BadgerCare Plus Home Page>>Updates>>Fact Sheet (P-00324)

Policy Changes Starting July 1, 2012

• BadgerCare Plus for Families
• BadgerCare Plus Core Plan

BadgerCare Plus for Families

Premiums

Q. When will I know if I have to pay a premium and how much will it be?

A. If you need to pay a premium, you will get a letter in the middle of June with your monthly premium amount. For most BadgerCare Plus families, your premium will increase. Your premium amount will be based on your family’s size and income.

Q. What will happen if I don’t pay?

A. If you are required to pay a monthly premium and you do not pay your premium, your benefits could end.

You will not be able to receive health care benefits through BadgerCare Plus for 12 months if you are an adult and 6 months for children.

Reporting Income and Providing Proof

Q. Will I be required to report changes in my income?

A. Yes. You will receive a letter that will tell you what you need to report. You will also need to provide proof of income changes.

Access to Affordable Employer-Sponsored Health Insurance

Q. What does Access to Affordable Employer-Sponsored Health Insurance mean?

A. This means you or other people in your home are able to or have been able to sign up for affordable health insurance through an employer.

Q. Will this change affect me?

A. 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. This rule 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.

BadgerCare Plus Core Plan

Premiums

Q. I have not been required to pay a premium in the past, will I be required to pay a monthly premium?

A. Depending on your income you may need to start paying a premium in order to stay enrolled in the BadgerCare Plus Core Plan.

Q. If I have a monthly premium, do I still have to pay a $60 non-refundable application processing fee?

A. Yes. You will need to pay the $60 processing fee. If you have a premium, this fee will be used to pay your first monthly premium.

Q. What will happen if I don’t pay my premium?

A. If you are required to pay a monthly premium and you do not pay your premium, your benefits could end. You will not be able to receive health care benefits through BadgerCare Plus Core Plan for 12 months.

Reporting Income and Providing Proof

Q. Will I be required to report changes in my income?

A. Yes. BadgerCare Plus Core Plan members will need to start reporting changes and providing proof of income. You will receive a letter that lists what income you are required to report and any proof your agency needs.

Access to Affordable Employer-Sponsored Health Insurance

Q. How does this change affect me?

A. If you have any access to health insurance, you cannot enroll in the BadgerCare Plus Core Plan.

Questions and Contact Information

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 memberservices@wisconsin.gov.

State of Wisconsin
Department of Health Services
Division of Health Care Access and Accountability

Printable Version (PDF 116KB)

P-00324

Last Revised:  February 21, 2013