Premiums.

(am)#

To the extent approved by the federal government and except as provided in pars. (dm) and (em), an individual who receives medical assistance under this section shall pay a monthly premium of $25 to the department.

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Premiums.

Official source

(am)#

To the extent approved by the federal government and except as provided in pars. (dm) and (em), an individual who receives medical assistance under this section shall pay a monthly premium of $25 to the department.

(bm)#

To the extent approved by the federal government, in addition to the $25 monthly premium under par. (am), an individual who receives medical assistance under this section and whose individual income exceeds 100 percent of the poverty line for a single-person household shall pay 3 percent of his or her adjusted earned and unearned monthly income under par. (cm) that is in excess of 100 percent of the poverty line.

(cm)#

For the purposes of par. (bm), an individual’s adjusted earned and unearned monthly income is calculated by subtracting from the individual’s earned and unearned monthly income his or her actual out-of-pocket medical and remedial expenses, long-term care costs, and impairment-related work expenses.

(dm)#

The department shall temporarily waive an individual’s monthly premium under par. (am) and, if applicable, par. (bm) when the department determines that paying the premium would be an undue hardship on the individual.

(em)#

If the department determines that a state plan amendment or waiver of federal Medicaid law is necessary to implement the premium methodology under this subsection and changes to the income and asset eligibility under sub. (3) and s. 49.47 (4) (c) 1., the department shall submit a state plan amendment or waiver request to the federal department of health and human services requesting those changes. If a state plan amendment or waiver is not necessary or if the federal department of health and human services does not disapprove the state plan amendment or waiver request, the department may implement subs. (3) and (4) and s. 49.47 (4) (c) 1. with any adjustments from the federal department of health and human services. If the federal department of health and human services disapproves the state plan amendment or waiver request in whole or in part, the department may implement the income and asset eligibility requirements and premium methodology under subs. (3) and (4), 2015 stats., and s. 49.47 (4) (c) 1., 2015 stats.