When a community spenddown case is in unmet status for the month the client enters a long term care facility, transmit 2 separate Form 552 actions in the following order:

First Action

  • Item 2 -Enter the current processing month and year.
  • Item 3 -Enter 31.
  • Item 33 -Enter 55.
  • Item 44 -See WAG 27-44-00.
  • Item 77 -Enter the beginning medical eligibility date (MM/DD/YY). If the monthly spenddown amount was met before admission to the facility, enter that date. If community spenddown was unmet, enter the admission date to the facility.
  • Item 80 -Line out 2 - unmet, in the PERSONS column, and enter 1 or 3 - met.

2nd Action

  1. Complete Items 2, 3, 30, 33, 44, 45, 77, and 80 on Form 552 printout (see WAG 18-05-13).
  2. As soon as the first action processes, immediately transmit the 2nd action. Do not wait for a return Form 552 printout.

The central office generates Form 469. The MediPlan Card shows coverage starting on the date entered in Item 77.