Institutional Title 19 - How to apply - T19 (1208)

Key points below

How to apply

What is Institutional Medicaid?

Institutional (also known as hospital) T19 (Medicaid) is a secondary insurance for your child’s hospital stay. It is part of BadgerCare. It may cover things your primary insurance does not cover.

Critera to apply:

Per Badgercare Plus Handbook 2.2.6
A child who has not been determined disabled must have their eligibility determined under BadgerCare Plus, not Medicaid for Elderly, Blind, or Disabled individuals (EBD Medicaid), even if the child has resided in an institution for 30 or more days.

And Process Help 11.2.4 Healthcare Applications for Institutionalized Children goes on to further explain

11.2.4.1 Minor child Not disabled

If an application is received for a minor child who is not disabled and has been institutionalized for 30 days or more, MAGI rules are applied in determining his/her health care eligibility. This includes any applicable premiums or deductibles.
1. If the parent(s) is claiming the child as a tax dependent in the tax year, then the parent(s) and any other relevant members in the MAGI tax group should be added to the case. All countable MAGI income and deductions must be verified. Code the child’s Living Arrangement as “01” on the Current Demographics page.
2. If the parent(s) is not claiming the child as a tax dependent for that tax year, then household relationship rules apply. Because the child is not living in the home with his/her parent(s), only count the child’s income in the eligibility determination. Code the child’s Living Arrangement as “01” on the Current Demographics page.

11.2.4.2 Minor Child - Disabled

If a minor child is disabled and has been institutionalized for 30 days or more, use EBD Institutional Medicaid rules to determine the child’s health care eligibility. Update the Living Arrangement to the appropriate type (e.g., “20 – Hospital-Long Term”). Create an Institutions Page for the child. Count only the child’s income in the eligibility determination. The AG code is MI A.
Note A minor child for EBD Institutional Medicaid is under 18.

The child must meet the disability criteria and all of the attached forms would need to be completed by the social worker, family, and provider prior to completing the application. Once the application has been completed and Social work Team provides notification. The Counselors send the required documents and tracking/case number to DHS EBD department for consideration.

It is important to apply within 30 days of discharge.

Institutional T19 does not look at parent income. A child will qualify if:

their assets total less than $2,000, and
they have been hospitalized for at least 30 days.

It is important to apply within 30 days of discharge.

How do I apply?

First, set up an account

Use the Help button in the upper left corner of any screen for more help.

Go to: https://access.wisconsin.gov/
Click on: Apply for Benefits.
Check: Start a new application for FoodShare, Health Care, Family Planning Waiver and/or Child Care.
- Are you already enrolled in any benefits right now?
  This means: FoodShare, BadgerCare Plus, Wisconsin Medicaid, Family Planning Only Services, Wisconsin Shares Child Care, or Caretaker Supplement. Answer No, then click Next.
Setting Up Account:
- Step 1 - Enter your first & last name. If you want, you can enter your e-mail address.
- Step 2 - Create a user ID and password. Write these down for future reference.
- Step 3 - Answer security questions. Write them down for future reference.
- Step 4 - Check box for User Acceptance Agreement. Click on Create Account.
Next screen will ask for your user ID & password.
- Log into new account with your user ID & password.

Apply for benefits: (Let's get started)

Review Apply for Benefits Overview and then click Apply for myself.
Using ACCESS page:
- Please write down your application number in the center of this page. It will let you finish at a later time if you need to stop before you are done. It will also let your CW Social Worker contact Milwaukee County Human Services to be sure that the application is flagged for this special program. Please let your CW Social Worker know when you have finished this process. Be sure to give them your tracking number.
Programs you're applying for:
- Scroll down to Health Care Coverage. Check: health care coverage through Badgercare Plus or Medicaid. Scroll down again and click on Save and next.
- I am using ACCESS to apply for another person.
Help paying for medical expenses:

Does anyone applying need help for medical expenses from the last 3 months that weren't paid for by insurance. Click on yes or no.

What months do you need help with? Select all boxes that apply.

Save and next.

Important Program Information

Click on Next.

Application overview

Please complete each section by clicking on the Start button for each individual section.

Your Information, Click Next.

Tell us about yourself:
First name, Last name, Date of Birth, Social Security number ( optional)
Click on Save and next

Would you like to check if you have a case, Click on Continue with this application
More about you:
Martial status, Sex, Ethnicity (optional), Race (optional), Are you a tribal member or a child or grandchild of a tribal member?
Click on Save and next
Where you live
Do you live in Wisconsin? Yes
Do you plan to keep living in Wisconsin? Yes
What county do you live in? Select Milwaukee
Do you live on tribal lands? No
Are you a migrant worker (optional)
Are you currently homeless? (optional)
How you been homeless in the past 12 months? ( optional)
Click on Save and Next

More about where you live
Where are you currently living?
*Select Health care facility
What type of health care facility do you live in?

