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BadgerCare Plus Program Rules — Updates
As of July 1, 2012, some of the BadgerCare Plus Program rules will change. The changes which may affect you and/or your family include:
If any of these changes affect you and/or your family, you will receive a letter in mid-June telling you of the changes, their impact on you and your right to appeal those changes.
Certain adults will have to start paying monthly premiums or pay higher premiums. The amount will be based on your family’s size and income.
Premiums will not change for members age 18 and under.
You will not pay a premium if you are:
If you are required to pay a monthly premium and you do not pay your premium, your benefits may end. Adults will not be able to receive health care benefits through BadgerCare Plus for 12 months and children for 6 months.
Income Reporting Rules/Providing Proof
There are new rules for reporting changes in income and providing proof of changes in income. You must report, within 10 days if your income goes over the BadgerCare Plus Program rules. This amount will be listed on your Letters of Enrollment. You will also be required to send proof/verification of the change in income.
Access to Affordable Employer-Sponsored Health Insurance
If you are a parent or a person who cares for a child and you have access to an affordable employer-sponsored health insurance plan, you may not be able to get health care through BadgerCare Plus. This change will not impact children and will no longer affect people who have a disability (must be determined disabled by the Disability Determination Bureau or the Social Security Administration).
If you have access to affordable employer-sponsored health insurance, you will get a letter telling you this information. You may no longer be able to get health care through BadgerCare Plus.
This change, if it affects you and/or your family, will go into effect at your next regularly scheduled renewal or when you get a new job. Your agency will check to see if you have access to employer-sponsored health insurance.
Questions and Contacts
A letter and a fact sheet was mailed to members enrolled in BadgerCare Plus for Families and Core Plan explaining these changes. The letter and fact sheet can be viewed at:
The Department of Health Services will not know until the middle of June if these changes apply to you or what your premium amount will be. At that time, you will get a letter with additional information including your right to appeal.
If you have other questions about these changes, you can contact Member Services at 1-800-362-3002 or by email at email@example.com.
Last Revised: April 18, 2013