Beijing, China

Dear Ben,

Recently I found a MCO member, who was disenrolled due to being over asset limits for Medicaid. He is working so wouldn’t he be eligible for Family Care using MAPP with a $15,000 asset limit?

Thanks, Maribeth

Here’s my response:

Hi Maribeth:

Thank you for your question. This question comes up frequently. You are correct. Someone who is receiving Family Care benefits can have higher assets if also enrolled in MAPP. In the situation that you described, if a person’s assets are higher than $2,000 and they meet all the other criteria for MAPP: at least age 18, have adjusted income below 250% of the FPL for their group size, have assets below $15,000 and pay their premiums, then they are eligible for Long Term Care Services in Group A. Their eligibility will continue as long as they meet the requirements set forth for the MAPP program.

Source: DHS 10.34(2)

(2) INDIVIDUALS ELIGIBLE FOR MEDICAL ASSISTANCE. A person who is eligible for medical assistance under ch. 49, Stats., and chs. DHS 101 to 108 is financially eligible for the family care benefit. Cost sharing requirements for the family care benefit for a medical assistance-eligible person are those that apply under ch. 49, Stats., and chs. DHS 101 to 108.