State of Wisconsin Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

2.1 NonFinancial Program Requirements

Wisconsin residents in the following coverage groups may be non-financially eligible for BadgerCare Plus:

• Children younger than 19 years old

• Pregnant women
• Parents and caretakers of children younger than 18 years old and dependent 18-year-olds

• Parents and caretaker relatives whose children have been removed from the home and placed in out-of-home care

• Former Foster Care Youth younger than 26 years old who were in out-of-home care when they turned 18
• Adults ages 19-64 who are not receiving Medicare and who do not have dependent children.

 

To be eligible for BadgerCare Plus, a person must meet the following criteria:

• Be a Wisconsin resident (see Chapter 3 Residence)
• Be a U.S. citizen or qualified immigrant (see Chapter 4 Citizen and Immigration Status)

 

Note: This is not a requirement for non qualifying immigrants receiving BadgerCare Plus Emergency Services (see Chapter 39 Emergency Services) or women applying for the BadgerCare Plus Prenatal Program (see Chapter 41 BadgerCare Plus Prenatal Program).

 

• Provide documentation of citizenship and identity or of immigration status (see Section 4.1 U.S. Citizens and Nationals)
• Cooperate with establishing medical support and TPLThird Party Liability. The obligation of a person or organization other than Medicaid or BadgerCare Plus to pay for a person's medical expenses. Examples of TPL include group or private health insurance, auto insurance, worker's compensation, and personal liability insurance. (see Chapter 5 Medical Support and Third Party Liability)
• Sign over to the state his or her rights to payments from a third party for medical expenses (see Section 5.2 Medical Support/CSA Cooperation)
• Meet BadgerCare Plus SSNSocial Security number requirements (see Chapter 6 Social Security Requirements)
• Cooperate with verification requests when information is mandatory or deemed questionable (see Chapter 9 Verification)
• Meet health insurance access and coverage requirements (see Chapter 7 Health Insurance Access and Coverage Requirements)

     

This page last updated in Release Number: 17-01

Release Date: 04/11/2017

Effective Date: 04/11/2017

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The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.

Publication Number: P-10171