WAG 19-02-04-g: Medical Redetermination Forms

PM 19-02-04-g

The table below identifies which redetermination forms a household due for medical redetermination will receive.

Household Scenario Any members ex parte eligible? Any members ex parte ineligible? CASH/SNAP/TANF due for redetermination? Forms household will receive:
1 Yes No No 2381C only
2 No Yes No 2381C and 643
3 Yes Yes No 2381C and 643
4 Yes No Yes 2381C and 1893
5 Yes Yes Yes 2381C and 1893