WAG 19-02-02: Family Health Plan, ACA Adult, Former Foster Care REDE

PM 19-02-02

IES Phase 2 Process

new text Upon implementation of the Integrated Eligibility System (IES) phase 2, the process for completing a redetermination is changed.


See WAG 19-02-04-a for the selection criteria for the auto-REDE process.

Legacy Process

Each active case must have a REDE at least once every 12 months. In addition, act on any information that shows a change which may affect eligibility or shows a change in spenddown. See PM 18  for policy on changes.

The system reviews a Family Health Spenddown case in the last 6 months of the 12-month period to see if it has an All Kids Assist member, a Moms and Babies member, or has met spenddown in one of the last 3 months. If so, the case is REDEd on the same cycle as all other Medical cases. Otherwise, the case centrally cancels and must reapply.