State of Wisconsin Department of Health Services

HISTORY

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

20-04 Version of 2.1 BadgerCare Plus Nonfinancial 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 who reside with them at least 40% of the time.

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	A non-qualifying immigrant receiving BadgerCare Plus Emergency Services (see Chapter 39 Emergency Services) or a BadgerCare Plus Prenatal Program applicant (see Chapter 41 BadgerCare Plus Prenatal Program) is not required to be a U.S. citizen or qualified immigrant.

• 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 Third Party Liability (TPL) (see Chapter 5 Medical Support and Third Party Liability)
• Sign over to the state their rights to payments from a third party for medical expenses (see Section 5.2 Medical Support/CSA Cooperation)
• Meet BadgerCare Plus Social Security Number (SSN) 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)

     

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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