WAG 17-02-00: Applicant Determined Eligible/Presumed Eligible (PE)

PM 17-02-00

When a cash application is approved, medical benefits are also approved.

Applications for deleted textAABD Cash and GA are approved on or after the 30th day following the date of application. However, for each program, exceptions apply.

(System) Centrally sends the MediPlan Card (Form 469CF) to applicant for each:

  • approved Cash case;
  • approved Regular Medical case; and
  • Spenddown case if eligibility worker determines that spenddown is met.

(FCRC) Issue a Temporary MediPlan Card (Form 1411), within 2 workdays when (see WAG 26-05-01):

  • a client requests a medical card; or
  • the Family Community Resource Center is aware that a medical need exists; and
  • the centrally issued medical card is not expected to be received sooner than the locally issued temporary medical card.

NOTE: If a temporary medical card is requested by the client, medical need does not have to be existing, anticipated, or specified.

Item 39 Client Notice Codes for All Cash and Medical Approvals

The code entered in Item 39 determines whether the system centrally sends the decision notice or suppresses the central notice.

  • 00 -Medical, Cash, Medical with FS, or Cash with FS (Send Both Cash or Medical and FS Forms Centrally)
  • The notice system mails Form 360C and Cash calculation forms, if needed, centrally. The system mails Form 360C for the Cash or Medical and FS approval if the case is coded to receive FS.
  • 80 -Medical with FS (Suppress Both Medical and FS Forms)
  • Family Community Resource Center completes and sends manual approval notice (Form 458, Form 458D or Form 458SP, and Form 458M as required) for Medical, the correct pages and sections of the manual Form 360 series for FS.
  • 90 -Cash with FS (Suppress Both Cash and FS Forms)
  • The Family Community Resource Center completes and sends the correct pages and sections of the manual Form 360 series and Cash calculation forms, if required, for Cash and FS. Form 360C is not mailed centrally.
  • 91 -Cash or Medical with FS (Send Cash or Medical Form, Suppress FS Form)
  • The notice system mails Form 360C and cash calculation forms centrally, if required, for the Cash decision. The system mails Form 360C for the Medical decision. The Family Community Resource Center completes and sends the correct pages and sections of manual Form 360 series for the FS approval.
  • 92 -Cash or Medical with FS (Send FS Form, Suppress Cash or Medical Form)
  • The system mails Form 360C centrally for FS. The Family Community Resource Center completes and sends the correct pages and sections of Form 360 series for the Cash approval. Family Community Resource Center completes and sends manual approval notice (Form 458, Form 458D or Form 458SP, and Form 458M as needed) for Medical.
  • Enter code 92 in Item 39 when approving a Medical case as spenddown and the FS notice is centrally sent.

Client Notice Code for Processing Approvals and Restoring Assistance via IPACS

When processing applications via IPACS, use Item 39 codes as follows:

  • Cash - code 90
  • Medical - codes 00, 80, 91, 92

AABD Cash, RRA Cash, and RRA Medical approvals must be processed through IPACS. Enter 00, 90, 91, or 92 for AABD Cash/FS IPACS approvals, or for RRA Cash/FS or RRA Medical/FS approvals through IPACS, enter 00, 80, 90, 91, or 92.