DHS 103.03(3)(b) (b) Physical presence and intention. An eligible person shall be a Wisconsin resident, as determined under 42 CFR 435.403. Residence shall be based on physical presence, except as provided in an interstate agreement, and on the person’s intent to maintain Wisconsin residence indefinitely, except as otherwise provided in pars. (c) to (g).

DHS 103.03(3)(c) (c) Migrant farm workers. A migrant farm worker who is living in Wisconsin and who entered with a job commitment or to seek employment shall be considered a resident so long as there is no medical assistance being received from another state. In this paragraph, “migrant farm worker” means any person whose primary employment in Wisconsin is in the agricultural field or cannery work, is authorized to work in the United States, who is not immediate family by blood or marriage of the employer, and routinely leaves an established place of residence to travel to another locality to accept seasonal or temporary employment. Members of the migrant farm worker’s family who live with the worker in Wisconsin shall also be considered Wisconsin residents.

DHS 103.03(3)(d) (d) Non-institutionalized persons. The residence of a person under age 21 shall be determined in accordance with the rules governing residence under the AFDC program except that non-institutionalized persons under age 21 whose MA eligibility is based on blindness or disability are residents if they are physically present in Wisconsin.

DHS 103.03(3)(e) (e) Institutionalized persons.

DHS 103.03(3)(e)1. 1. For any institutionalized person who is under age 21, or who is age 21 or older and became incapable of indicating intent before age 21, the state of residence is that of:

DHS 103.03(3)(e)1.a. a. The parents or the legal guardian, if one has been appointed, and parental rights have terminated at the time of placement in an institution; or

DHS 103.03(3)(e)1.b. b. The parent applying for MA on behalf of the applicant if the parent resides in another state and there is no appointed legal guardian.

DHS 103.03(3)(e)2. 2. Institutionalized persons over age 21 are Wisconsin residents when they are physically present with the intent to reside in Wisconsin except that persons who become incapable of indicating intent at or after age 21 are residents of the state in which they are physically present.

DHS 103.03(3)(f) (f) Out-of-state institutional placements. When a state arranges for a person to be placed in an institution located in another state, the state making the placement is the state of residence irrespective of the person’s indicated intent or ability to indicate intent.

DHS 103.03(3)(g) (g) Establishment of residence. Once established, residence is retained until superseded by a new place of residence.

DHS 103.03(4) (4) Furnishing of a social security number.

DHS 103.03(4)(a) (a) All individuals for whom MA benefits are requested shall have a social security number and shall furnish the number to the agency, except an individual who is one of the following:

DHS 103.03(4)(a)1. 1. An alien who is requesting medical assistance only for emergency services.

DHS 103.03(4)(a)2. 2. A child who is eligible for medical assistance under 42 USC 1396a (e) (4). During the time that the child is eligible under 42 USC 1396a (e) (4), the agency shall use the mother’s MA identification number.

DHS 103.03(4)(a)3. 3. An individual who is not eligible to receive a social security number.

DHS 103.03(4)(a)4. 4. An individual who does not have a social security number and may only be issued a social security number for a valid non-work reason in accordance with 20 CFR 422.104.

DHS 103.03(4)(a)5. 5. An individual who refuses to obtain a social security number because of well-established religious objections as provided in s. 49.82 (2) (b) 3., Stats.

DHS 103.03(4)(b) (b) If an applicant who is required to furnish a social security number under par. (a) does not have a social security number, application for the number shall be made by or on behalf of the applicant to the federal social security administration. If there is a refusal to furnish a number or apply for a number, the person for whom there is a refusal is not eligible for MA. The department may not deny or delay services to an otherwise eligible applicant pending issuance or verification of the individual’s social security number.

DHS 103.03(5) (5) Assignment of medical support. The parent or caretaker relative of a dependent child enumerated in s. 49.19 (1) (a), Stats., shall be deemed to have assigned all rights to medical support to the state as provided in s. 49.45 (19) (a), Stats. If there is a refusal to make the assignment, the person who refuses is not eligible for MA.

DHS 103.03(6) (6) Not a person detained by legal process. A person detained by legal process is not eligible for MA benefits. For purposes of this subsection, “detained by legal process” means incarcerated because of law violation or alleged law violation, which includes misdemeanors, felonies, and delinquent acts. A person who returns to the court after observation, is found not guilty of a law violation by reason of mental deficiency and is subsequently committed to a mental institution shall not be considered detained by legal process.

DHS 103.03(7) (7) Not a person residing in an institution for mental diseases. A person 21 to 64 years of age who resides in an institution for mental diseases (IMD) is not eligible for MA benefits, unless the person is 21 years of age, was a resident of the IMD immediately prior to turning 21 and has been continuously a resident of the IMD since then. An IMD resident 21 to 64 years of age may be eligible for MA benefits while on convalescent leave from the IMD.

