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4.1.4 Resources (including any standards relating to spend downs and disposition of resources):

There is no resource test.

4.1.5

Residency (so long as residency requirement is not based on length of time in state):

Be physically present in Wisconsin with the intent to reside in the state.

4.1.6 Disability Status (so long as any standard relating to disability status does not restrict eligibility):

Not applicable.

4.1.7

Access to or coverage under other health coverage:

Unborn Children

May not be covered under a group health plan or under health insurance coverage, as defined in section 2791 of the Public Health Service Act during the month of application or in the previous three calendar months, unless a good cause exemption is granted.

May not have access to a State employee’s health benefits plan or to an employer’s group or individual health insurance plan in the month of application or in the three calendar months following the month of an application, annual review or the start of new employment, or in the previous 12 months, unless a good cause exemption is granted.

A good cause exemption is granted to those unborn children with past or present coverage or access to a health insurance or a group health plan, if the insurance only covers services provided in a service area that is beyond a reasonable driving distance from the individual’s residence.

A good cause exemption is granted to those individuals who were covered by a group health plan or health insurance coverage in the three months prior to application, if insurance did not pay for pregnancy-related services or if: o The individual through whom the insurance was available involuntarily lost their job with the employer providing that

WISCONSIN

Effective Date:

Approval Date: 14