WDP Q & A

Are family members who are not disabled or Medically Needy in the MFBU with the 250% WDP eligible individual?      Answer: No. The 250% WDP eligible individual is in his or her own MFBU. H/She is treated as an “Other Public Assistance” eligible client. Exception: A couple that are both eligible for the 250% WDP are in the same MFBU.

Can the 250% WDP eligible individual be ineligible in his/her family MFBU?  Answer: No, eligibility must be evaluated for all requesting family members first. If the entire family is ineligible, the working disabled individual must be offered the 250% WDP. If the individuals agrees to the program and the premium, an eligibility determination must be completed. If he/she is eligible, he or she is considered “other PA” and is in his/her own MFBU. The rest of the family is reviewed again for other programs without the 250% WDP individual included in the MFBU.

Are 250% WDP child applicants required to be working or just disabled with working parents?  Answer: A child must meet the same work requirements as an adult to be eligible for the 250% WDP.

Whose MFBU would a 250% WDP disabled child be in, if a parent also qualifies for the program?                                  Answer: The 250% WDP disabled child is considered a single individual and will be in his/her own MFBU.

Should the EW evaluate an applicant for the 250% WDP isf he/she has been denied under the SGA rules?                Answer: Yes, SGA does not apply to the 250% WDP.

What are the reporting requirements for the 250% WDP?    Answer: All changes must be reported within 10 days and at the yearly redetermination.

If the family of a 250% WDP client report changes in income, does the EW also update the income/eligibility for the 250% WDP client?      Answer: Yes.

Will the Department of Health Care Services (DHCS) discontinue the client for client request, death of client, loss of legal residence or loss of contact?      Answer: No. If such information is provided to DHCS, the information will be forwarded to the EW for action. DHCS will only discontinue clients for failure to pay premiums.

Is there a Medicare Part “B” buy-in provision for the 250% WDP?  Answer: Yes, the 250% WDP individuals are entitled to a State Part “B” buy-in.

How is “work” defined for 250% WDP eligibility?     Answer: For the 250% WDP only: “work” is not defined. Individuals must only provide proof of employment (pay stubs or written verification). If the individual is self-employed, he/she is required to provide records that substantiate “work”. For independent contractors the IRS form 1099 is acceptable. An individual is considered working if he/she is receiving vacation or sick leave from the employer.

Can a 250% WDP eligible individual qualify for In-Home Supportive Services (IHSS)?   Answer: The 250% WDP does not affect IHSS, if the client is otherwise eligible for IHSS.