|
State of Wisconsin |
Release 26-02 |
Payment of premiums is not a condition of eligibility for BadgerCare Plus. An initial premium will not be charged for a current or past month at application or renewal. Premiums will be charged only for future months after advance notice is provided, following adverse action logic.
If eligibility is determined prior to adverse action, the child will be charged a premium starting the following month.
| Example 1 | Roberto applies for BadgerCare Plus for himself and his son Jorge on July 2, 2024. The application is processed on July 8, and Jorge is determined eligible effective July 1 with household income at 215% of the FPL. A premium is not charged for July. A premium will be charged for Jorge beginning with the month of August. A statement will be sent to Roberto at the end of July. |
| Example 2 | Melissa's daughter Beth has been open for BadgerCare Plus since August 2023. Beth completes a renewal on July 1, 2024. On July 5, 2024, Beth is determined eligible effective August 1 with household income above 201% of the FPL. A premium will be charged for Beth beginning with the month of August. A premium statement will be sent to Melissa at the end of July. |
If eligibility is determined after adverse action, the child will be charged a premium the month after the following month.
| Example 3 | Lisa and her family apply for BadgerCare Plus on July 25, 2024. The application is processed on July 31, and the family is determined eligible effective July 1 with the household income above 201% of the FPL. A premium is not charged for July or August. A premium will be charged for each child beginning with the month of September. A premium statement will be sent to Lisa at the end of August. |
| Example 4 | Cua applies for BadgerCare Plus for her son Blong on August 31, 2024. The application is processed on September 27, and Blong is determined eligible effective August 1 with a household income at 225% of the FPL. A premium is not charged for August, September, or October. A premium will be charged for Blong beginning with the month of November. A premium statement will be sent to Cua at the end of October. |
| Example 5 | Julio's daughter Mia has been open for BadgerCare Plus since September 2023. Julio completes a renewal on August 23, 2024. On August 29, 2024, Mia is determined eligible effective September 1 with household income above 201% of the FPL. A premium is not charged for September. A premium will be charged for Mia beginning with the month of October. A premium statement will be sent to Julio at the end of September. |
| Example 6 | Carly's son Jasper has been open for BadgerCare Plus since October 2023. Carly completes a renewal on September 30, 2024. Due to the need to verify income, Jasper's eligibility is not confirmed until October 22, 2024. Jasper is determined eligible effective October 1 with household income above 201% of the FPL. A premium will not be charged for October or November. A premium will be charged for Jasper beginning with the month of December. A premium statement will be sent to Carly at the end of November. |
This page last updated in Release Number: 24-01
Release Date: 04/03/2024
Effective Date: 04/01/2024
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