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BadgerCare Plus Update

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    1. Claire Smith Senior Communications Specialist Wisconsin Department of Health Services Division of Health Care Access & Accountability Administrators Office claire.smith@wi.gov May 2010 BadgerCare Plus Update

    2. 2 Overview ForwardHealth Basics Program Updates BadgerCare Plus for Families BadgerCare Plus Core Plan BadgerCare Plus Basic Plan Family Planning Waiver Program for Men ACCESS Updates Check My Benefits Renew My Benefits Resources

    3. Wisconsin ForwardHealth Programs - Administered by the Department of Health Services (DHS) FoodShare BadgerCare Plus- Standard, Benchmark & Core Plans Medicaid for the elderly, blind and disabled (EBD) Family Planning Waiver SeniorCare Well Woman Program and Well Woman Medicaid FamilyCare and Community Waivers Caretaker Supplement Heath Care Tax Credit Wisconsin Chronic Disease Program Katie Beckett

    4. FoodShare Facts FoodShare economically boosts Wisconsin farmers and businesses because FoodShare dollars are spent in local communities. The USDA estimates every $5 of FoodShare benefits spent generates $9.20 in economic activity. For the average two-parent family, the average monthly benefit is $386. The maximum allotment for a group of four is $668. FoodShare data and statistics is available online at: http://dhs.wisconsin.gov/foodshare/fsataglance.htm More than 10% of WI Residents are receiving FoodShare In March 2010, $83 million in FoodShare benefits were issued to 721,877 Wisconsin residents. The number of eligible households has grown 39% over the past 12 months. Only individuals or families with very little or no monthly net income will receive the maximum amount of FoodShare benefits.*Only individuals or families with very little or no monthly net income will receive the maximum amount of FoodShare benefits.*

    5. BadgerCare Plus for Families

    6. New: Pre-Printed Renewal Form Purpose: Make it easier for families to renew their benefits and improve retention of kids Sent to families that want to complete renewal by mail Does not affect the process for members who choose to complete their renewal in person, over the phone or by using ACCESS renew my benefits Can also be used for EBD Medicaid, Family Planning Waiver and Caretaker Supplement paper renewals Will also work for cases that also have FoodShare Family will also need to complete FoodShare interview

    7. BadgerCare Plus Core Plan

    8. BadgerCare Plus Core Plan Benefit Changes As of January 1, 2010 the following benefits were added: Podiatry services for diagnosis and treatment of the feet and ankles Hospice services for people who are terminally ill and for their family members Home health services for 30-days following an inpatient hospital stay, if ordered by the doctor. Health education for members with asthma, diabetes or hypertension

    9. BadgerCare Plus Core Plan Service Changes As of January 1, 2010 the following services were changed: Prescription drug co-payments will change to $4.00 for generics and $8.00 for brand-name drugs. $24.00 per provider per month copayment limit Outpatient hospital visits are limited to 25 outpatient visits per member per enrollment year. Emergency room visits dont count to limit ER visits for members with family income at or below 100% of the Federal Poverty will have a $3.00 copayment. If you are admitted to the hospital, the emergency room copayment will be waived. You will then pay the inpatient hospital copayment

    10. Other Core Plan Items Physical Exam Requirement Reminder Letters Role of Member and HMO Core Plan HMO Enrollment in SE WI Renewals Core Plan Waitlist

    11. BadgerCare Plus Basic Plan

    12. Badger Care Plus Basic Plan General Information Optional, limited benefit health care plan. Only individuals who are on the Core Plan waitlist will have the option to enroll in basic We will begin enrolling members in BC+ basic on June 1, 2010 with benefits beginning July 1, 2010 Individuals on waitlist before June 1, 2010 will receive a letter with a fact sheet and instructions on how to enroll $130 per person per month for coverage

    13. BadgerCare Plus Basic Plan General Information Members enrolled in the Basic Plan: Will stay enrolled as long as premiums are paid and they are on the core plan waitlist and meet the core plan rules Will be invited to enroll in the core plan as openings are available based on funding and in the order in which they applied Will not be enrolled in an HMO May be asked to verify income and/or insurance coverage information Will be asked to report changes

    14. Family Planning Waiver Program for Men

    15. Family Planning Waiver Program for Men General Information Men - ages 15 through 44 Will Cover: Contraception supplies Sterilization procedures for males 21 years of age and older Limited services related to the testing and treatment of sexually transmitted infections Office visits related to these services are also covered Same temporary enrollment/presumptive eligibility process

    16. ACCESS Updates

    17. Online Enrollment and Benefit Management Tools ACCESS.wisconsin.gov online tools Am I Eligible? Apply for Benefits MyACCESS: Check benefits and report changes Renew benefits

    18. 18 MyACCESS Members can go here to check benefits, renew benefits, report changes, view application status, get case status updates For partners, working with clients to set this up is the best way to get up-to-date information about the case, without having to call the caseworker or ESC. Best Practice opportunity: helping client set up MyACCESS account. Updating Address Finding out when renewal is due

    19. 19 Renew My Benefits Allows members to complete FS, health care and childcare renewals online and to submit FoodShare and child care six month report forms online Get to this through MyACCESS Approximately 45 days before a program certification period is schedule to end, ACCESS account users will receive a message on MyACCESS indicating that it is time to renew their benefits By clicking on the link, they will be directed to complete their renewal by answering a series of questions based on the information currently known for their case and the programs they are renewing. Two days after the paper SMRF has been mailed, members will be able to complete the SMRF online via MyACCESS. ACCESS will require all questions on the SMRF be answered and the form signed before it can be submitted

    20. Resources

    21. Resources ACCESS Handbook http://www.emhandbooks.wi.gov/ah ForwardHealth Page dhs.wisconsin.gov/forwardhealth ACCESS - Training website https://trn.access.wisconsin.gov/