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Medicaid : Legal Action of Wisconsin


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RULES FOR SPECIAL GROUPS 1. PREGNANT WOMEN Can I get Medicaid if I am pregnant? You can apply for Medicaid as soon as your doctor says you are pregnant. Your income must be below the Healthy Start limits. See INCOME & ASSET LIMITS . How can I get pre-natal care? Pre-natal care is the health care you receive during your pregnancy. As soon as you get a doctor’s statement showing that you are pregnant you should ask your doctor’s office about getting a Presumptive Eligibility (P.E.) card. In Milwaukee call 414-286-8833 to find out where you can apply for a P.E. card. What is a “P.E.” card? A P.E. card is a temporary Medicaid card that can pay for your pre-natal care. It will not pay for labor, delivery and other services that the regular Medicaid card pays. You can apply for a P.E. card at many hospitals, clinics and doctor’s offices. Once you have your P.E. card it is good for about 60 days. It is important that you apply for regular Medicaid as soon as possible. If you haven’t received a Medicaid card by the time your first P.E. card ends, then another P.E. card can be issued to you. How long will my Medicaid last after my pregnancy? Medicaid due to pregnancy will continue for 60 days after your baby is born, even if your income goes up. After that your caseworker will have to do a review to see if you continue to be eligible. 2. NEWBORNS Can my baby get a Medicaid card? If you were on Medicaid at the time of the birth of your baby and if your baby lives with you, your baby will be eligible for Medicaid until the baby is one year old, even if your income goes up. After one year, your caseworker must do a review to see if your baby is still eligible for Medicaid. You must make sure the hospital or HMO reports your baby’s birth to the state. A Medicaid card will be issued for the baby for one year by the state. You must also report the birth to your caseworker. 3. MINORS What if I am a minor and I am not living with my parents? If you are a minor (under 18 years of age) you do not have to live with a relative or another adult to get Medicaid. If you are able to, you can apply on your own or an adult that you live with can apply for you even if that person is not a relative. What happens when I turn 18? In Wisconsin, most teens are eligible for Medicaid until age 19. If you have a minor child in your care or are pregnant, you may continue to receive Medicaid even after age 19. Ask your case worker if you are eligible. 4. KINSHIP CARE RELATIVES What happens if I am taking care of my grandchildren or nieces and nephews? If you are taking care of your relative children, they may be eligible for Medicaid. If they are receiving Kinship Care benefits, they are eligible for Medicaid. Your income and assets must not be counted for the children’s Medicaid . As a relative you may also be eligible for Medicaid if you are below the income limits. 5. FOSTER CHILDREN What happens to children in Foster Care? Children in foster care are eligible for Medicaid. Your child welfare social worker must help you get a Medicaid card. If you have problems contact your social worker. If you are a minor parent and your baby lives with you, your social worker must also help you apply for Medicaid for your baby, even if your baby is not in foster care. Can I get Medicaid if my child does not live with me? Unless you are disabled, a minor or are pregnant, you must have a child in your care in order to get Medicaid. However, if you were receiving Medicaid for yourself and your children and the children have been temporarily placed out of your home, you may be able to continue to get Medicaid. You may qualify for Medicaid as long as the following conditions apply: Your child has been temporarily placed with a friend or relative or removed from your home by the child welfare agency (without a court order) and is expected to be out of the home for less than six months; or If the child is expected to be out of the home for more than six months, there must be a plan by the child welfare agency to return the child to your home, and you must be cooperating with that plan; or The child has been removed by court order (through a CHIPS petition) and there is a plan to return the child to you and you are cooperating with this plan. Note: The law requires also that you must be exercising care and control over the child. A parent is exercising care and control if the parent is cooperating with the child welfare agency or if the parent is making important decisions for the child. For the child welfare agency to find that you are not cooperating with a plan to return the child, you must be not complying with the plan so much that the child welfare agency decides to not return the child to your home. 6. SSI RECIPIENTS What if I receive SSI? If you get SSI you are eligible for Medicaid. Contact your local Social Security district office by calling 800-772-1213 if you have problems. 7. HOMELESS PEOPLE What if I am homeless? If you are a homeless person living in Wisconsin, and are found eligible for Medicaid, a Medicaid card must be issued to you even though you have no fixed address. In Milwaukee you will be able pick up your card at the County Department of Human Services at 1220 West Vliet Street. 8. IMMIGRANTS Can I receive Medicaid if I am not a United States Citizen? If you are a legal immigrant and you entered the United States before August 22, 1996, you should get Medicaid. If you are a legal immigrant and you entered the United States after August 22, 1996, you can get Medicaid only if: You are in the U.S. Military. You are a veteran. You are the spouse, widow or unmarried dependent child of someone in the military or a veteran. You have been in the U.S. more than 5 years. You have been in the U.S. less than 5 years and have a medical emergency. If I came as a refugee am I eligible for Medicaid? If you came to the U.S. as a refugee or a Cuban/Haitian entrant, have political asylum or an order withholding deportation, or you are an Amerasian or an American Indian subject to special treaty rights and you meet other Medicaid eligibility rules, you can get Medicaid upon arrival in the U.S. What if I am undocumented? If you are undocumented and in the U.S. without legal papers, you can only get emergency medical care, including care for labor and delivery. There are other rules that apply to immigrants. Please call Legal Action of Wisconsin at 414-278-7722, if you have been denied Medicaid.