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39.1 Emergency Services Income Limits

BadgerCare Plus Emergency Services is a limited BadgerCare Plus benefit for documented immigrants who have not been in the U.S. for 5 years or more and for undocumented immigrants.

 

A citizen is not eligible for BadgerCare Plus Emergency Services even when he or she cannot produce citizenship and/or identity verification.

 

Example 1: Jill applies for BadgerCare Plus, declares U.S. citizenship and is asked to provide documents proving her citizenship and identity.  She has a driver license to prove identity but does not have anything to prove her citizenship.  Since Emergency Services BadgerCare Plus does not require proof of citizenship and identity as an eligibility requirement, she then asks to be considered for this program.  However, the IM worker cannot process BadgerCare Plus Emergency Services eligibility for persons declaring to be U.S. citizens.  BadgerCare Plus Emergency Services is reserved for non-qualifying non-citizens.

 

Because Emergency Services is funded through Title XIX only those who would receive their BadgerCare Plus benefits under Title XIX are eligible for BadgerCare Plus Emergency Services.  Therefore, not everyone who meets the income limits for BadgerCare Plus qualifies for BadgerCare Plus Emergency Services.

 

Immigrants who only meet the criteria for BadgerCare Plus under the childless adults’ coverage group are ineligible for Emergency Services.

 

An immigrant who is ineligible for BadgerCare Plus because of his or her immigration status is eligible for BadgerCare Plus Emergency Services coverage if:

  1. He or she meets the income limits listed in the chart below and
  2. Meets all other eligibility requirements, except having or applying for an SSN .

 

BadgerCare Plus Emergency Services Income Limit

 

Group

Income

Pregnant Women

Up to 306% FPL

Newborns to age 1

Up to 306% FPL

Children ages 1 - 5

Up to 191% FPL

Children ages 6 - 18

Up to 156% FPL

Former Foster Care Youth

Any FPL Level

Parents and Caretakers

Up to 100% FPL

 

Note:  Pregnant non-qualifying immigrants may be eligible under the BadgerCare Plus Prenatal Program.

 

An emergency means a medical condition (including labor and delivery) that shows acute symptoms of sufficient severity (including severe pain) such that the lack of immediate medical treatment could result in one or more of the following:

  1. Serious jeopardy to the patient's health.

  2. Serious impairment to bodily functions.

  3. Serious dysfunction of a bodily organ or part.

 

BadgerCare Plus Emergency Services covers :

 

See Process Help, Section 11.1 BC+ Emergency Services Manual Application Processing, for BadgerCare Plus Emergency Services manual application processing.

 

 

 

This page last updated in Release Number: 17-01

Release Date: 04/11/2017

Effective Date: 04/11/2017