WAG 17-01-03-a: Changing Category from Cash to Medical

revised text(EW) If an applicant reports a financial change that makes the case ineligible for cash, take the following actions:

  1. (EW) Change the category in AIS.
    • Step 1. In Option 7 of AIS, on the Change I.D. Screen, enter the original AID (or assistance) requested by the customer (a cash, medical, SNAP request is entered as C, M, F).
    • Step 2. Enter the new Aid request (M, or M, F) on the Change I.D. Screen.
    • Step 3. On the Change I.D. Screen, enter the former case ID number (category, local office, group, basic) originally registered and the new category and group number for the new category determination. The system assigns the basic number for the new category determination.
      • NOTE: If a previous number exists for the new category, enter it in this field.
    • Step 4. Enter on the AIS Miscellaneous Entry Screen the denial TAR for the original category determination. Press the return key.
    • Step 5. TA 62 and the denial TAR are displayed on the AIS Actions to Be Taken Screen. The denial reason message for every TAR entered in Item 33 is printed on the Form 360C when the final disposition is made.
  2. (EW) Determine eligibility for Medical and QMB. Use the original application date unless the applicant has stated they do not want to receive medical.
  3. (EW) If the customer is income ineligible for QMB benefits, determine eligibility for SLIB benefits.
    • For Family Health Spenddown, if the case has income which exceeds the All Kids Assist income standard, determine eligibility for All Kids Share, All Kids Premium, and All Kids Rebate. If the family is ineligible for All Kids Share, All Kids Premium, and All Kids Rebate, set up a spenddown case only if the conditions in PM 17-02-04 are met.
    • For AABD Medical, if the case has income which exceeds the Community Standard or assets which exceed the asset limits, approve the case for spenddown if all other eligibility factors are met including the conditions in PM 17-02-04.
    • If the case's income is not greater than the appropriate income standard, and for AABD Medical the assets are not greater than the asset limits, set up a FamilyCare Assist, All Kids Assist, or AABD Medical case if all other eligibility factors are met.