2.3 Where to Apply

2.3.1 Where To Apply Introduction

Click here to view the directory of IM agencies in Wisconsin or call 1-800-362-3002. The applicant must apply with the local agency serving their county or tribe. The applicant must apply with the agency serving their county or tribe.

An individual who resides in a nursing home/hospital for 30 days or more is considered a resident of the county in which the nursing home/hospital is located.

The applicant’s county of residence at the time of admission must receive and process applications for persons living in these state institutions:

Northern, Central, and Southern Centers.
Winnebago and Mendota Mental Health Institutes.
The University of Wisconsin Hospital.

When an applicant contacts the wrong agency, redirect him or her to the agency responsible for processing the application immediately. Anytime an application is received in the wrong agency, it must be redirected to the agency responsible for processing that application no later than the next business day. A paper application must be date stamped before it is redirected. The filing date remains the date originally received by the wrong agency.

2.3.2 Intercounty Placements

When a county 51.42 board, 51.437 board, human services department, or social services department places a person in a congregate care facility that is located in another county, the placing county remains responsible for determining and reviewing the applicant’s Medicaid eligibility. This does not include situations where a guardian or the member elects to move the member to another county. A congregate care facility is a:

Child care institution.
Group home.
Foster home.
Nursing home.
AFH .
CBRF .
Any other like facility.

The placing county may request the assistance of the receiving county in completing applications for persons who are not enrolled in Medicaid and reviews for Medicaid members. The receiving county must then forward the information to the placing county. The placing county remains responsible for determining the applicant’s eligibility. If the placing county requests assistance from the receiving county, the placing county must provide the other agency with:

The applicant’s name, age, and SSN .
The date of placement.
The applicant’s current Medicaid status.
The name and address of the congregate care facility in which the applicant has been placed.
The name of the county and agency making the placement.

When there is a dispute about responsibility, the social or human services department of the receiving county may initiate referral to the Department of Health Services' Area Administration office for resolution. Pending a decision, the county where the person is physically present must process the application, any changes, and reviews.

2.3.3 Applications Outside Wisconsin

Generally, an application should not be taken for a resident of Wisconsin when he or she is living outside of Wisconsin. An exception is when a Wisconsin resident becomes ill or injured outside of the state or is taken out of the state for medical treatment. In this case, the application may be taken, using Wisconsin’s application forms (see Section 2.2 Application Types/Methods), by the public assistance agency in the other state. The forms should be forwarded to the IM agency in the other state. The Wisconsin IM agency determines eligibility when the forms are returned.

This page last updated in Release Number: 15-01

Release Date: 06/10/2015

Effective Date: 06/10/2015