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State of Wisconsin Wisconsin Funeral and Cemetery Aids Program (WFCAP) Manual Release 09-01 September 29, 2009 |
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State of Wisconsin Wisconsin Funeral and Cemetery Aids Program (WFCAP) Manual Release 09-01 September 29, 2009 |
County/tribal (human and social service) agencies administer the WI Funeral and Cemetery Aids Program (WFCAP) locally on behalf of the Wisconsin Department of Health Services (DHS or “the Department”). Local administration includes reimbursing funeral and cemetery service providers in accordance with the DHS approved reimbursement policies documented herein. DHS authorizes the disbursement of program funding to county/tribal agencies. Within DHS, the Division of Health Care Access and Accountability (DHCAA) is responsible for monitoring local program administration.
The Department may reimburse cemetery and/or funeral expenses of a person who, on the date of death was any one of the following individuals:
Wisconsin Works (W-2) participant (paid placement only).
Child for whom a Caretaker Supplement (CTS) or Kinship Care benefit was being made on their behalf.
Categorically needy EBD related Medicaid recipient.
Parent or caretaker relative receiving BadgerCare Plus with family income that does not exceed 50% of the federal poverty level.
BC + Med Stat Codes
X6, X7, B9, B8
BL if income does not exceed 50% of the FPL.
Child receiving foster care or adoption assistance.
Child under age 6 or pregnant woman receiving BadgerCare Plus with family income that does not exceed 185% of the federal poverty level.
BC+ Med Stat Codes (Child Under Six)
X6, X7, B8, B9, BE, BJ, BU
BK, NC, N1, and BC if income does not exceed 185% of FPL.
BC+ Med Stat Codes (Pregnant Woman)
B8, B9, X6, X7
BA, BS, BX, and BV if income does not exceed 185% of FPL
Child at least age 6, but not yet 19, receiving BadgerCare Plus with family income that does not exceed 100% of the federal poverty level.
BC+ Med Stat Codes
B8, B9, X6, X7, BE,
NC and BU if income does not exceed 100% of FPL
Eligible for categorically or medically needy Institutional Medicaid at the time of death.
All Home and Community Based Waiver recipients (Group A, B and C).
All Medicaid eligible Family Care recipients.
Recipients of Tuberculosis (TB) related Medicaid services
The fetus of a woman in a WFCAP eligible Medicaid or BadgerCare Plus category as identified in 1.1 #3, #4, #5, #6, #7, #9, #10, #11, #13, or #14.
Child certified for Katie Beckett Medicaid.
Supplemental Security Income (SSI) or SSI State Supplement (SSI-SSP) recipient who was a Wisconsin resident.
Note: Funeral and cemetery expenses for any individual who does not meet at least one of the above criteria will not be reimbursed by the Department.
The agency that administered the decedent's benefits (1.1 Eligible Persons #1-#14) prior to death is responsible for processing the WFCAP reimbursement request. If the decedent was a child certified for Katie Beckett Medicaid (1.1 #13) or an SSI case (1.1 #14), the county in which the decedent was living at the time of death is responsible for processing the reimbursement request.
See 7 BC+ Med Stats for a listing of BC+ medical status codes and potential eligibility for WFCAP.
When a county 51.42 board, 51.437 board, human services department or social services department places a person in a congregate care facility that is located in another county, the placing county remains responsible for processing the WFCAP reimbursement request in accordance with established policy. A congregate care facility is a:
Child Care institution
Group home.
Foster home.
Nursing home.
Adult Family Home (AFH).
Community Based Residential Facility (CBRF).
Any other like facility.
The Department will not reimburse cemetery and/or funeral expenses for individuals not listed in (1.1) #1-# 14 nor will it reimburse cemetery/funeral expenses for a fetus if at the time of the fetus's death the mother was not in a WFCAP eligible Medicaid category . WFCAP eligible Medicaid categories are identified in 1.1 #3, #4, #5, #6, #7, #9, #10,#11, #13 or #14.
The Department will not reimburse cemetery/funeral expenses for a person who on the date of death was receiving or qualified for:
Refugee Medical Assistance benefits,
Medicaid Purchase Plan (MAPP),
Non-Medicaid FamilyCare,
Well Woman Medicaid,
Any limited benefit Medicaid program (except TB related Medicaid see 1.1),
Note: For a description of limited benefit Medicaid programs, see MEH 21.3.
SeniorCare recipients (unless they happen to also be in one of the non-Medicaid WFCAP eligible categories as detailed in 1.1 Eligible Persons ), or
BadgerCare Core Plan Childless Adults/transitional Core Plan members.
Deductible
Persons who are Medicaid recipients by virtue of meeting a Medicaid deductible do not qualify for reimbursement of their funeral/cemetery expenses.
Note: An exception is made for someone who met a Medicaid deductible and also qualified as a group A community waiver or Family Care case under Group A rules at the time of death.
Providers are encouraged to contact local agencies to confirm potential program eligibility before submitting a reimbursement request. Local agencies are authorized by the Department to provide advance confirmation of potential program eligibility.
This page last updated in Release Number: 09-01
Release Date: 09/29/09
Effective Date: 09/29/09
