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BadgerCare Plus Core Plan Update. Covering Kids and Families Wisconsin October 26, 2009. ForwardHealth Health and Nutrition Programs. dhs.wisconsin.gov/forwardhealth. Am I Eligible Tool. Simple 10-15 minute screening Shows what benefits families may be eligible to receive: BadgerCare Plus

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badgercare plus core plan update

BadgerCare Plus Core Plan Update

Covering Kids and Families Wisconsin

October 26, 2009

forwardhealth health and nutrition programs
ForwardHealth Health and Nutrition Programs
  • dhs.wisconsin.gov/forwardhealth
am i eligible tool
Am I Eligible Tool
  • Simple 10-15 minute screening
  • Shows what benefits families may be eligible to receive:
    • BadgerCare Plus
    • FoodShare
    • Family Planning Waiver
    • Heating Assistance
    • Tax Credits
    • WIC
    • And more!
  • Personalized results and next steps for applying
badgercare plus core plan
BadgerCare Plus Core Plan
  • Was designed for low-income adults with no dependent children, most of whom have been chronically uninsured
  • Is for individuals who are not pregnant, disabled, or qualified for any other BadgerCare Plus, Medicaid, or Medicare program
  • Will provide access to basic health care services, including primary and preventive care

Enroll at access.wi.gov

No paper applications!

the enrollment services center
The Enrollment Services Center
  • Enrollment Services Center will take all applications for adults with no dependent children:
    • BadgerCare Plus Core Plan
    • FoodShare
    • Family Planning Waiver
  • Enrollment Services Center will determine eligibility and provide ongoing case management
  • The ESC will be comprised of a combination of state and vendor staff
  • The vendor is Automated Health Services (AHS).
badgercare plus core plan program design
BadgerCare Plus Core Plan Program Design

Eligibility Requirements

  • Adults between ages 19 and 64 who are low-income adults and have no dependent children
  • Individuals who are not pregnant, disabled, or qualified for any other BadgerCare Plus, Medicaid, or Medicare program
  • Must be a citizen or a qualifying immigrant
badgercare plus core plan program design8
BadgerCare Plus Core Plan Program Design

Eligibility Requirements

Income up to 200% of the Federal Poverty Level (FPL)

$20,800 annual income for single person (~$10/hour)

$28,000 annual income for married couple (~13.46/hour for both)

Reporting requirements

Move out of state, turn 65, change living arrangement, death, obtain health insurance, or become eligible for BC+, Medicaid or Medicare.

badgercare plus core plan covered services
BadgerCare Plus Core Plan Covered Services
  • The BadgerCare Plus Core Plan will cover these services:
    • Doctor visits Hospital services
    • Emergency room visits Emergency ambulance rides
    • Emergency dental services Physical therapy
    • Occupational therapy Durable medical equipment
    • Speech therapy Cardiac rehabilitation
    • Dialysis/kidney-related services
    • Some disposable medical supplies
    • Chiropractic Services (effective July 1, 2009)
    • Generic and some brand name prescription drugs

**For More Information See Covered Services Handout**

badgercare plus core plan non covered services
BadgerCare Plus Core Plan Non-Covered Services
  • The BadgerCare Plus Core Plan does not cover these services:
    • Non-emergency dental services
    • Hearing services
    • Routine vision exams
    • Home health care
    • Hospice
    • Nursing home care
    • Podiatry
    • Non-emergency transportation
    • Inpatient mental health/substance abuse treatment
    • Reproductive health services (These services are covered by the Family Planning Waiver.)
core plan waitlist
Core Plan Waitlist
  • Core Plan Suspended Friday, Oct. 9
    • Number of applications received was greater than the number of spots available
  • Governor Doyle also directed DHS to design a proposal to offer some basic level of self-funded coverage for those on the Core Plan waiting list. 
    • More information available in late November 
applying for the core plan
Applying for the Core Plan
  • Apply online at access.wi.gov
  • The BC+ Core Plan has a four step enrollment process:
      • Application
      • Health Survey (Health Needs Assessment)
      • HMO Selection (Available January 2010)
      • Payment
  • If you are assisting with a Core Plan application and the individual has a question that you cannot answer, they can call 800-291-2002
what s next
What’s next?
  • BC+ for children and families
  • Strengthening Partner Network
  • FNS and CHIPRA Outreach Grants
slide14
Claire Smith

Senior Communications Specialist

Division of Health Care Access and Accountability

Wisconsin Department of Health Services

608-266-1334

claire.smith@wi.gov