WAG 06-10-11-b: In Met Spenddown Status

  1. (FCRC/All Kids Unit) revised textDo not approve a 90-day medical eligibility period.
  2. (FCRC/All Kids Unit) revised textApprove a 15-day eligibility period only if the met period ends within the 15-day period.
  3. (FCRC/All Kids Unit) Review MMIS to see the last date for medical coverage.
  4. (FCRC/All Kids Unit) revised textProcess a TA 55/TAR 45 in IPACS to approve a 15-day eligibility period if coverage ends within the 15-day period. This will happen only when the MPE eligibility period begins in one calendar month and ends in the next calendar month.

    Example: revised textMPE coverage starts 01/26 and ends 02/09. MMIS shows medical coverage starting 01/22, the date spenddown was met, and ending 01/31. Approve a 15-day eligibility period (for 01/26 through 02/09) since medical coverage ends before the end of the 15-day period. The client will have full coverage from 01/22 through 01/31, and MPE only coverage from 2/01 through 2/09.

  5. (FCRC/All Kids Unit) Review the case to see if the client should be changed to Cash or Moms & Babies.
  6. (FCRC/All Kids Unit) Change the case, if needed.
  7. (FCRC/All Kids Unit) Send notification about the action taken to:
  • the client, and
  • the provider.