Medicaid Renewal Data

These tables provide enrollment and renewal statistics by month for Medicaid, BadgerCare Plus, and other state-funded programs and subprograms that provide health care insurance coverage. The "Miscellaneous" category includes a number of programs with lower enrollment totals compared to the others. It includes Wisconsin Chronic Disease Program Medicaid, dental orthodontics/dentures-only Medicaid, and others. Programs/subprograms that include "N/A" are those that do not require annual renewals. Find more information about our programs and subprograms. In order to protect the identity of individuals in the data set, any values of 20 or less are suppressed and replaced with “<21”. In some cases, it’s necessary to also mask the denominator so that it is not possible to calculate a suppressed value.

Total Members (Baseline at end of PHE): This shows enrollment in a given category for April 2023, before the resumption of renewals after the end of the continuous coverage policy.

Total Members: This is the number of members enrolled in that category as of that month.

Individuals Required to Reapply: There is a group of people whose eligibility was maintained outside of CARES, the system used by income maintenance (IM) agencies to determine and manage eligibility for BadgerCare Plus, and Medicaid for the Elderly, Blind and Disabled. This process was established at the beginning of the pandemic as a “safety net” to ensure that we were maintaining coverage for members who lost eligibility in CARES but needed continuous coverage under the provisions in the Families First Coronavirus Response Act. As a result of this systems limitation, these members needed to reapply rather than renew during the Unwinding in order to have a full determination of their eligibility. All these individuals had the same application deadline of May 31, 2023. May is the only month when this metric is reported.

Renewals Due: This column shows the number of members with a renewal due by the end of that month.

Coverage Retained: This column shows the number of members who were found eligible at renewal.

Coverage Ended: This column shows the number of members who were found ineligible at renewal.

Pending Processing: This column shows the number of members whose renewal has been submitted but the agency is still processing the renewal.

Total Members: This metric is a count of the number of individuals enrolled during the month specified. Some individuals may be enrolled in more than one program. The Department of Health Services uses an algorithm to reflect each member only once in order to produce an unduplicated count in this dashboard.

Enrollment data will continue to be updated for three months after it is first posted. This is because an individual may receive up to three months of retroactive coverage if they meet eligibility requirements during that time. For example, January enrollment numbers will first post in February. The January enrollment numbers will update again in March, April, and May to count those individuals who renewed or applied between February and April and received retroactive eligibility to January. When the data are updated in May, the January enrollment data will be final.

The total members count includes people who are:

• Already enrolled in a Medicaid program and who do not have a renewal due.
• Already enrolled in Medicaid and who were found eligible at their renewal.
• New applicants who were found eligible since the last update of this data

Data Source: InterChange

Individuals Required to Reapply: This metric is a count of the number of members required to reapply by May 31st, 2023 in order to have a full determination of their eligibility.

Renewals Due: This metric is a count of the number of members with a renewal due in the report month. The report month reflects the month of the members’ original renewal month, regardless of whether the member received a temporary extension of eligibility into the next month. Please note that members enrolled in Supplemental Security Income Medicaid (SSI MA) and members enrolled in Foster Care Medicaid are not required to renew, as their Medicaid coverage is automatically granted as long as they are getting SSI or in out-of-home placement.

“Renewals due” is the base population from which “coverage retained,” “coverage ended,” and “pending processing” are drawn. Theoretically, adding these metrics together should equal “renewals due,” however, in practice a small number of data irregularities is to be expected which may prevent this from always being the case. Additionally, “pending processing” does not get updated as the value decreases over time (see “pending processing” below).

Data Source: CARES

Coverage Retained: This metric is a count of the number of members found eligible at renewal. This number is a subset of the metric “renewals due.” The report month reflects the members’ original renewal month. This metric is updated for three months after the data are first posted to capture individuals who may not have submitted their renewal on time, but did so within the three month late renewal period. For example, January “coverage retained” numbers will first post in February. The January “coverage retained” numbers will update in March, April, and May to count those who submitted a late renewal between February and April and were found eligible for benefits. When the data are updated in May, the January “coverage retained” data will be final.

Data Source: CARES

Coverage Ended: This metric is a count of the number of members found ineligible at renewal. This number is a subset of the metric “renewals due.” This metric is updated for three months after the data are first posted to capture those who may not have submitted their renewal on time, but did so within the three month late renewal period. For example, January “coverage ended” numbers will first post in February. The January “coverage ended” numbers will update in March, April, and May to count those who submitted a late renewal between February and April but were found ineligible. When the data are updated in May, the January “coverage ended” data will be final.

Data Source: CARES

Pending Processing: This metric is a count of the number of members whose renewal has been submitted but has not yet been processed. This number is a subset of the metric “renewals due.” The value of this metric does not update. It reflects the number of renewals pending for processing at the end of the month the renewal was due. While this value will not be updated over time, income maintenance agencies will continue processing renewals until they are all complete.

Data Source: CARES

This chart shows the monthly count of individuals enrolled in Medicaid, BadgerCare Plus, and other state-funded programs that provide health care insurance coverage. This chart includes historical data going back to March 2019 in order to provide one year of data leading up to the public health emergency.

Data Source: InterChange.

This metric is a count of the number of members with a renewal due in the report month.

These pie charts present members by race, and are broken out by categories. Race categories are self-identified by members when they enroll. They can help users understand the demographic breakdown of Medicaid members.

Find more information about our programs and subprograms.

Data Source: InterChange and CARES.

Members are asked their race at enrollment and when receiving certain services, but they do not have to report it in order to be eligible for Medicaid or to receive services.

These pie charts present members by ethnicity, broken out by category. They can help users understand the demographic breakdown of Medicaid members. Ethnicity categories are self-identified by members when they enroll.

Find more information about our programs and subprograms.

Data Source: InterChange and CARES.

Members are asked their ethnicity at enrollment and when receiving certain services, but they do not have to report it in order to be eligible for Medicaid or to receive services.