40.7 Program Choice

An individual applying for both BadgerCare Plus and FPOSFamily Planning Only Services - This plan provides certain services and supplies to people who are of childbearing or reproductive age to prevent unplanned pregnancies. may request at any time to discontinue enrollment in BadgerCare Plus in order to receive only FPOS. Change the health care request on the program request page to "No” in order to receive the FPOS.

An individual applying for both BadgerCare Plus and FPOS is not given a choice at the time of confirmation if they meet the eligibility for both benefits. They will be enrolled in BadgerCare Plus.

An individual found to be eligible for a deductibleThe amount of health care expenses an insured person is required to incur before benefits are payable under a health insurance plan. may also be eligible for FPOS benefits during a deductible period. The member may receive FPOS benefits until they have met a deductible. The member can report any out-of-pocket medical bills incurred while they are receiving services through FPOS, in order to meet a deductible. Once a deductible has been met, they are receiving full-benefit BadgerCare Plus/Medicaid, and are no longer eligible for FPOS. However, they will continue to receive the same family planning services through BadgerCare Plus/Medicaid.

Example 1

Theresa is an 18-year-old woman applying for Medicaid, BadgerCare Plus and FPOS for herself and for BadgerCare Plus for her daughter Sara (age three). She is found to be eligible for BadgerCare Plus with a premium or a deductible. If Theresa chooses BadgerCare Plus, she is required to pay a premium but would be able to receive family planning services through BadgerCare Plus as well as having coverage for her whole family. If she chooses the deductible, she can receive family planning-related services through FPOS until her deductible has been met.

This page last updated in Release Number: 13-02
Release Date: 10/25/13
Effective Date: 10/01/13

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