BadgerCare Plus: Frequently Asked Questions
BadgerCare Plus provides health insurance benefits to people aged 0-64. It is the state's largest Medicaid program, with roughly 1 million members. BadgerCare Plus covers preventive care, urgent and emergency visits, vaccinations, prescriptions, and more. Common questions about BadgerCare Plus are answered below.
General program information
The program is BadgerCare Plus—there is no BadgerCare. However, people will often call it BadgerCare as a shorthand. You may also see the acronym BC+. They are all the same thing.
ForwardHealth is a term that applies to a variety of programs that support your health and well-being. You can use your benefits for multiple programs from this single card.
Coverage for children under age 19
Members who are under age 19 will keep their coverage until it has been 12 months since their last application or renewal. Before January 1, 2024, if a family had a change in income or other circumstances, children in the household could lose their coverage because of that change. Continuous coverage means children under age 19 will keep their benefits for 12 months even when their family’s household circumstances change during that time.
The 12-month period starts with the month of their benefit application, the new certification period at renewal, or when the child otherwise becomes eligible under a qualifying group.
Just like any other existing member, a child who has continuous coverage would complete at renewal process at the end of their 12-month period to see if they are still eligible for benefits. They will get a renewal packet in the mail and should fill out the information and return it to see if they qualify. If not, free help is available to help them find other coverage.
Members under age 19 in the following programs qualify for continuous coverage:
- BadgerCare Plus
- Emergency Services Medicaid
- Family Planning Only Services
- Foster Care Medicaid
- Home and Community-Based Waiver (HCBW) Medicaid
- Institutional Medicaid
Katie Beckett Medicaid
- Medicaid Purchase Plan (MAPP)
- Medicare Savings Programs
- Special Status Medicaid
- SSI-Related Medicaid
- Supplemental Security Income(SSI) Medicaid
- Tuberculosis-Related Medicaid
- Wisconsin Well Woman Medicaid (WWWMA)
Continuous coverage does not apply to children who are:
- Enrolled under presumptive eligibility (also known as Express Enrollment).
- Required to meet a deductible to enroll in BadgerCare Plus or Medicaid.
There are a few things that can end a child’s coverage during the 12-month period:
- They turn 19
- They move out of Wisconsin
- Their citizenship or immigration status is not verified
- The family asks to end their coverage
Monthly premiums and payments for children
A premium is a set amount of money we are required by state law to charge each month for your child’s BadgerCare Plus benefits if your family has an income over a certain amount.
Premium amounts are based on the income we have on file for your household. Children ages 1 through 18 enrolled in BadgerCare Plus with family income over 201% of the federal poverty level are charged a premium unless they are exempt. Premiums are set at a specific amount depending on your family’s income and will not be more than 5% of your family’s counted income.
You will receive a statement in the mail each month that lists the amount of your premium. You can pay the premium by:
- Check
- Money order
- Electronic funds transfer (EFT)
- Wage withholding
- Credit or debit card using the ACCESS website or MyACCESS mobile app
A child’s benefits will not end if you do not pay the premium. They will keep their BadgerCare Plus coverage for the 12-month period until their next renewal. There is no penalty for not paying.
If you paid your premium in person or by mail, it may take a few days to show on the page.
- If you have questions about your premium amount or general eligibility questions, contact your local agency.
- If you have questions about ACCESS or MyACCESS online payments, call Member Services at 800-362-3002.
- Refer to the ForwardHealth Enrollment and Benefits Handbook, P-00079, for more information.