WAG 17-01-02
See Medical Morsel regarding: Case Progression and When to Approve Applicant for AABD dated 04/11/2014
After receipt of required verification, compare case information to program requirements and make a determination of eligibility. Based on the kind of application made, make sure every person gets the most help they qualify for.
If a person requested cash and medical, determine if they qualify for any of the benefit programs including any of the Family Health Plans, SNAP benefits, QMB, SLIB, and QI-1. But do not determine eligibility for programs they said in writing they do not want.
Consider eligibility for all potential benefits, using the programs that provide the most benefits first. If the applicant is not eligible for one program, but is eligible for another, use the original application date to determine eligibility and the effective date for benefits.
Use the following order to determine the correct type of cash and medical benefits.
- TANF or AABD Cash
- RRA Cash
- Family Assist
- AABD Medical without a Spenddown, Moms and Babies, FamilyCare Assist, or All Kids Assist
- AABD Spenddown or Family Health Spenddown Met
Family Planning Program- Family Health Spenddown Unmet
- QMB
- SLIB
- Qualified Individual-I (QI-1)
For the Family Planning (FP) program only assess if applicant chose to opt-in to FP determination if found ineligible for full medical coverage. Please see PM 06-26-01 for more information.
