ForwardHealth Partners: Medicaid Purchase Plan (MAPP) Partner Toolkit

Worried about the federal government shutdown?

DHS is closely monitoring the current federal government shutdown. Our goal is to keep the public informed, especially our members who receive vital health and nutrition support and services. We will share updated information about the status of coverage and benefits as soon as it is available. Here is what Medicaid, FoodShare, and WIC members need to know:

  • Medicaid and BadgerCare Plus members still have coverage to get the care and services they need. For updates, visit the Medicaid News page.
  • FoodShare members can use their October benefits on their QUEST cards to buy food during a shutdown and will get October benefits on schedule. For updates, visit the FoodShare News page.
  • Wisconsin WIC is currently available. You can continue to use your WIC benefits, attend WIC appointments, and do not need to take any action. Contact your local WIC agency with any questions.

Easy access to outreach materials and resources

This toolkit is designed to give you the information and the communication tools you need to help members better understand their Medicaid Purchase Plan (MAPP) benefits.

You can find more information about MAPP eligibility, enrollment, work requirements, and premiums at the Medicaid Purchase Plan webpage.

Illustration of hands shaking, cell phone, gears, light bulb

  MAPP premium enhancements timeline

Key DatesCommunication or Action
October 20
  • MAPP premium enhancements go live
  • ACCESS AutoPay goes live
  • November premium statement sent
  • MAPP Consumer Guide begins mailing to all current MAPP members
  • Letter sent to members who have not paid premiums recently—one or more missed payments in July, August, or September
November 5Premium reminder text message sent
Note: Text message reminders are sent on the 5th and 20th of each month. Second reminder only sent if premium is unpaid
November 10November premium due date
November 19December premium statement mailed
Note: During this transition month, if a member has not paid their November premium, it will not be reflected on the December premium statement
December 5Premium reminder text message sent
December 10December premium due date
December 20Premium reminder text message sent if December premium has not been paid
December 22January premium statement sent
Updated premium statement will include January premium amount and if unpaid the past due December amount with a cover letter to draw attention to past due premium
January 10January premium due date
January 16January Adverse Action
If member has not paid December premium, they will receive a letter informing them that their last day of MAPP coverage will be January 31
January 31First possible disenrollment for nonpayment of premium
If member has not paid December premium, they are disenrolled from MAPP

  Meetings

MAPP webinar

This webinar is for Wisconsin Department of Health Services partners who want to know more about the enhancements being made to MAPP premium payments.

When

  • Date: September 30, 2025
  • Time: 9–10 a.m.

  Frequently asked questions

Checks and money orders, along with the tear-off portion of the premium statement, should be mailed to:

Medicaid Purchase Plan
PO Box 93187
Milwaukee, WI 53293-0187

Payment sent to this address will be processed within 2-3 days after receipt.

MAPP members should call Member Services at 800-362-3002 for questions about or issues with:

  • ACCESS
  • MyACCESS
  • ACCESS AutoPay

To avoid processing delays, MAPP premiums should be paid online or by mail. If someone comes to a local agency with a premium payment, the agency staff will help them pay online or mail their check or money order.

In very limited circumstances, in-person premiums can be accepted for processing by a local agency.

For this to happen, all of the following criteria must be met:

  • The individual is unable to pay their premium online.
  • The individual's benefits will end before the payment can be processed by mail.
  • The individual has a specific and immediate medical need, where a delay in the beginning of benefits or a temporary closure of benefits will result in not being able to get a prescription, not being able to attend a medical appointment, or loss of long-term care services prior to the premium being processed.

  Find partner resources

   These are for partner awareness only. These are not to be edited, printed, or shared with members.

Letter to members who have not paid MAPP premiums

This one-time letter will be sent October 20, 2025, to members who have not paid MAPP premiums in one or more of the past three months (July, August, and September).

Pay your initial MAPP premium

A new cover letter is sent with the initial premium statement telling applicants how to pay their initial premium.

Premium statement with past due amount

When a member owes a premium from the previous month, both months will be included on the premium statement and a cover letter will be included.

  • Premium statement with past due amount—Coming soon!
  • Past due cover letter—Coming soon!

Automatic premium payment reminder

Members who have an recurring payment method set up (ACCESS AutoPay, EFT, or wage withholding) will receive this letter instead of a premium statement to avoid duplicate payments.

How to set up electronic funds transfer

The electronic funds transfer (EFT) form is sent with a new cover letter when members request information about EFT.

