BadgerCare Application Instructions


There are various ways to apply for BC+:

  • Via telephone: Call Member Services at 1-800-362-3602 and set up an appointment where you can go through the application process. You may also call your local agency directly for appointments with them. For a list of the telephone numbers of the agency handling BC+ applications in your area, please go to http://www.dhs.wisconsin.gov/em/imagencies/index.htm.

  • Online: Just go to http://access.wi.gov and log in with your Wisconsin username and password before proceeding with the online application. If you don’t have a username and password yet, just click on “Create an Account” at the rightmost side of the site.

Aside from submitting a completed application form, you also need to submit proof of your identity, US citizenship, tribal membership (if applicable), monthly income, pregnancy (if applicable), child support, current health insurance plans, and medical costs and expenses. Coordinate with your local agencies as to what documents they will accept as proof of these.

Your application will then be immediately processed and you can expect a reply from your local agency within 30 days. Also, you can still apply for BC+ benefits even if you have been denied before. Simply follow the same steps discussed above.

However, in the following cases, you may be able to receive “backdated coverage” for your medical bills up to three months prior to your BC+ application:

  • You are a pregnant woman

  • You are a young adult under 19 years old about to leave foster care

  • You have a monthly income of less than 150% of the Federal Poverty Level and are currently caring for a child

STANDARD AND BENCHMARK PLANS

For Standard and Benchmark plans, you and your family members will be enrolled in one of the BC+ HMOs after approval. These HMOs would be responsible for providing you and your family with your primary health needs and other covered services. You will receive an HMO Enrollment Packet (such as this: http://www.dhs.wisconsin.gov/publications/p1/p12020.pdf) that would give you a list of HMOs in your area plus details about the HMOs you plan to enroll in. You may be able to change your HMO within 90 days of your enrollment, which is termed as the “open enrollment” period. Afterwards, you need to stick with your HMO for nine months (termed as “lock-in” period) after which you may opt to switch HMOs.

For questions regarding HMO enrollment, you may contact the Enrollment Specialist at 1-800-291-2002.

CORE PLANS

In the case of Core Plans, please note that you will not be directly enrolled in the program; you will simply be placed on a waitlist. You also do not need to provide proof of anything until a slot opens up for you. At which time you can start the enrollment process.

TEMPORARY FAMILY-PLANNING ONLY SERVICES

You can receive this benefit when a qualified family planning service provider sees that you meet the criteria for enrollment in the program but decides to give you the services right away. This enrollment is valid only for two months, starting from the date you filled out an application form. For a list of qualified family planning service providers, you may contact Member Services at 1-800-362-3602.


Eligibility Requirements

Each BC+ plan has different requirements that must be satisfied in order for you to receive their benefits. These are:

For STANDARD/BENCHMARK PLANS:

  • Family income must be at or below 200% of the Federal Poverty Level*

  • You are a child or young adult under 19 years old leaving foster care, regardless of income

  • You have a child in foster care or are currently taking care of a child within your home

  • You are a pregnant woman living up to 300% of the Federal Poverty Level*

  • You are a Wisconsin resident

  • You are a US citizen or qualifying immigrant**

For CORE PLAN (waitlist only):

  • You are within 19-64 years old

  • You do not have any dependent children under 19 years old living with you

  • You are not pregnant

  • Your family income is at or below 200% of the Federal Poverty Level*

  • You are a Wisconsin resident

  • You are a US citizen or qualifying immigrant**

  • You currently do not have health insurance or have availed of one in the past 12 months, whether private or through an employer

  • You have not quit your job and in the process have lost your health insurance provided by the employer

  • You do not have access to health insurance within 3 months following the date of application

  • You do not have access to insurance through your current employer in the past 12 months

  • You are able to pay a non-refundable application fee (if you are homeless or are eligible to get Indian Health Services, you no longer need to pay this)

For special cases and other requirements for Core Plan enrollment, please visit http://www.dhs.wisconsin.gov/publications/p0/p00062.pdf.

For FAMILY-PLANNING ONLY SERVICES:

  • You must be a US citizen or a qualifying immigrant

  • Your family gross income must be at or below 300% of the Federal Poverty Level*

  • You must not be receiving ForwardHealth services for the elderly, blind, or disabled

  • You must not have any dependent children

  • You must not be currently enrolled in BC+ Standard or Benchmark Plans

 

* To see the current Federal Poverty Limits per family size (as of July 2012), please visit http://www.badgercareplus.org/fpl.htm.

** If you are not a US citizen or a qualifying immigrant, you may be able to receive other services through Emergency Services or BadgerCare Plus Prenatal Services Plan (for pregnant women). Your immigration status will not be shared with the US Citizenship and Immigration Services (USCIS).

To further check for your eligibility in getting BC+ benefits, visit https://access.wisconsin.gov/ and click on “Am I Eligible?” at the leftmost side of the site and input your particulars for assessment.