WAG 19-02-02

IES Phase 2 Process

new text Upon implementation of the Integrated Eligibility System (IES) phase 2, the process for completing a redetermination is changed.

For Family Health Plan, ACA Adult and Former Foster Care Cases:

  • Complete a REDE at least every 12 months.
  • Act on any information that shows a change which may affect eligibility.
  • Act on any information which may affect All Kids Assist or Moms & Babies spenddown. See PM 18 for policy on changes.

Family Health Spenddown cases containing an All Kids Assist member and/or a Moms and Babies member, or have met spenddown in the 8th, 9th, or 10th month remain active and are REDEd like all other medical cases.

The first REDE for a Family Health plan, ACA Adult or Former Foster Care case is due 12 months from the calendar month in which the case is approved. The next REDE is then due 12 months from the date the last one was reported.

The REDE processed is described in greater detail in PM 19-02-04.

Legacy Process

For Assist cases:

  • Complete a REDE at least every 12 months. A client must cooperate in the child support enforcement process as asked (see PM 24-02-00).
  • Act on any information that shows a change which may affect eligibility or shows a spenddown. See PM 18 for policy on changes.

Family Health Spenddown cases which have an All Kids Assist member, a Moms and Babies member, or have met spenddown in the 8th, 9th, or 10th month remain active and are REDEd like all other Medical cases. Cases which do not have an All Kids Assist member, a Moms and Babies member, or have not met spenddown in a specific month centrally cancel and must reapply.

NOTE: Cases containing individuals who do not meet spenddown in the first 6 months of eligibility are not centrally canceled.

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