How to set up wage withholding

The wage withholding form is sent with a new cover letter when members request information about wage withholding.

AutoPay enrollment confirmation

This letter confirms that a member signed up for ACCESS AutoPay to pay their MAPP premiums.

AutoPay disenrollment confirmation

This letter confirms that a member's ACCESS AutoPay for MAPP premiums has ended. There are several versions of this depending on the reason that AutoPay has ended.

Premium payment reminder #1

SMS Text Message Saying a MAPP Payment Is Due

Reminder message sent around 1:30 p.m. on the 5th of the month to members who owe a MAPP premium and do not have an automatic payment method set up.

Premium payment reminder #2

SMS Text Message Saying a MAPP Payment Is Past Due

Reminder message sent around 1:30 p.m. on the 20th of the month to members who have not yet paid their premium for that month.

ACCESS AutoPay enrollment confirmation

SMS Text Message showing MAPP Autopay Enrollment

This text message is sent to members who successfully enrolled in ACCESS AutoPay. The message is sent around 11 a.m. daily and reflects enrollment between 5:30 a.m. the previous day and 5:30 a.m. the day the message is sent.

ACCESS AutoPay disenrollment confirmation

SMS Text Message Showing MAPP Autopay Disenrollment

This text message is sent to members who have been disenrolled from ACCESS AutoPay. The message is sent around 11 a.m. daily and reflects disenrollments between 5:30 a.m. the previous day and 5:30 a.m. the day the message is sent.

Automatic premium payment confirmation

SMS Text Message Showing MAPP Autopayment Confirmation

MAPP members who have an automatic payment method set up (ACCESS AutoPay, EFT, wage withholding) receive this message to confirm that their premium payment has been received. This will be sent around 10:15 a.m. on the 4th day of the month.

 

Agency

Your agency is the local county or Tribal office that helps you with your state benefits. Your agency is responsible for enrolling you in MAPP and registering your Independence Accounts.

Family

For MAPP, a family is the applicant, the applicant’s legal spouse, and any dependent, natural, or adoptive child(ren) who live with the applicant. Stepchildren are not included in the family group for MAPP.

Health and Employment Counseling (HEC)

This is the program certified by the Department of Health Services to help you plan for reaching your work goals. For more information, call the HEC coordinator at 866-278-6440.

Impairment-Related Work Expense (IRWE)

An IRWE is the cost for items or services that you need to work because of an impairment. For example, if you needed a service animal to work, the cost of the animal, training, or even food, could be considered an IRWE. Other examples of IRWEs include modified audio/visual equipment, typing aids, specialized keyboards, prostheses, reading aids, vehicle modification (plus installation, maintenance, and associated repair costs), and wheelchairs.

You pay for IRWE expenses out of pocket. They are subtracted from your gross income before we decide if your income is over the 250% FPL to be eligible for MAPP. We also subtract IRWEs from the income we use to set your premium amount. IRWE expenses may lower your premium amount.

Independence Accounts

These are financial accounts that you open or existing retirement accounts that are exempt from the $15,000 asset limit for MAPP. Independence accounts allow you to save some money from earnings without losing MAPP benefits.

Initial Premium Payment

This is the full premium for the first month that must be paid before you can be enrolled in MAPP.

Medicaid Purchase Plan (MAPP)

The Medicaid Purchase Plan is a program that allows adults with disabilities who are working or are interested in working the opportunity to enroll in health care coverage.

Medical Expenses

Medical expenses are anticipated, incurred expenses for services or goods that have been prescribed or provided by a licensed medical practitioner for diagnosis, cure, treatment, or prevention of disease or treatment affecting any part of the body. These are expenses that are the responsibility of the member and cannot be paid by any other source, such as Medicare, Medicaid, private insurance, or employer.

Examples of medical expenses include:

  • Deductibles and copayments for Medicaid, Medicare, and private health insurance
  • Health insurance premiums
  • Bills for medical services that are not covered by Wisconsin Medicaid

Member

A person who is enrolled in MAPP.

Remedial Expenses

Remedial expenses are costs for services or goods that are provided to relieve, remedy, or reduce a medical or health condition. These expenses are a member’s responsibility and cannot be paid by any other source, such as Medicaid, private insurance, or employer.

Examples include:

  • Case management
  • Daycare
  • Housing modifications for accessibility
  • Respite care
  • Supportive home care
  • Transportation

Remedial expenses do not include housing or room and board services.

Glossary

 
Last revised October 3, 2025