17.8 Changes In Income

Once the deductibleThe amount of health care expenses an insured person is required to incur before benefits are payable under a health insurance plan. has been met, changes in income do not affect the group’s eligibility for the remainder of the deductible period.

If there are income changes reported during the BadgerCare Plus deductible period but prior to meeting the deductible, recalculate the BadgerCare Plus deductible amount.

Add together the monthly excess income of the months of the BadgerCare Plus deductible period that have already gone by.

Using prospective net income, find the excess income of the months in the deductible period after the month when income changed.
Add the results of #1, #2 and #3.

Example 1: Cicely, a pregnant woman with income over 300% FPL, applied for BadgerCare Plus in July. She had excess income of $20 a month. Her BadgerCare Plus deductible was $120. On October 8th, she reports a pay increase of $10 a month. The change is effective for November. The BadgerCare Plus deductible amount is recalculated by:

Adding together the excess income of months July through October. The result is $80.
Calculating her November excess income. The result is excess income of $30.
Prospective excess income for December is $30.
Cicely's new BadgerCare Plus deductible amount is: $80 + $30 + $30 = $140.

If the income change results in lower excess income in the month of change, the applicantA request for BadgerCare Plus coverage. The request must be on the Department's or Federally-facilitated Marketplace’s application, registration form or account transfer (from Federally-facilitated Marketplace) and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. can choose to:

Recalculate the current BadgerCare Plus deductible, or

Create a new deductible period.

Example 2: Mary, a pregnant woman, goes from full time to part time employment in the fourth month of her BadgerCare Plus deductible period. She still has excess income, but it is lower than in the previous three months. She can choose either to recalculate her BadgerCare Plus deductible to a lower amount or to start a new deductible period.

If she chooses to start a new deductible period, she will forfeit any eligibility she might have acquired in the previous deductible period if she had met the previous deductible.

If the income change results in no excess income the applicant has an additional choice:

Recalculate the deductible.
Create a new deductible period.
Begin eligibility immediately.

This page last updated in Release Number: 07-01

Release Date: 10/29/07

Effective Date: 02/01/08