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State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
Non-exempt children with an assistance group income above 201% of the FPL will be required to pay premiums. Each child’s premium will be based on their own assistance group’s size and income. The 5% cap for the cost of total household premiums for children will continue to apply. The cap will be 5% of the income of the premium paying assistance group with the highest countable income amount. The total household’s premiums will be determined based on the combined amount of all children’s premiums or the 5% cap, whichever amount is less. See Section 19.2 Premium Calculations and Section 19.3 Premium Limits for more information on premium caps.
The below table outlines the premium amounts for children.
| FPL Income Range | Above 201% to 210.99% | 211% to 220.99% | 221% to 230.99% | 231% to 240.99% | 241% to 250.99% | 251% to 260.99% | 261% to 270.99% | 271% to 280.99% | 281% to 290.99% | 291% to 300.99% | 301% to 306.00% |
| Premium Amounts | $10 | $10 | $10 | $15 | $23 | $34 | $44 | $55 | $68 | $82 | $97.53 |
| Note |
Children in extensions are not required to pay premiums (see Section 19.1 BadgerCare Plus Premiums). If a parent in the household is in an extension, the children are exempt from paying premiums regardless of their income. |
The table below displays the 5% caps of BadgerCare Plus premiums for children in certain households with incomes above 201% and at or below 306% of the FPL. Families pay the combined premiums for the children but no more than 5% of the family’s countable income.
| Example 1 | A family with 10 children and an income of 295% of the FPL would ordinarily owe premiums amounting to 10 times $82, which equals $820. However, if the children’s assistance group size, including the parent, is 11, the 5% cap found in the table below is $800. That is the maximum premium amount that the family should be charged for that month. |
| Group Size | 201 - 211% | 211% - 221% | 221 - 231% | 231 - 241% | 241 - 251% | 251 - 261% | 261 - 271% | 271 - 281% | 281 - 291% | 291 - 301% | 301% - 306% |
| 1 | $122.00 | $128.00 | $134.00 | $140.00 | $146.00 | $152.00 | $158.00 | $164.00 | $170.00 | $176.00 | $182.00 |
| 2 | $165.00 | $173.00 | $181.00 | $189.00 | $198.00 | $206.00 | $214.00 | $222.00 | $230.00 | $239.00 | $247.00 |
| 3 | $208.00 | $218.00 | $228.00 | $239.00 | $249.00 | $259.00 | $270.00 | $280.00 | $291.00 | $301.00 | $311.00 |
| 4 | $251.00 | $263.00 | $276.00 | $288.00 | $301.00 | $313.00 | $326.00 | $338.00 | $351.00 | $363.00 | $376.00 |
| 5 | $294.00 | $308.00 | $323.00 | $338.00 | $352.00 | $367.00 | $382.00 | $396.00 | $411.00 | $426.00 | $440.00 |
| 6 | $337.00 | $354.00 | $370.00 | $387.00 | $404.00 | $421.00 | $438.00 | $454.00 | $471.00 | $488.00 | $505.00 |
| 7 | $380.00 | $399.00 | $418.00 | $437.00 | $456.00 | $475.00 | $493.00 | $512.00 | $531.00 | $550.00 | $569.00 |
| 8 | $423.00 | $444.00 | $465.00 | $486.00 | $507.00 | $528.00 | $549.00 | $570.00 | $591.00 | $613.00 | $634.00 |
| 9 | $466.00 | $489.00 | $512.00 | $536.00 | $559.00 | $582.00 | $605.00 | $628.00 | $652.00 | $675.00 | $698.00 |
| 10 | $509.00 | $534.00 | $560.00 | $585.00 | $610.00 | $636.00 | $661.00 | $686.00 | $712.00 | $737.00 | $763.00 |
| 11 | $552.00 | $580.00 | $607.00 | $635.00 | $662.00 | $690.00 | $717.00 | $745.00 | $772.00 | $800.00 | $827.00 |
| 12 | $595.00 | $625.00 | $654.00 | $684.00 | $714.00 | $743.00 | $773.00 | $803.00 | $832.00 | $862.00 | $891.00 |
| 13 | $638.00 | $670.00 | $702.00 | $734.00 | $765.00 | $797.00 | $829.00 | $861.00 | $892.00 | $924.00 | $956.00 |
| 14 | $681.00 | $715.00 | $749.00 | $783.00 | $817.00 | $851.00 | $885.00 | $919.00 | $953.00 | $986.00 | $1,020.00 |
This page last updated in Release Number: 23-01
Release Date: 02/25/2023
Effective Date: 02/01/2023
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