DHS 103.03(8) (8) Not an ineligible caretaker relative. A caretaker relative enumerated in s. 49.19 (1) (a), Stats., with whom a dependent child as defined in s. 49.19 (1) (a), Stats., is living when the income and resources of the MA group or fiscal test group exceed the limitations of ss. 49.19 and 49.77, Stats., or title XVI of the social security act of 1935, as amended, is not eligible unless the caretaker relative is SSI-related in accordance with sub. (1) (c), or is a woman who is medically verified to be pregnant.

DHS 103.03(9) (9) Not a striker. A person on strike is not eligible. When the striker is a caretaker relative, all members of the MA group who are 18 years of age or older shall be ineligible except that if the member of the MA group who is on strike is medically verified pregnant or, if the MA group includes a medically verified pregnant woman, the pregnant woman continues to be eligible during her pregnancy and through the month in which the 60th day following the end of pregnancy falls. In this subsection, “striker” means anyone who on the last day of the month is involved in a strike or a concerted effort with other employees to stop work, including a stoppage of work due to the expiration of a collective bargaining agreement, or any concerted slowdown or other concerted interruption of operations by employees.

DHS 103.03 History History: Cr. Register, February, 1986, No. 362, eff. 3-1-86; am. (1) (b) 1., Register, February, 1988, No. 386, eff. 3-1-88; emerg. r. and recr. (7), eff. 8-1-88; r. and recr. (7), Register, December, 1988, No. 396, eff. 1-1-89; emerg. am. (7), eff. 6-1-89; am. (7), Register, February, 1990, No. 410, eff. 3-1-90; am. (1) (b) 1., 2. and 4, (2), (3) (b) and (9), r. and recr. (4), Register, March, 1993, No. 447, eff. 4-1-93; emerg. am. (1) (a) and (b) 3., eff. 7-1-99; am. (1) (a) and (b) 3. and cr. (1) (f), Register, March, 2000, No. 531, eff. 4-1-00; cr. (1) (g) and (h), Register, November, 2000, No. 539, eff. 12-1-00; correction in (1) (b) 1. made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636; CR 21-067: am. (intro.), cr. (1) (g) 4., (h) 5. Register March 2022 No. 795, eff. 4-1-22, am. (intro.), r. (1) (g) 4., (h) 5. eff. the first day of the month after the emergency period, as defined in 42 USC 1320b-5 (g) (1) (B) and declared in response to the COVID-19 pandemic, ends; correction in (intro.) made under s. 35.17, Stats., and correction in (1) (g) 4., (h) 5. made under ss. 13.92 (4) (b) 4., 35.17, Stats., Register March 2022 No. 795; CR 23-046: am. (1) (title), (a), (b) (title), (intro.), 1., 2., cr. (1) (b) 2m., am. (1) (b) 3., 4., cr. (1) (b) 5. to 8, am. (1) (f) (title), (intro.), 1., r. and recr. (1) (f) 2., cr. (1) (f) 2m., am. (1) (f) 3. (intro.), r. and recr. (1) (f) 3. a., b., cr. (1) (f) 3. cm., d., 3m., r. and recr. (1) (f) 4., cr. (1) (f) 4g., 4r., am. (1) (f) 5. (intro.), c., r. (1) (f) 5. d., am. (1) (f) 6., 8., cr. (1) (fm), renum. (2) to (2) (intro.) and am., cr. (2) (a) to (e), (2m), am. (4) (a) 1., 2., cr. (4) (a) 3. to 5., am. (4) (b) Register April 2024 No. 820, eff. 5-1-24; correction in (1) (b) 1., (f) 5. made under s. 35.17, Stats., and correction in numbering of (1) (f) cm. and (fm) 1. to 4. made under s. 13.92 (4) (b) 7. Register April 2024 No. 820.

DHS 103.04 DHS 103.04 Asset and income limits. The nonexempt assets and budgetable income of the MA group or, when applicable, the fiscal test group, shall be compared to the following asset and income limits established in this section to determine the eligibility of the MA group:

DHS 103.04(1) (1) Categorically needy.

DHS 103.04(1)(a) (a) The MA group or fiscal test group shall first be tested against the categorically needy standard. Persons who meet the non-financial eligibility conditions and who meet the income and asset standards specified in this subsection shall be determined eligible as categorically needy in accordance with s. 49.46 (1) (e), Stats., and shall receive MA benefits in accordance with s. 49.46 (2), Stats., and chs. DHS 101 to 108.

DHS 103.04(1)(b) (b) The BadgerCare Plus-related categorically needy income standard for MA applicants shall be the appropriate standard as specified in s. DHS 103.03 (1) (a).

DHS 103.04(1)(c) (c) The SSI-related categorically needy income standard shall be the maximum SSI payment including state supplement that a single person or a couple, as appropriate, could receive in Wisconsin under s. 49.77, Stats., or federal title XVI of the social security act of 1935, as amended. The SSI-related categorically needy asset standard shall be the same as specified in section 1613 of title XVI of the social security act of 1935, as amended.