Wis. ForwardHealth Online Handbook, Hospice, Topic #228

Medicaid is a joint federal/state program established in 1965 under Title XIX of the Social Security Act to pay for medical

services for selected groups of people who meet the program's financial requirements.

The purpose of Medicaid is to provide reimbursement for and assure the availability of appropriate medical care to persons who

meet the criteria for Medicaid. Wisconsin Medicaid is also known as the Medical Assistance Program, WMAP (Wisconsin

Medical Assistance Program), MA (Medical Assistance), Title XIX, or T19.

A Medicaid member is any individual entitled to benefits under Title XIX of the Social Security Act and under the Medical

Assistance State Plan as defined in Wis. Stat. ch. 49.

Wisconsin Medicaid enrollment is determined on the basis of financial need and other factors. A citizen of the United States or a

"qualified immigrant" who meets low-income financial requirements may be enrolled in Wisconsin Medicaid if they are in one of

the following categories:

• Age 65 and older

• Blind

• Disabled

Some needy and low-income people become eligible for Wisconsin Medicaid by qualifying for programs such as:

• Katie Beckett

• Medicaid Purchase Plan

• Foster care or adoption assistance programs

• SSI (Supplemental Security Income)

• WWWP (Wisconsin Well Woman Program)

Providers may advise these individuals or their representatives to contact their certifying agency for more information. The

following agencies certify people for Wisconsin Medicaid enrollment:

• Income maintenance or tribal agencies

• Medicaid outstation sites

• SSA (Social Security Administration) offices

In limited circumstances, some state agencies also certify individuals for Wisconsin Medicaid.

Medicaid fee-for-service members receive services through the traditional health care payment system under which providers

receive a payment for each unit of service provided. Some Medicaid members receive services through state-contracted MCOs

(managed care organizations).