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Demonstration Project Waiver
The Wisconsin Department of Health Services received approval
for a new five-year Section 1115 Demonstration Project Waiver, the
BadgerCare Reform Waiver.
The new waiver became effective January 1, 2014 and goes through December 31,
The waiver allows Wisconsin to provide health care coverage
through BadgerCare Plus to all childless adults between ages 19 and 64 and who
have incomes that do not exceed 100%
of the federal poverty level (FPL) beginning April 1, 2014. The 2013-15
biennial budget had
originally planned for the program changes to go into effect on January 1, 2014;
however, due to challenges with the federal Health Insurance Marketplace,
Governor Walker and the Wisconsin Legislature delayed these changes by 90 days
to April 1, 2014.
Through the BadgerCare Reform waiver, Wisconsin will provide full Medicaid
benefits through the Standard Plan, including enhanced mental health benefits,
substance abuse treatment and prevention benefits, to all adults in poverty who
are enrolled in Medicaid and BadgerCare Plus. Previously, this level of coverage
had not been available to childless adults.
Beginning April 1, 2014, the new BadgerCare Reform waiver will allow
Wisconsin to provide BadgerCare Plus health care coverage to individuals who:
- Are between ages 19 and 64 years old,
- Are not otherwise eligible for BadgerCare Plus for Families or Medicaid,
- Are not entitled to Medicare,
- Meet all Medicaid non-financial requirements like citizenship and
identity, SSN, etc., and
- Have a gross income, calculated using the federally-mandated Modified
Adjusted Gross Income (MAGI) methodology, that does not exceed
100% of the FPL before
application of a 5% disregard.
The waiver will implement the following changes to BadgerCare
Provide all BadgerCare Plus members with Standard Plan
Eliminate the BadgerCare Plus Core Plan,
Remove the current enrollment cap for childless adults under
100% FPL, and
Require all parents and caretaker relatives who qualify for
transitional medical assistance (TMA) to pay a monthly premium. TMA adults
with incomes above 133% FPL
will be required to pay a monthly premium once they qualify for TMA and
adults with incomes from 100%
FPL to 133% FPL will begin paying monthly premiums after the first six
months of TMA coverage.
January 2014: View the Department's Letter Accepting CMS' BadgerCare Reform Waiver Agreement
(PDF, 160 KB)
December 2013: View the Center for
Medicare and Medicaid Services' (CMS) BadgerCare Reform Waiver Approval Letter (PDF,
December 2013: View the BadgerCare
Reform Waiver Special Terms and Conditions (PDF, 607 KB)
December 2013: View the
BadgerCare Reform Waiver Expenditure Authority (PDF,
December 2013: View the
BadgerCare Reform Waiver Authority List (PDF, 8 KB)
August 2013: Updated August 15, 2013: View Wisconsin's BadgerCare Plus
Demonstration Project Waiver submitted to the federal government (PDF, 2.7 MB)
July 2013: View the public notice about the BadgerCare
Plus Demonstration Project Waiver. (PDF, 339 KB)
July 2013: View
Wisconsin's Proposed BadgerCare Plus Demonstration Project Waiver Request
- Version Reviewed for Public Comment - July 2013.
(PDF, 417 KB)
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accommodations because of a disability or need an interpreter or translator, or
if you need this material in another language or in an alternate format, you may
request assistance to participate by contacting Al Matano at (608)267-6848. You
must make your request at least 7 days before the activity.
DHS es una agencia que ofrece igualdad en las oportunidades de empleo y
servicios. Si necesita algún tipo de acomodaciones debido a incapacidad o si
necesita un interprete, traductor o esta información en su propio idioma o en un
formato alterno, usted puede pedir asistencia para participar en los programas
comunicándose con Kim Reniero al número (608)267-7939. Debe someter su petición
por lo menos 7 días de antes de la actividad.
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January 09, 2014