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BadgerCare Plus Basic Plan — Benefits Guide

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As of March 19, 2011, the Department of Health Services will no longer be signing up new members in the BadgerCare Plus Basic Plan. However, the Basic Plan will continue to serve those already enrolled.

The costs for the Basic Plan need to be funded by member premiums. The current premium level is not meeting the requirement that the program be self-funded. For current members, premiums will increase to $325 per month beginning with the payment due on October 5 for coverage in November 2011.

You will find the following information in this booklet. If you have questions, before you contact the Enrollment Services Center, please read this booklet. You may find your answer.

• Premiums
• Benefits and Copayments
• Other Coverage and Programs
• Basic Plan Rules 
• Your Rights
• Letters 
• ForwardHealth Basic Plan Card

Basic Plan members can see any provider taking part in BadgerCare Plus. To see if your provider is a BadgerCare Plus provider or to find a provider, call Member Services at 1-800-362-3002.

You can stay enrolled in the Basic Plan as long as you pay your monthly premium and stay on the Core Plan Waitlist and meet all Core Plan rules. To meet the Core Plan rules, you must be 

• Living in Wisconsin,
• Age 19 through 64, and
• A U.S. citizen or legal immigrant.

Also, you must not:

• Have dependent children under age 19 living with you,
• Be pregnant,
• Have income above the program income limits of 200% of the federal guidelines (for current income guidelines, go to badgercareplus.org/fpl.htm)
• Have private health insurance coverage when you request Core Plan coverage or in the 12 months before that date unless you lost your health insurance coverage for a good cause reason,
• Be able to sign up for insurance from an employer during the month you apply or next three months,
• Have had access to health insurance through an employer in the last 12 months,
• Be disabled or blind and able to get Medicare, or
• Be able to get Medicaid or BadgerCare Plus for Families.

Next Section - Premiums

P-00148 (07/11)

Last Revised:  September 16, 2011