Family Planning Only Services
Printable Versions (PDF) (English,
Hmong,
Spanish)
This plan provides certain family planning
related services.
The purpose of this plan is to stop unplanned pregnancies and sexually
transmitted diseases (STDs).
For information on Family Planning Only
Services For
Males, see the Fact Sheet P-00176.
Covered Services
The following family planning
related services may be
covered if provided at an initial or annual office visit:
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Contraceptive services and supplies (such as birth control pills, condoms, etc.)
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Natural family planning supplies
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Family planning pharmacy visits
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Pap tests
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Tubal ligation
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Tests and treatment for Sexually
Transmitted Diseases (STD) including chlamydia, gonorrhea, herpes and
syphilis as well as certain other lab tests
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Routine preventive primary
services only if related to family planning.
If you are able enroll in Family Planning Only Services,
you may be able to get regular BadgerCare Plus which pays for more services.
Note: Only certain services are covered under this
plan. For example, mammograms and
hysterectomies are not covered. You
should tell your health care provider you have this coverage before you get
services. Your provider should tell
you if a service is not covered. If
your provider tells you a service is not covered and you still choose to get the
service, you will have to pay for it. You
may also call 1-800-362-3002 to ask if a service is covered.
Federal law allows members to choose their provider,
including physicians and family planning clinics, for family planning services
and supplies. Therefore, you can
also go to any family planning clinic that will accept your ForwardHealth card,
even if the clinic is not part of your HMO.
If you need health care services your family planning
provider is unable to provide, s/he will refer you to a provider who can.
You may also be referred to your local community health center if you
need any follow up care. If you have
questions about getting a referral, ask your family planning provider.
To enroll, you must:
- Be a U.S. citizen, or have proof of immigration status,
- Not be getting ForwardHealth for the Elderly, Blind or Disabled or
BadgerCare Plus Standard or Benchmark Plans, and
- Have a family gross income of no more than 300% of the federal poverty
level (For minors, parents’ income is not counted).
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Family
Size
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300%
FPL
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1
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$2,792.50
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2
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$3,782.50
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3
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$4,772.50
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There is no asset test for this plan.
Temporary Enrollment for Family
Planning Only Services
Temporary Enrollment means that if a qualified provider decides you meet the program rules, you can get family planning services right away, even before you have applied Family Planning Only Services with the Enrollment Services
Center.
A “qualified provider” is Family Planning approved and
s/he can decide if you can get temporary family planning services.
Your own doctor may be a qualified provider; if not, it is easy to find
one. Member Services at
1-800-362-3002 can give you a list of Family Planning Only Services qualified
providers in your area.
Note: If you are not a U.S. citizen, you must apply for
Family Planning Only Services with
your agency and provide proof of immigration status to the Enrollment Services
Center.
Temporary Enrollment Period
Temporary enrollment for this plan begins on the day you
fill out the Temporary Enrollment for Family Planning Only Services application
and a “qualified provider” finds you are able to enroll.
The qualified provider will help you fill out the application.
You will stay enrolled until the end of the second month following the month you are temporarily enrolled.
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For example,
Jane goes to the clinic and her provider enrolls her for temporary Family Planning
Only Services on March 10.
If Jane does not file an application with the agency, her temporary enrollment will end on April 30th.
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How to Apply
To keep getting family planning services, you must
apply for Family Planning Only Services with the Enrollment Services Center.
You can apply by phone by calling Member Services at 1-800-362-3002 or online at access.wi.gov.
Confidentiality
If you apply for or get coverage from Family Planning
Only Services, you will have the following protections:
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Written information can be sent to an address other
than your home address.
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If you are under 18 years of age, you will not be
referred to the child support agency.
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Your parent’s income will not be used to see if
you can enroll in Family Planning Only Services, if you are under 18 years
of age.
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The local agency will not contact parents or other
caretakers.
Getting Services
If you are enrolled temporarily in Family Planning Only
Services the qualified provider will give you a temporary paper ID card.
This card shows that you are temporarily enrolled in Family Planning Only
Services. You should show your card
to your family planning provider each time you get services.
A short period of time after you get your temporary ID
card, you will get a plastic “ForwardHealth” card to use for Family Planning
Only Services. Use your
ForwardHealth card once you get it, instead of the paper ID card.
If you are not enrolled in Family Planning Only Services by
the Enrollment Services Center, the ForwardHealth card will be turned off once
your temporary enrollment ends. You
should keep your ForwardHealth card because if you apply for any BadgerCare Plus
Plan at a later date and your application is approved, you will use the same
ForwardHealth card to get services.
Special Note for Teens
If you are a minor and do not mind if your parents know
you applied, you can apply for full BadgerCare Plus coverage if you can give
information about your parent’s income.
Wisconsin
Well Woman Medicaid
You may be able to enroll in Wisconsin Well Woman Medicaid
if you are enrolled in Family Planning Only Services and:
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Are screened for, and diagnosed with, cervical cancer
or a precancerous condition of the cervix, or
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Receive a clinical breast exam through Family Planning
Only Services and through follow up medical testing outside of Family Planning
Only Services are diagnosed with breast
cancer, and are found to be in need of treatment for breast or cervical
cancer or a pre-cancerous cervical condition.
Wisconsin Well Woman Medicaid covers the same services as
regular BadgerCare Plus. For more
information on what is covered, see the ForwardHealth Enrollment &
Benefits handbook (P-00079)
or call Member Services at 1-800-362-3002.
For More Information Contact:
- Information provided in this brochure is general.
For more detailed information,
- Call 1-800-362-3002 or
- Go to dhs.wi.gov/em/customerhelp.
The Department of Health Services (DHS) is an equal
opportunity employer and service provider. If
you have a disability and need to access this information in an alternate
format, or need it translated to another language, please contact (608) 266-3356
(voice) or 1-888-701-1251 (TTY). All
translation services are free of charge. For
civil rights questions call (608) 266-9372 (voice) or 1-888-701-1251 (TTY).
P-10068 (02/12)
Last Revised:
April 18, 2012
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