State of Wisconsin
Department of Health Services

HISTORY

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

17.9 Non-financial Changes

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  1. 17.9.1 Non-Financial Changes Introduction
  2. 17.9.2 Group Size Changes
  3. 17.9.3 Death

 

17.9.1 Non-Financial Changes Introduction

If there is a change in non-financial eligibility during the deductibleThe amount of health care expenses an insured person is required to incur before benefits are payable under a health insurance plan. period, discontinue BadgerCare Plus eligibility for those persons who have become non-financially ineligible.

 

If a child enters the BadgerCare Plus group after the deductible for another child in the group has been met, that child will also be eligible for the remainder of the deductible period.
 

If an adult caretaker relative who is EBD, or is medically verified as pregnant, enters the BadgerCare Plus group, his or her name will appear on the BadgerCare Plus card for the remainder of the deductible period.  

 

If a member loses non-financial eligibility and regains it during the same deductible period, the member may choose:

 

OR

17.9.2 Group Size Changes

When the group size is different on the last day of the month from what it was on the last day of the previous month, and the deductible is not met, you must recalculate the deductible.  Compare the new group's countable monthly income with the new group's FPL limit.  If there is excess monthly income, recalculate the deductible in the same way as for income changes.

17.9.3 Death

If the member dies during the deductible period, and is not already certified, look at all countable expenses prior to death.  If those countable expenses meet the deductible, certify the person.  The time period for the deductible remains six months.  All months that remain of the six-month deductible period from the point the member dies, are considered to have $0 income.  The deductible amount should be recalculated.  If the deductible was met, eligibility will be the point from which eligibility was determined to have been met through the date of death.  

 

If the member prepays the deductible and dies after the deductible period starts, the deductible is non-refundable.  If the member prepays and dies before the deductible period starts, the deductible pre-payment is refundable.

 

 

 

 

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.

Publication Number: P-10171