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3.3.1.2 Children in Continuous Coverage Periods If a child would be negatively impacted or move to a CHIP category of health care because of a change, person-add, or new program request during their 12-month continuous coverage period, the child will not get a new 12-month certification period. They will remain in their current period. However, other eligible household members can get new 12-month certification periods. Households may also have different health care renewal dates. See BadgerCare Plus Handbook, Section 1.2.10 Certification Period Changes for Children in Continuous Coverage Periods for examples. 3.3.1.3 Other Health Care Programs If an individual opens for a new certification period for Wisconsin Well Woman Medicaid, Katie Beckett Medicaid, the SeniorCare Prescription Drug Program, or benefits outside of the CARES eligibility system, new 12-month certification periods will not be established for existing members on the case. For more information regarding changes in circumstances for Katie Beckett members, see SECTION 29.3 KATIE BECKETT MEDICAID CHANGES IN CIRCUMSTANCES. 3.3.2 Member Transition to Disability When a member enrolled in BadgerCare Plus or other health care program not based on disability no longer meets the requirements of their current health care category due to a change in circumstances, the IM agency must determine if they qualify for Medicaid based on disability if any of the following are true: • The member has been determined disabled. • The member indicates they want to apply for a disability determination. • The member is enrolled in an adult long-term care program (Family Care, Family Care Partnership, PACE, or IRIS). Prior coverage is maintained while the Medicaid Disability Application Form, F-10112 (MADA), Authorization to Disclose Information to Disability Determination Bureau, F-14014 (ADDD), and any other necessary information (including an Asset Assessment, if appropriate) are requested. If the member is otherwise eligible for EBD Medicaid types after the MADA, ADDD, and all necessary information is collected, the prior coverage continues to be maintained while the Disability Determination Bureau (DDB) makes the determination of disability. Example 9 Hoai is enrolled in BadgerCare Plus and IRIS. On March 20, he reports an income increase from his part- time job that puts him over the limit for BadgerCare Plus. He does not have a disability determination and is not married. Because he is enrolled in a long-term care program, BadgerCare Plus must be maintained until it is determined if Hoai is eligible for Medicaid based on disability.

On March 21, a request for asset information and the MADA and ADDD are sent to Hoai.

Hoai provides the requested asset information and disability application forms by the due date, and he meets the eligibility criteria for Medicaid Purchase Plan (MAPP) if determined disabled by the DDB. On April 10, Hoai’s disability application is sent to the DDB. Hoai’s BadgerCare Plus coverage (and IRIS enrollment) will be maintained until the DDB makes a decision, as long as he remains otherwise eligible for MAPP or another form of full-benefit Medicaid based on disability. A notice is sent informing Hoai that he is now subject to EBD reporting rules, and his existing coverage will be maintained while the DDB is making their decision.