions
18.2.2 Supplemental Security Income Exception

18.2.1 Earned Income Extensions

To receive a BadgerCare Plus extension due to an increase in earnings, a parent, caretaker, or pregnant woman must meet all of the following requirements:

The income increase which caused the countable income for his or her BadgerCare Plus AGassistance group to exceed 100 percent FPL must be due solely to one of the following:

1. Increased earnings (of anyone in the same AG)
2. Increased earnings along with other income (changed or unchanged)

He or she must be a BadgerCare Plus member with income at or below 100 percent FPL at the time the income increased to over 100 percent FPL.

He or she must have been enrolled in BadgerCare Plus with income that was at or below 100 percent FPL for at least three of the six months immediately preceding the month in which the income went above 100 percent FPL.

He or she must otherwise meet the BadgerCare Plus eligibility criteria for persons with income below 100 percent FPL.

He or she verified his or her income unless he or she is exempt from paying a premium because he or she and any co-parent or spouse in the AG are disabled, a tribal member, or pregnant. (This policy applies to all adults in the AG. Unless they are all exempt from paying a premium, income must be verified.)
He or she must not be eligible as a Former Foster Care Youth.

Note: These requirements do not apply to children (see Section 18.1.3 Children).

Example 1: Jane lives with her two teenage children and Dave, the non-marital co-parent of the two children. Jane is claiming both children on her taxes and her income for her MAGA AG of three is 90 percent FPL. Dave’s MAGA AG consists only of himself, and he is eligible for BadgerCare Plus with income of 95 percent FPL. The children-in-common are eligible in a MAGC AG group of four, with both parents as counted adults in their AG and their group’s income is 121 percent FPL. Jane was enrolled in BadgerCare Plus with income below 100 percent FPL for three of the prior six months. In June, her earned income increased to 120 percent FPL. She is eligible for a 12-month BadgerCare Plus extension. Dave is not included in the extension because he was not a counted member of Jane’s AG. The children are eligible for a 12-month extension because they were eligible in June when Jane’s income rose above 100 percent and their own AG’s income was below 156 percent FPL at the time.

18.2.2 Supplemental Security Income Exception

A person who was eligible for SSISupplemental Security Income. A program based on financial need operated by the Social Security Administration that provides monthly income to low-income people who are age 65 or older, blind, or disabled. benefits may be eligible for a BadgerCare Plus extension if he or she loses SSI and would have been eligible for BadgerCare Plus with countable income at or below 100 percent if he or she had not been an SSI recipient.

Example 2: Mary is receiving SSI. Her two children are enrolled in BadgerCare Plus with countable income at or below 100 percent FPL. Mary started a job and her earnings put her above the SSI income limit. Her earned income also caused the BadgerCare Plus countable income to exceed 100 percent FPL. Both Mary and her two children are eligible for a 12-month BadgerCare Plus extension.

This page last updated in Release Number: 17-01

Release Date: 04/11/2017

Effective Date: 04/11/2017