Family Planning Only Services Program

Changes to COVID-19-related coverage

Starting October 1, 2024, the Family Planning Only Services Program will no longer cover the cost of COVID-19 testing and treatment, including the COVID-19 vaccine.

COVID-19 vaccines may be available at low or no cost through either the Vaccines for Children program (under 19 years old) or the Vaccines for Adults program (over 19 years old).

The Family Planning Only Services Program provides low to no-cost sexual and reproductive health care for people with limited income to prevent unplanned pregnancies. Benefits include contraceptive services and supplies, tests and treatments for sexually transmitted diseases, and routine preventive services related to family planning.

To learn more, view the Family Planning Only Services Program Fact Sheet, P-02314.

Who is eligible

You are eligible for the Family Planning Only Services Program if:

  • You live in Wisconsin.
  • You are a U.S. citizen or have a qualifying immigration status.
  • You are of childbearing or reproductive age.
  • Your income is $3,840.30 or less per month.
    • This income limit took effect on February 1, 2024. It is based on federal guidelines and may change each year.
    • Only your own income is counted. Your assets do not count as income.
  • You are not enrolled in Wisconsin Medicaid or BadgerCare Plus. (You can have a private health plan.)

What services are covered

The Family Planning Only Services Program covers certain services you get during a family planning office visit. For example: A pap test done at a family planning office visit or with the referral of a family planning provider.

Covered services provided at a family planning office visit by an approved provider may include:

  • Contraceptive services and supplies (such as birth control pills and condoms).
  • Limited vaccines (such as those for HPV and mpox).
  • Natural family planning supplies (such as items to track fertility).
  • Routine primary preventive services that are related to family planning (such as pap tests).
  • Tests and treatment for sexually transmitted diseases (such as chlamydia, herpes, gonorrhea, and syphilis) and certain other lab tests.
  • Voluntary sterilizations (tubal ligation and vasectomies) for those 21 years old or older.

A family-planning office visit includes initial, yearly, and follow-up visits.

Over-the-counter oral contraception is available with no copay through your pharmacy. Use your ForwardHealth card to get this benefit. See the fact sheet BadgerCare Plus and Wisconsin Medicaid: Over-the-Counter Oral Contraceptives, P-03564 (PDF) for details.

What services are not covered

Not every service is covered. Some services that are not covered include:

  • Hysterectomies.
  • Inpatient hospital services.
  • Mammograms.
  • Services provided at a family planning visit that are not related to family planning.

How to get temporary coverage

If you need family planning services right away, you may be able to enroll for temporary coverage (also known as Express Enrollment). You will need to meet the eligibility criteria.

Your health care provider or hospital would start your Express Enrollment. Some community partners may be able to start Express Enrollment for children. You cannot apply for temporary benefits on your own. If your provider cannot help you, call Member Services at 800-362-3002. They can tell you the qualified hospitals, providers, or partners near you.

Temporary coverage starts the day you enroll. It ends on the last day of the following month. If you want to keep getting services after this temporary coverage ends, you will need to fill out an application for the Family Planning Only Services Program.

How your privacy is protected

If you apply for or enroll in the Family Planning Only Services Program, you can have information sent to an address other than your home address. If you are under 18:

  • Your local agency will not contact your parents or caretakers.
  • You will not be referred to a child support agency.

Who to contact for help

Call Member Services at 800-362-3002.

Glossary

 
Last revised September 6, 2024