PM 06-08-02-b

(FCRC/All Kids Unit)

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See WAG 27-33-01-q for Type Action Reasons to use for denials.

Family Care Expansion Cases Approved Prior to June 30, 2009

Once household income decreases below 185% of the FPL, the adult is only eligible as long as income stays at or below 185% of the FPL. If household income increases above 400%, eligibility for FamilyCare ends. Delete the adult from the case or cancel the case as appropriate. To qualify for FamilyCare again, the adult must submit an application or a Form 243 Request for Medical Benefits and have income at or below 185% of the FPL.

Compare the countable income to the FamilyCare income standard on the Desk Aid to determine if the income is above or below 185% of the FPL.

  • Example 1: Ms. B and her daughter receive All Kids/FamilyCare Premium Level 2. At renewal, Ms. B's income drops to the Share level. The All Kids unit changes the case to Share. Three months following the renewal, Ms. B's income increases to Premium Level 2. Ms. B is no longer eligible for FamilyCare. The All Kids unit deletes Ms. B from the case. Ms. B's daughter continues eligibility in Share until the next renewal.

Take appropriate action when income changes between Premium Level 1, 2, and 3, but remains in the 185% to 400% range.

  • Example 2: Ms. C is active on a FamilyCare Premium Level 1 case. Her income is between 185% and 200% of the FPL. Ms. C reports an increase in income and is now eligible for FamilyCare Premium Level 3. The All Kids unit changes her eligibility to Premium Level 3.