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State of Wisconsin |
Release 25-02 |
The health care application processing period is 30 days. This means that, as a rule, the agency must process the application, determine eligibility, and issue a notice of decision no later than the 30th calendar day after the date on which the application is received (or the next business day if the 30th day falls on a weekend or holiday). However, the application processing period must be extended as needed to ensure the applicant has at least 20 days from the mailing date of a verification request to provide the requested verification.
| Note | For ACCESS and Marketplace applications, the “date received” for purposes of determining when the application processing period begins may be different from the filing date (see SECTION 25.6 FILING DATE). The date received is the date on which the application is delivered to the agency or the next business day if delivered weekdays after 4:30 p.m., on a weekend, or on a holiday. |
| Example 1 | A signed application is received on March 15. The worker processes the application on April 7 and requests verification. Verification will be due on April 27 to allow the applicant at least 20 days to provide verification. |
| Example 2 | A signed application was submitted to the Marketplace on February 28. The Marketplace assessed the person as potentially eligible for BadgerCare Plus and transferred the person’s account to the agency on March 5. The first day of the 30-day period for processing requirements was March 6. The end of the 30-day period would have been April 4. The application was approved on March 31, and the applicant is determined eligible beginning February 1. |
Changes that occur between the filing date and the confirmation date should be used in the initial eligibility determination. For information on application denials for failure to provide verification, see Section 9.2 Application.
This page last updated in Release Number: 23-02
Release Date: 04/17/2023
Effective Date: 02/25/2023
The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10171