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Customer Help - Family Planning Only Services
To see if you may be able to
enroll or to apply online, go to access.wi.gov.
Application Packet —
(PDF, 189KB) — To apply for BadgerCare Plus including Family
Planning Only Services or you can apply online at access.wi.gov.
To renew your benefits, contact your local agency.
Representative — F-10126,
(PDF 600KB) — To appoint someone to
apply for BadgerCare Plus for you.
Report — F-10183, (English,
(PDF 33KB) — To report changes to the local agency. You can
also report changes online at access.wi.gov.
Request (exit DHS) - To request a hearing if you don't agree with a
decision about your benefits.
Hearing Voluntary Withdrawal
DHA 17, (PDF 10KB) *(exit
DHS) — If you want to withdraw your request for a hearing.
Income Report (SEIRF) form —
(PDF KB) — Use this form to report self-employment
Identity — F-10154,
(PDF, 91KB) — To provide proof of identity
for children under 18 years of age.
ForwardHealth Enrollment and Benefits Handbook
- July 2014
(PDF 2.6 MB)
ForwardHealth Enrollment and Benefits Handbook - November 2013
(PDF 3.3 MB)
A handbook will be mailed to each
family who applies for a ForwardHealth Plan.
Guide to Applying for Wisconsin's Health and Nutrition
ACCESS/Marketplace Takeaway Card,
More information about Family Planning Only
Services can be found at badgercareplus.org.
Directory - To find the telephone number and address of your
a provider — If you need to find a BadgerCare Plus provider
in your area.
Limits - To find current income limits.
Legal Services - To find the name and telephone number of who in
your area can provide you with legal help. You may also go
August 14, 2014