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Table of Contents>>BadgerCare Plus Plans — Enrollment Information>>

BadgerCare Plus for Families

Standard and Benchmark Plans Enrollment Information

The following will tell you what plan is available under each BadgerCare Plus income level for families. It will also list whether or not you:

  • If you will have copays.

  • If you will be required to pay a monthly premium.

  • If you can get backdated coverage.

  • If you will have a spenddown.

Young adults leaving out-of-home care (foster care) — If you are a young adult leaving out-of-home care, you may enroll in the Standard Plan. If you qualify as a BadgerCare Plus youth, you will not pay copays or premiums, regardless of your income.

Please keep in mind, there is no income limit for young adults leaving out-of-home care.

Self-employed parents and caretakers — If your family income is at or below 200% of the FPL without deducting depreciation, you will be enrolled in the Standard Plan.

If your income is at or below 200% only by deducting depreciation expense, you will be enrolled in the Benchmark Plan. If your family income is over 150% of the FPL, you will have to pay premiums. You will also have to pay copays regardless of your income.

Click Here for Income Limits Pregnant Women Children  Children with access to employer health insurance
At or below 100% FPL 

Standard Plan
Premium - No
Copay - No
Backdated Coverage - Yes

Standard Plan
Premium - No
Copay - No
Backdated Coverage - Yes

Standard Plan
Premium - No
Copay - No
Backdated Coverage - Yes
From 100% to 150% FPL

Standard Plan
Premium - No
Copay- No
Backdated Coverage - Yes

Standard Plan
Premium - No
Copay - No*
Backdated Coverage - Yes 

Standard Plan
Premium - No
Copay - Yes*
Backdated Coverage - Yes
Over 150% FPL

Standard Plan
Premium - No
Copay - Yes
Spenddown**
150% to 200% FPL

Standard Plan
Premium - No
Copay - No

Standard Plan
Premium - No
Copay - Yes

From 200% to 300% FPL

Benchmark Plan
Premium - No
Copay - No

Benchmark Plan
Premium - Yes
Copay - Yes

300% FPL and over  Benchmark Plan
Premium - No
Copay - No
Spenddown** - Yes		 Benchmark Plan
Premium - Yes
Copay - Yes
Children age 1 to 6 who are tribal members Children age 6 to 18 who are tribal members Parents and relatives who care for a child
At or below 100% FPL

Standard Plan
Premium - No
Copayment - No
Backdated Coverage - Y

Standard Plan
Premium - No
Copayment - No
Backdated Coverage - Y

Standard Plan
Premium - No
Copayment - No
Backdated Coverage - Y
From 100% to 150% FPL Standard Plan
Premium - No
Copayment - Y
Backdated Coverage - Y 		 Standard Plan
Premium - No
Copayment - Y
Backdated Coverage - Y 		 Standard Plan
Premium - No
Copayment - Y
Backdated Coverage - Y
150% to 185% FPL Standard Plan
Premium - No
Copayment - Y 		 Standard Plan
Premium - No
Copayment - No		 Standard Plan
Premium - Y
Copayment - Y
From 185% to 200% FPL  Standard Plan
Premium - No
Copayment - No		 Benchmark Plan
Premium - No
Copayment - No		 Standard Plan
Premium - Y
Copayment - Y
From 200% to 250% FPL Benchmark Plan
Premium - No
Copayment - No		 Benchmark Plan
Premium - No
Copayment - No		 Benchmark Plan*
Premium - Y
Copayment - Y
From 250% to 300% FPL Benchmark Plan
Premium - No
Copayment - No		 Benchmark Plan
Premium - No
Copayment - No		 Benchmark Plan*
Premium - Y
Copayment - Y
300% FPL and over Benchmark Plan
Premium - Y
Copayment - Y 		 Benchmark Plan
Premium - Y
Copayment - Y		 Benchmark Plan*
Premium - Y
Copayment - Y

*Children under age 6 with family income of 100% up to 150% of the FPL do not have copays.

Click here for income limits

Parents and Relatives Who Care For a Child
Income Limit Plan Premium Copay Backdated Coverage
At or below 100% FPL Standard No Yes Yes
From 100% to 133% FPL Standard No Yes Yes
133% to 200% FPL Standard Yes Yes No
From 200% to 300% FPL Benchmark* Yes Yes No

*Only self-employed parents and/or relatives who care for a child can be enrolled at this income level.

Click here for income limits

Income Limit Children age 1 to 6 who are tribal members Children age 6 to 18 who are tribal members
At or below 100% FPL Standard Plan
Premium - No
Copay - No
Backdated Coverage  - Yes		 Standard Plan
Premium - No
Copay - No
Backdated Coverage - Yes
From 100% to 150% FPL Standard Plan
Premium - No
Copay - Yes
Backdated Coverage  - Yes		 Standard Plan Premium - No
Copay - Y
Backdated Coverage - Yes
150% to 185% FPL Standard Plan
Premium - No
Copay - Yes		 Standard Plan
Premium - No
Copay - No
From 185% to 200% FPL Standard Plan
Premium - No
Copay - No		 Benchmark Plan
Premium - No
Copay - No
From 200% to 300% FPL Benchmark Plan
Premium - No
Copay - No		 Benchmark Plan
Premium - No
Copay - No
300% FPL and over Benchmark Plan
Premium - Yes
Copay - Yes		 Benchmark Plan
Premium - Yes
Copay - Yes

 

Individual(s) — Income Limit Premium Copay Copay for Indian Health Services
Tribal Members and Children of Tribal Members
  • Adults
  • Age birth to 1, income at 300% FPL and over
  • Age 1 to 5 years, income at or below 185% FPL
  • Age 6 to 18 years, income at or below 150% FPL
 No Yes No
Tribal Members and Children of Tribal Members
  • Age 6 to 18 years, income at 150 to 300% FPL
  • Age 1 to 5 years, income at 185 to 300% FPL
 No No No
Other people who are eligible to get services from an Indian Health Center
  • Adults
  • Age birth to 1, income at 300% FPL and over
  • Age 1 to 5 years, income at or below 185% FPL
  • Age 6 to 18 years, income at or below 150% FPL
 No Yes No
Other people who are eligible to get services from an Indian Health Center
  • Age 6 to 18 years, income at 150 to 300% FPL
  • Age 1 to 5 years, income at 185 to 300% FPL
 Yes Yes Yes

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Last Revised: February 06, 2013