Medicaid: Forms and Publications
This page includes links to Medicaid forms and publications. Selecting a link will take you to a page where you can choose to view a form or publication in your preferred language.
You can find:
- Forms—Files for members to fill out
- Guides—Files that explain how Medicaid works
- Publications—Files you can use to share details about Medicaid
- Waiver documents—Information about waivers that give Wisconsin flexibility to design and improve our Medicaid programs.
If you’d like a printed version of a form or publication, make sure it’s available in print first. To do so, select the link you want, then check the “Other Location” column. If it says “None,” it’s not available in print. If it is available, you’ll see a link to fill out a request form.
Give these forms to Medicaid members (or potential members) if:
- They’re ready to apply for Medicaid.
- Paper:
- BadgerCare Plus/Medicaid Health Insurance Information, F-10115
- Medicaid Disability Application, F-10112—Use this form if you need a disability determination.
- Wisconsin Medicaid, BadgerCare Plus, and Family Planning Only Services Registration Application, F-10129—Use this form if you need to start your application process and set your application date.
- Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, F-10101
- Online using ACCESS (ACCESS in Spanish)
- Paper:
- They want someone to act on their behalf. This can be a person or an organization. Learn more from the Representative Types Quick Reference, P-02176
- They have a life change. This could mean moving, getting married, or having a child.
- Paper—Medicaid Change Report, F-10137
- Online using ACCESS (ACCESS in Spanish)
- They need to allow someone to see information about their eligibility. Use the Release of Confidential Information Authorization for Wisconsin Medicaid, BadgerCare Plus, FoodShare, Family Planning Only Services, SeniorCare, and Caretaker Supplement, F-02340
- They disagree with a decision made by Medicaid. They can request a formal hearing. Use the Request for Fair Hearing form.
- They live with kids under 18 years old. They must share details with Medicaid. Use the Statement of Identity for Children Under 18 Years of Age, F-10154 form.
- They need to transfer property after a member dies. Use the Transfer by Affidavit form (PDF).
Guides
View these guides to learn more about Medicaid topics. These are helpful to give to Medicaid members:
- Guide to Applying for Wisconsin’s Health, Nutrition, and Other Programs, P-16091
- Medicaid and BadgerCare Plus Private Duty Nursing Guide, P-01122
- Wisconsin Medicaid Purchase Plan (MAPP) Consumer Guide, P-00181
- Wisconsin Medicaid SSI HMO Program Guide, P-12770
Handbooks
- ForwardHealth Enrollment and Benefits Handbook, P-00079—Each family who applies for a ForwardHealth plan gets a handbook in the mail.
- Wisconsin Estate Recovery Program Handbook, P-13032
Brochures and flyers
- BadgerCare Plus or Medicaid SSI HMO Ombuds, P-12002
- Estate Recovery Transfer by Affidavit, P-13009
- HealthCheck: Supporting Your Child’s Health, Brochure, P-01007
- MyACCESS Mobile App Flyer, P-02309
- Prenatal Care Coordination, P-01046
Wallet cards
- ACCESS/Marketplace Takeaway Card (50/pad, order by pad), P-00555
- MyACCESS Mobile App Wallet Card, P-02308
Fact sheets
- Health Care for Migrant Workers, P-10053
- Key Contacts, P-16108
- Medicaid and BadgerCare Plus Emergency Services, P-10072
- Medicaid—Enrollment Renewal Fact Sheet, P-10049
- Medicaid—Patient Liability, P-10061
- Medicaid Purchase Plan, P-10071
- Medicare Savings Programs, P-10062
- Non-Emergency Medical Transportation
- Wisconsin Estate Recovery Program Policy Changes Effective August 1, 2014 Fact Sheet, P-00694 (PDF)
- Wisconsin Medicaid and BadgerCare Plus Tuberculosis-Related Only Services, P-10022
- Wisconsin Medicaid Divestment, P-10058
- Wisconsin Medicaid—Home and Community-Based Services Waiver Programs, P-10059
- Wisconsin Medicaid Spousal Impoverishment Protection, P-10063
- Wisconsin Well Woman Medicaid, P-10065
Poster
Download the MyACCESS Mobile App Poster, P-02307.
- The BadgerCare Waiver provides benefits to certain childless, low-income adults.
- The Section 1115 Postpartum Coverage Demonstration Waiver seeks to extend the length of postpartum coverage.