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Wisconsin Department of Health Services

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ACCESS

BadgerCare Plus for Families 

Family Planning Only Services

FoodShare

Medicaid

SeniorCare

Caretaker Supplement

Fair Hearing Request

Fair Hearing Withdrawal

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Eligibility Management (Income Maintenance) Home >> Customer Help >> BadgerCare Plus Help

Customer Help - BadgerCare Plus

To see if you may be able to enroll or to apply online, go to access.wi.gov.

Forms

Application Packet F-10182, (English, Hmong, Spanish), (PDF 189KB) To apply for BadgerCare Plus including Family Planning Services or you can apply online at access.wi.gov. To renew your benefits, contact your local agency.

Authorization of Representative F-10126, (English, Hmong, Spanish) (PDF 600KB) To appoint someone to apply for BadgerCare Plus for you.

Change Report F-10183, (English, Hmong, Spanish) (PDF 33KB) To report changes to the local agency. You can also report changes online at access.wi.gov.

Fair Hearing Request (exit DHS) - To request a hearing if you don't agree with a decision about your benefits.

Fair Hearing Voluntary Withdrawal DHA 17, (PDF 10KB) *(exit DHS) If you want to withdraw your request for a hearing.

Self-Employment Income Report (SEIRF) form F-00107, (English, Hmong, Spanish) (PDF 38KB) Use this form to report self-employment income.

Statement of Identity F-10154, (English, Hmong, Russian, Spanish), (PDF, 91KB) To provide proof of identity for children under 18 years of age.

Publications

ForwardHealth Enrollment and Benefits Handbook - July 2014 P-00079 (English) (PDF 2.6 MB)
ForwardHealth Enrollment and Benefits Handbook - November 2013 P-00079-P
(English, Spanish) (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 Programs P-16091, (English, Hmong, Spanish), (PDF 181KB)

ACCESS/Marketplace Takeaway Card, P-00555 - (English, Spanish) (PDF, 549KB)

Health Insurance Premium Payment (HIPP) Plan P-10095, (English)

Healthy Start, Grow Smart: Baby's first year one month at a time.

Other Links

Agency Directory To find the telephone number and address of your local agency.

Find a provider If you need to find a BadgerCare Plus provider in your area.

More information about BadgerCare Plus can be found at badgercareplus.org.

Income 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 to:

Last Revised: September 15, 2014