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• The LTC services the person receives are not subject to estate recovery (see Medicaid Eligibility Handbook, Section 22.1.2 Recoverable Services) unless the individual is 55 years old or older. This page last updated in Release Number: 21-01 Release Date: 3/29/2021 Effective Date: 3/29/2021 42.3 Institutionalized Individuals Determined Eligible for Elderly, Blind, or Disabled Medicaid The conditions outlined in SECTION 42.2 PATIENT LIABILITY, ESTATE RECOVERY, AND OTHER POLICIES FOR CHILDLESS ADULTS ELIGIBLE FOR BADGERCARE PLUS WHILE IN LONG-TERM CARE only apply to institutionalized individuals while they remain eligible for BadgerCare Plus as a childless adult. When an institutionalized individual has been determined eligible for EBD Medicaid, they are not eligible for BadgerCare Plus as a childless adult. When an individual becomes eligible for LTC under EBD Medicaid rules, they are subject to regular estate recovery rules and will have to pay the monthly nursing home patient liability. If the individual later becomes ineligible for EBD Medicaid, they may again become eligible for BadgerCare Plus. Example 1 Andrew is institutionalized and is eligible for BadgerCare Plus as a childless adult. BadgerCare Plus covers his LTC services. Andrew starts receiving Medicare Part A on August 1, so he is no longer eligible for BadgerCare Plus as a childless adult as of August 1. To continue receiving coverage for LTC services, Andrew would have to meet all regular EBD Medicaid eligibility criteria. He would then be subject to regular estate recovery rules and patient liability.

Example 2 Jana is an institutionalized childless adult eligible for BadgerCare Plus and is waiting on a disability determination. She will receive coverage for LTC services under BadgerCare Plus until the agency receives and processes the disability determination. Once this happens, if she meets all other criteria for EBD Medicaid (including providing asset information and meeting the asset test), she will begin receiving coverage of LTC services under EBD Medicaid. However, if Jana still does not meet all of the eligibility criteria for EBD Medicaid (for example, because she fails to verify assets), she will continue to receive coverage for LTC services under BadgerCare Plus as long as she continues to meet all of the eligibility criteria for BadgerCare Plus. This page last updated in Release Number: 23-03 Release Date: 08/14/2023 Effective Date: 01/01/2023 43.1 Nonfinancial Requirements Individuals who are infected with tuberculosis (TB) and who are not otherwise eligible for full benefit BadgerCare Plus or Medicaid may be eligible for Tuberculosis (TB)-related Medicaid, a special category of Medicaid. "Infected with TB" means that a physician has examined them and found that one or more of the following diagnoses apply to them: • They are infected with latent or active TB. • They have a positive TB skin test. • They have a negative TB skin test but a positive sputum culture for the TB organism.