5. The department shall notify the applicant or the applicant’s county veterans service officer if any required documentation is missing or if further verification is required to make a decision on the applicant’s eligibility. The department may terminate an application if such documentation or verification does not arrive at the department’s central office within 60 days after that notification.
(b) Eligibility. 1. Except for applicants who are eligible under par. (e), the applicant’s household income may not exceed 200 percent of the federal poverty guidelines, in effect on the date the application arrives at the department’s central office, for the number of family members living in the primary residence.
2. Applications approved by the department shall have the balance of the maximum available aid allocated unless the applicant indicates a lesser amount in writing.
3. Applications shall be denied if no unallocated funds are available at the time of application.
4. The department shall indicate on each description of benefits the type of aid authorized, the date the department confirmed that the applicant was eligible for the grant, a date 90 calendar days from that date, the unallocated amount available for the type of aid and for the cumulative limits of aid under this section, and the amount of aid being authorized.
5. The department’s determination whether the veteran has sufficient available liquid assets to contribute towards a payment is based on verification of the applicant’s income at the time of the application.
a. If the veteran’s income increases after the department determines eligibility, the veteran shall notify the department in writing within 30 days.
b. The department shall make a decision whether the veteran remains eligible for future aid payments based on the veteran’s availability of liquid assets and capability to make payments on any outstanding statement balances from a health care provider.
(c) Payments. 1. No more than one description of benefits may be outstanding at any time, except where all health care providers have submitted binding quotes prior to the issuance of more than one description of benefits, and are willing to accept payment from this program in full for any service rendered to the applicant in accordance with the description of benefits.
2. The department shall pay the lesser amount of either the actual cost of services invoiced or the binding quote submitted by the health care provider.
3. No payment shall be made by the department unless an itemized written invoice is received by the department within 60 days of the expiration date, or any approved extension of that expiration date, as identified in the applicable description of benefits.
4. Authorized applications for health care aid may not be withdrawn without the agreement of the provider of the health care aid.
(d) Unremarried surviving spouses and dependents of veterans who die in the line of duty. Unremarried surviving spouses and dependents claiming eligibility due to the death of a veteran in the line of duty shall submit evidence from the appropriate military service indicating that the veteran died in the line of duty.
(e) Spouses and dependents of activated or deployed members. Spouses and dependents of a member of the U.S. armed forces or of the Wisconsin national guard claiming eligibility shall submit evidence that the service member has been deployed or activated, that due to the activation or deployment a loss of income has occurred, that an economic emergency has occurred during the activation or deployment, and that the spouse and dependents are residents of the state.
(f) Health care providers. 1. The department may grant payments for health care aid to a health care provider if the health care services are rendered within 90 days after the department confirms that the applicant is eligible and only after a description of benefits has been transmitted to the applicant or the county veterans service officer.
2. The department may accept a second application for the health care listed on the first description of benefits if the department receives a statement from the health care provider, within 14 calendar days before the expiration listed on the first description of benefits, that the health care authorized is still being provided and that the patient will not incur costs.
(g) Extensions. A health care provider providing health care services under par. (f) may submit an application to the department to request an extension of the 90 days. The application requesting the extension shall comply with all of the following:
1. Include a statement that the health care services to be provided are included in the description of benefits authorized under par. (f).
2. Include a statement that the patient will not incur additional costs for health care services authorized under par. (f).
3. Be received by the department no later than 14 calendar days before the expiration date listed on the description of benefits authorized under par. (f).
(h) Limitations. 1. The department may not pay health care aid under this subsection if the liquid assets of the veteran are in excess of $1,000. When determining the liquid assets of the veteran, the department may not include the first $50,000 of cash surrender value of any life insurance policy.
2. The department may provide a grant only if the health care provider accepts payments from the grant, available health insurance, 3rd party payments on behalf of the applicant, and any department-approved payment from the veteran as payment in full.
3. The department may approve a payment by the veteran when a provider refuses to accept the maximum grant available to the veteran as payment in full if the veteran has sufficient available liquid assets to contribute an amount that will induce the provider to accept the aggregate payment as payment in full.
section 21.
VA 2.01 (3) (d) to (g) is renumbered VA 2.01 (3m) (i) and amended to read: VA 2.01 (3m) (i) Dental care aid Types of health care aid. 1. ‘Dental care aid.’ a. A dental health care professional provider shall indicate in writing that the dental procedures performed were directly necessary to dental care.
b. Such Aid for the dental procedures shall may not exceed $500.00 $800.00 in any consecutive 12-month period except where a full or partial upper / or a lower denture is required.
c. The grant for such denture or dentures shall Aid for extended dental care may not exceed $1,875 for one or $3,750 for both $4,000 in any consecutive 48 24-month period.
2. ‘Hearing care aid.’ a. Hearing care shall aid may not exceed $200.00 in any consecutive 12-month period except where a left and / or right ear hearing aid, or both, is required.
b. The grant Aid for each hearing aid shall may not exceed $1,875 in any consecutive 48 24-month period.
c. A participant An applicant may obtain qualify for a grant to fund for an additional or more costly hearing aids and a related examination, if a licensed audiological health hearing care professional provider identifies, in writing, compelling a medical circumstances which have required this added condition that warrants additional financial assistance.
3. ‘Vision care aid.’ a. A grant for vision care shall may not exceed $400.00 in any consecutive 12-month period; however, a participant an applicant may obtain a grant for replacement glasses before 12 consecutive months have elapsed if the eyewear is prescribed because of a documented change in refractive error.
b. Vision care replacement. A participant An applicant may obtain a grant qualify for vision care aid for an additional visit to a licensed vision care provider and for a more costly set of corrective eyewear or for an additional set of corrective eyewear where if an optometrist or an ophthalmologist identifies, in writing, a compelling medical circumstance which has required this added condition that warrants additional financial assistance.
section 22.
VA 2.02 (1g) is created to read: VA 2.02 (1g) Authority and purpose. The purpose of ss. VA 2.02 to 2.05 is to establish rules for the implementation and administration of grants to veterans for tuition reimbursement and retraining, as authorized under ss. 45.20 and 45.21, Stats. section 23.
VA 2.02 (1) (intro.) is renumbered VA 2.02 (1r) (intro.) and amended to read: VA 2.02 (1r) (intro.) Definitions. In this section ss. VA 2.02 to 2.05, the following terms shall have the designated meanings: section 24.
VA 2.02 (1) (a) is repealed.section 25.
VA 2.02 (1) (b), (c), and (d) are renumbered VA 2.02 (1r) (b), (c), and (d). section 26.
VA 2.02 (1) (e) is repealed. section 27.
VA 2.02 (2) (title) is amended to read: VA 2.02 (2) (title) Reimbursement application Application.
