State of Wisconsin Department of Health Services

Release 24-03 December 18, 2024

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8.2 Continuously Eligible Newborns

Newborn children are automatically eligible for BadgerCare Plus as Continuously Eligible Newborns (CEN) from the date of birth through the end of the month in which they turn one year old if both the following are true:

1. They are younger than 13 months old.
2. The mother who gave birth was determined eligible in the state of Wisconsin for the month of the birth for one of the following programs:
   1. BadgerCare Plus
   2. Other full-benefit Medicaid (see Medicaid Eligibility Handbook, Section 21.2 Full-Benefit Medicaid)
   3. Emergency Services BadgerCare Plus
   4. Emergency Services Medicaid (see Medicaid Eligibility Handbook, Section 34.1 Emergency Services)
   5. BadgerCare Plus Prenatal Program as a nonqualifying immigrant

There is no income or resource test for these children while they are eligible under CEN status; therefore, they are not required to provide any income tax filing information in order for their BadgerCare Plus eligibility to be determined.

Note	Children born to incarcerated mothers who are eligible for the BadgerCare Plus Prenatal Program (and not eligible for any other type of BadgerCare Plus or Medicaid) on the date of the child’s birth will not be eligible as CENContinuously eligible newborns.

A child qualifies as a CEN if they are born to a mother whose eligibility for one of the programs listed above was determined either prior to the date of delivery or retroactively to cover the date of delivery.

Example 1

Sasha gave birth on April 15. On June 15, she applied for BadgerCare Plus. Her eligibility was backdated to March 15. Her infant son is eligible as a CEN from April 15 through April 30 of the following year, the end of the month in which he turns one year old.

The newborn child does not receive this automatic eligibility as a CEN if the mother who gave birth was temporarily enrolled in BadgerCare Plus (see Chapter 32 Presumptive Eligibility).

A newborn is not required to reside with the mother who gave birth to be eligible as a CEN. This is true even if the newborn is being placed in foster care, adoption, or is residing with a caretaker relative . A CEN who no longer resides with the mother who gave birth but still resides in Wisconsin should remain eligible as a CEN through the end of the month in which they turn one year old.

Anyone who has ever been eligible as a CEN under Wisconsin Medicaid or BadgerCare Plus is exempt from the citizenship and identity documentation requirements.

The CEN will not have to pay premiums and is not subject to the health insurance access/coverage requirements.

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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.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10171