State of Wisconsin Department of Health Services

Release 24-02 August 22, 2024

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39.3 Emergency for Pregnant Members

A pregnant non-qualifying immigrant may apply for BadgerCare Plus Emergency Services up to one calendar month before the due date. Certify an eligible pregnant non-qualifying immigrant from the date of 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., if they apply no more than one calendar month prior to the due date, through the end of the month in which the 60th day occurs following the due date. Adjust the certification period based on the actual pregnancy end date, once it is known.

Note	Pregnancy does not need to be verified (see Section 9.9.3 Pregnancy).

 

Example 1

Sara is a pregnant non-qualifying immigrant applying for BadgerCare Plus Emergency Services. Sara has two weeks until her due date, which is March 3. Certify Sara for BadgerCare Plus Emergency Services from the date of application through the end of May.

 

Example 2

Erica applied for BadgerCare Plus Emergency Services because she was a pregnant non-qualifying immigrant on March 13. Her expected due date is April 5. Erica is certified for BadgerCare Plus Emergency Services from March 13 through the end of June. Erica delivers her son on March 15. Her certification period should be adjusted from March 13 through the end of May.

If a pregnant non-qualifying immigrant applies for BadgerCare Plus Emergency Services prior to the calendar month before the due date, and they have not received a service, deny BadgerCare Plus Emergency Services eligibility because they have not received a service.

If an individual applies for BadgerCare Plus Emergency Services, within three months after the pregnancy has ended, certify BadgerCare Plus Emergency Services from the pregnancy end date through the end of the month in which the 60th day occurs.

Example 3

Vienne miscarries on April 5, which is more than one month from her due date of July 15. Vienne applies on April 6 for BadgerCare Plus Emergency Services. Certify Vienne for BadgerCare Plus Emergency Services from April 5 through the end of June.

 

Example 4

Guadeloupe was in a car accident and admitted to a Fort Atkinson hospital on February 18. On March 15, Guadeloupe applied for BadgerCare Plus Emergency Services for both the February hospital stay and her pregnancy, with a due date of April 15. Certify Guadalupe for BadgerCare Plus Emergency Services from February 18 through the end of June.

An immigrant who gives birth while enrolled in BadgerCare Plus Emergency Services remains eligible for emergency services for an additional 60 days after the last day of pregnancy through the end of the month in which the 60th day occurs. The emergency does not have to be related to the pregnancy.

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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