Wisconsin Medicaid and BadgerCare Plus
Adults enrolled in BadgerCare Plus and have income above 133% of the
FPL will be required to pay a premium. The monthly premium will cover
all adults over 18 in your house. If you are one of the following, you
will not be required to pay a premium:
- Tribal members, children and grandchildren of tribal members.
- Tribal members and any children of tribal members who are
eligible to get Indian Health Services.
- Pregnant women.
- Adults who are blind or disabled, as determined by the
Disability Determination Bureau.
- Young adults leaving out-of home care (example: foster care).
Premiums are between 3% and 9.5% of your family’s gross income. If
your family's income is between 133% and 140% of the
federal poverty level (FPL)
your premiums would start at 3%. The most your premium could be is 9.5%
of your family's income. The premium will be calculated based on your
actual income and rounded to the nearest dollar (premiums will not be
rounded if income is at 300% of the FPL).
If there are two adults (mother and father) and one
child (under age 19) living in your home and your family is 135% of the
FPL, ($2,197.13 for a family of
3) your premium would be 3% of your family income.
||Gross Family Income
||Percent of Income
|= $ 65.91
||($66) Premium Amount
Because premiums are rounded to the nearest dollar, this family's
premium would be $66. For more information on premium
amounts, click here.
If you are a self-employed parent or relative who takes care of a child
and you are required to pay a premium, your premium will be based on
your income after your depreciation expenses are added back to your net
self-employment income (see How Income from Self-Employment is Counted). If that income amount exceeds 200% of the FPL, the premium
is 5% of the family’s income.
If you have children who are required to pay a premium, their premiums
are set at specific amounts depending on the family’s income and will
not be more than 5% of the family’s income. See
BadgerCare Plus Month Premium Amounts.
Premium Payment Methods
If you are required to pay a monthly premium, you will have choices on
how you can to pay your premium. You may pay by check or money order,
electronic funds transfer (EFT) or wage withholding. To learn more about
your options or for help, contact the Premium Payment Unit at
Non-Payment of Premiums
If you are required to pay a monthly premium and you do not pay your
premium, your benefits may end. If your BadgerCare Plus benefits end
because you didn't pay your monthly premium, adults will not be able to
enroll in BadgerCare Plus for 12 months and children for 6 months.
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February 07, 2013