PM 15-07-03: Deceased Applicants

WAG 15-07-03.

Medical coverage can be provided for a deceased applicant when an application for Medical is made:

  • by a person who dies after the application is filed but before the date of decision; or
  • on behalf of a deceased person.

For a deceased applicant, determine eligibility for the 3-month period before the month of application through the month of death. If eligibility exists for any month, compare countable monthly income received during each eligible month to the appropriate Income Standard for the same month. Also compare nonexempt assets to the correct asset limit for the case.

If countable monthly income for the month of death or any of the prior months is equal to or less than the appropriate income standard, and nonexempt assets are less than the asset limit as of the date of decision, the case is eligible for payment of covered medical services for the full month.

For each month countable monthly income is more than the appropriate income standard, or nonexempt assets exceed the asset limit as of the date of decision, determine if the client's medical bills or receipts exceed the monthly spenddown amount. See PM 15-08-10 for the authorization of medical coverage if spenddown is met.

See PM 22-06-07 if a request is made for the payment of funeral and burial expenses of the decedent.