25.4 Valid Application

A valid applicationA request for BadgerCare Plus coverage. The request must be on the Department's application or registration form and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. for BadgerCare Plus must include the applicant’s:

Name
Address
Signature in the Rights and Responsibilities section of one of the following forms:
- Wisconsin Medicaid for the Elderly, Blind and Disabled Application / Review Packet (F-10101),
- Medicaid, BadgerCare Plus and Family Planning Services Registration Application (F-10129),
- BadgerCare Plus Application Packet (F-10182),
- BadgerCare Plus Supplement to FoodShare Wisconsin Application (F-10138)
- Application for Health Coverage & Help Paying Costs from the FFMFederally-Facilitated Marketplace (also known as the Marketplace or the Exchange). Applications for BadgerCare Plus or Medicaid may be filed with the Federally-Facilitated Marketplace, run by the U.S. Department of Health and Human Services. The Marketplace will assess their applicants as potentially eligible for the State’s Medicaid or CHIP programs, and, if found potentially eligible, will transfer individual accounts to the income maintenance agency for a full determination. Individuals who apply at income maintenance agencies or ACCESS and are found ineligible for Medicaid or CHIP will be sent to the Marketplace.
- Telephonic signature in CWW
- Electronic signature in ACCESS
- Electronic signature in an account transfer from the FFM.

The date the BadgerCare Plus paper or ACCESS application is received by the IM agency with the applicant’s name, address and a valid signature (see Section 25.5 Valid Signature) is the filing date . Applications must be processed within 30 days of the filing date (see Section 25.7 Time Frames)

For applications assessed as BadgerCare Plus or Medicaid-eligible that were filed at the FFM and subsequently determined eligible for BadgerCare Plus or the Medicaid, the filing date for the BadgerCare Plus or Medicaid coverage will be the date the application was submitted to the FFM. FFM-referred applications must be processed within 30 days of the date the FFM application was received by the consortium or agency. For additional information about the filing date, see Section 25.6 Filing Date.

This page last updated in Release Number: 17-01

Release Date: 04/11/2017

Effective Date: 04/11/2017