Covered Services and Copays

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BadgerCare Plus Standard Plan covers the following services.  These services could change.  You should always check with your provider or call Member Services at 1-800-362-3002, for the most up to date information on what services are covered and if there are any limits on the services you need.

  • Case management services
  • Chiropractic services
  • Dental services
  • Family planning services and supplies
  • HealthCheck (Early and Periodic Screening, Diagnosis and Treatment) for people under 21 years of age.
  • Some Home and community-based services
  • Home health services or nursing services if a home health agency is unavailable
  • Hospice care
  • Inpatient hospital services other than services in an institution for mental disease
  • Inpatient hospital, skilled nursing facility, and intermediate care facility services for patients in institutions for mental disease who are:
  • Under 21 years of age
  • Under 22 years of age and was getting services when you turned 21 years of age
  • 65 years of age or older
  • Intermediate care facility services, other than services at an institution for mental disease
  • Laboratory and X-ray services
  • Medical supplies and equipment
  • Mental health and medical day treatment
  • Mental health and psychosocial rehabilitative services, including case management services, provided by staff of a certified community support program
  • Nurse midwife services
  • Nursing services, including services performed by a nurse practitioner
  • Optometric/optical services, including eye glasses
  • Outpatient hospital services
  • Personal care services
  • Physical and occupational therapy
  • Physician services
  • Podiatry services
  • Prenatal care coordination for women with high-risk pregnancies
  • Prescription drugs and over-the-counter drugs
  • Respiratory care services for ventilator-dependent individuals
  • Rural health clinic services
  • Skilled nursing home services other than in an institution for mental disease
  • Smoking cessation treatment
  • Speech, hearing, and language disorder services
  • Substance abuse (alcohol and other drug abuse) services
  • Transportation to obtain medical care 
  • Tuberculosis (TB) services


Co-payments for the Standard Plan are between $0.50 and $3.00 depending on the services.  If you have more than one services you may have more than one co-payment.

Cost of Service

Up to $10.00

From $10.01 to $25.00

From $25.01 to $50.00

Over $50.00







Last Revised: January 5, 2015