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   To request a hearing if you don't agree with a decision about your benefits.

Fair Hearing Voluntary Withdrawal — DHA 17, (PDF 10KB) * — 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 P-00079 (English, Spanish) (PDF 2.6 MB) (01/15)
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:

Legal Action of Wisconsin, Inc. web site at http://www.legalaction.org,  or
The Wisconsin Judicare, Inc. web site at www.judicare.org

Last Revised: January 28, 2015