WAG 18-02-02: Case Becomes Ineligible for Cash Benefits

PM 18-02-02.

1. When you learn that an AABD or TANF case is ineligible for Cash benefits, review eligibility for a Medical Only program. If eligible for medical, authorize extended medical (TANF only - see WAG 18-05-06), SWAP the case using the same basic number, or cancel the existing case and set up a new case under a different category with a new basic number (see WAG 25-08-01-b or WAG 25-08-02-b). The client does not have to complete a written request, even if the existing case is being canceled and eligibility established under a different category.
   1. Complete and send Notice of Change (Form 157).
   2. If income makes the Cash benefits stop, complete and send a manual computation form with the cancellation notice.
      • For TANF use TANF/Food Stamp Computation - Work Pays (Form 553J) and, when needed, Attachment to Computation of TANF Grant/Food Stamps (Form 553G).
      • For AABD use AABD/Food Stamp Computation (Form 4050).
2. SWAP the case to AABD Medical, Assist, Family Health Spenddown, or Moms and Babies by completing the current Form 552 as follows.
   • Item 1 -
     • Category: Enter the new category code above the current category. Do not line out the printed category code.
     • Local Office: Do not change this item. If an inter-office transfer is involved, process the transfer action before the SWAP. See WAG 18-02-01 for transfer-in and SWAP.
     • Group Number: If the Medical case does not have FS on the same Form 552, enter 00 for the group number. If the Medical case has FS on the same Form 552, enter 22 for the group number.
     • Basic Number: Do not change this item.
   • Item 2 -Effective Date: Line through the printed date. Enter the effective date (2-digit month and 2-digit year) of the Cash cancellation. The Medical case is approved for the same month.
   • Item 3 -Type Action: Enter code 81 or 82 as follows:
     • 81 Enter when opening the case under the new category as a new approval.
     • TA 11 is centrally entered on the Form 552 printout. The system automatically registers a new application, TA 01.
     • 82 Enter when the case previously received benefits under the new category and benefits are restored.
     • TA 12 is centrally entered on the Form 552 printout. The system automatically registers a reapplication, TA 02.
   • Item 4 -Enter 1.
   • Item 5 -Complete as needed.
   • Item 6 -Complete (caseworker).
   • Items 7-31-Complete as needed.
   • Item 33 -Enter the correct SWAP TAR (see WAG 27-33-01-s for TANF or WAG 27-33-02-q for AABD). The TAR appears on the Cash cancellation printout. One of the following opening TARs is automatically generated on the Medical opening printout:

     SWAP from	Medical Opening Reason
     00 to 90	90
     01 to 91	85
     02 to 92	86
     03 to 93	87
     04 to 94	88
     06 to 96	88

     Item 35 -Complete as needed.

   • Item 39 -Enter code 80 or code 92, if the SWAP includes Food Stamps. For the Medical opening, complete and send Form 458 or Form 458SP and the correct food stamp notice.
   • Item 42 -Enter a date when necessary.
   • Item 44 -Complete.
   • Items 50-52 -Complete when needed.
   • Item 60 -
     • For a case being SWAPped to Family Health Plans, reenter or enter QMB status indicator as needed. For clients enrolled in State Buy-In, reenter SMIB status indicator 6 to continue Buy-In. Also reenter HIB status indicator 2.
     • For AABD, reenter or enter QMB status indicator as needed. For clients enrolled in State Buy-In, reenter SMIB status indicator 6 to continue Buy-In. Also reenter HIB status indicator 2, 3, or 4, or SMIB status indicator 5, 7, or 9 when already present.
   • Items 61-74 -Complete as needed.
   • Item 78 -For a case being SWAPped to Family Assist, keep code C for a child If eligible for All Kids Assist, enter code G or H based on the client's situation.
   • Item 80 -Revise as needed.

SWAP with Food Stamps Cash to Medical

(System) Centrally issues the correct amount of benefits even when a case SWAPs from cash to medical for different processing months (outside the window). If the case SWAPs from Schedule 01 through 04 the system will issue a full month's benefit, and if the case SWAPs from Schedule 05 through 09 the system will issue half the full month's benefits. The system issues the benefits using TA 56, TAR 21 on the availability date of the cash group. The following chart shows the portion of the monthly benefit that is sent.

(FCRC) Completes and sends Form 2807, Notice About Change in Benefit Availability Date, to notify the unit of the new availability date.

Example: Regular roll cutoff for July for Schedule 22 is 06/l7. Regular roll cutoff for July for Schedule 05 is 06/30. On 06/20, a group 05 case is SWAPped to medical. The SWAP action closes the cash case for July and opens the medical case for August because cutoff for July is passed. The FS unit last received June food stamps for 06/16 through 07/15. The next benefits they will receive on the regular roll are for August (08/01 through 08/31). The system centrally issues July benefits to cover the period 07/16 through 7/31 as TA 56, TAR 21. The benefits will be held by the system and issued on the availability date for Group 05 (July 14).