Select Hospital ( been living there for more than 30 days)

Your Address ( This is the hospitals address)
9000 West Wisconsin Avenue Milwaukee, WI 53226
Do you have a separate mailing address? (optional)
Click on Save and next
Language information
What is the primary language spoken in your home? (optional)
Is this your preferred language? (optional)
Phone information ( optional )
Email information
Do you want to view most of your letters online instead of getting them by mail? ( optional)
Do you want to get emails about your health care services from our health care partners? ( optional)
Click on Save and next

You finished the application information section click on Application overview
Application overview
People in your household click on Start
This should be the patient ( child) only click on Save and next
Former foster care youth: Was anyone in foster care, subsidized guardianship, or court-ordered kinship care when they turned 18 years old Yes or No. Click on Save and next
Tax files
Is anyone in the household planning to file federal income taxes for 2024?
Click on the no button, Click on Save and next
People who can apply
You can choose which household members apply for this program ( make sure your name has a blue checkbox next to your name.
Apply for Family Planning Only Services? Leave this box unchecked, Click on Save and Next
You finished the people in your household section. Click on Application overview
Application overview click on Household details Start
Citizenship information
Are all household members U.S. citizens? Yes, Save and next
People with a disability, illness, or injury, answer No, click on Save and Next
Your Household’s health
Does anyone in your household need help with activities of daily living? No
Has anyone in your household been diagnosed with tuberculosis? Yes or No
Has anyone in your household been in an accident in the last three months? Yes or No
Click on Save and Next
Medicare coverage
Is anyone in your household getting or able to get Medicare Part A or Part B? Yes or No
Click on Save and next
You finished the household details section, Click on Application overview
Application overview
Income and benefits Click on Start
Income and benefits, click on Next
Work activities
Does anyone in your household have work activities? Click on No, Save and Next
Other income
Does anyone in your household have other income? Click on No, Save an Next
Other benefits
Is anyone getting grants, scholarships, or other aid for education or training? Click on No
Has anyone gotten an SSI approval letter, but not yet gotten a payment? Yes or No
Is anyone getting Medicaid benefits through SSI 1619(b)?
Yes or No, Click on Save and Next
Tribal Benefits
Has anyone in your household gotten health care from Indian Health Services, a tribal program, or through a referral from on of these programs? No
Is anyone in your household eligible to get healthcare from Indian Health Services, a tribal program, or through a referral from one of these programs, even if they have not needed to get this health care? No
Click on Save and Next
Income and Benefits
What do think (name of patient) total income will be in 2024? This should be the gross income, which is the amount of money you get before taxes and other deductions are taken out. ( optional)
Enter in $0.00 Click on Save and Next
You finished the income and benefits section
Click on Application overview
Bills click on Start, Next
Your other bills
Does anyone in your household have tax deductions (optional)
Answer No, Save an Next
You finished the bills section, click on Application overview
Health Insurance, Start, Next
Health insurance policy holders
Does anyone have a health insurance policy that covers one or more people in your household? Yes or No
If Yes Who is the owner of the health insurance policy? Click on Save and next
Does (patient pay a premium? Yes or No
Does patient’s plan cover services from a doctor? Yes or No
Who is (patients) household is covered by this policy?
Application overview
Finish and submit, Click Start
Page down to the end check the box (blue checkmark will appear).By checking this box, I attest that I have read and understand the rights and responsibilities on this screen. Click on Save and next
Submit your application
Check the box (blue checkmark) I understand that by checking this box and typing my name below, I am providing my electronic signature. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
First name
Middle initial (Optional)
Last Name
Chick on Submit your application

Thank you for submitting your application!

Please let your Children’s Wisconsin Social Worker know when you have completed this process. Give them both parents’ social security numbers and your case number so they can follow up with Milwaukee County Human Services.

If approval of Medicaid coverage is obtained. It is the Parent/Legal Guardian’s responsibility to report within 10 days of discharge that the child is no longer in the Hospital. This allows Medicaid to properly close the case. Parents/Legal Guardian please call 888-947-6583 to report the change.

Please contact your Children’s Wisconsin social worker if you have further questions.
You can call directly, have your nurse page them, or call 414-266-3465.