BadgerCare Plus Handbook
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State of Wisconsin
Department of Health Services

HISTORY

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

19.7 Advance Payments

Through December 31, 2013, payments can be made in advance (further than the next month), but the payment cannot exceed the current certification period .

 

If paying in advance, the payments must be the full amount of subsequent month’s premiums (no partial month payments).  If the income amount changes, the premium amount will be recalculated and the member will be notified through CARESThis system supports the Income Maintenance operations for DHS and DCF. CARES is used to determine eligibility, issue benefits, track premium payments, and manage support for BadgerCare Plus, EBD Medicaid, W-2, Child Care, and Work Programs. that his or her premium amount has changed.  If the premium amount has decreased, the fiscal agent will refund any excess premium that was paid.  If the premium amount has increased and the premium coupon has not been sent for that month, the member will receive a coupon with the new premium amount.  If the premium coupons have already been sent, the member will need to pay the additional amount owed.  The member will not receive a coupon for the difference that is owed.

 

Effective January 1, 2014, premium payments can no longer be made in advance.

19.7.1 Refunds

Contact the BadgerCare Plus Unit at 1-888-907-4455 to issue a refund if the premium was paid in advance and the premium is for a month in which the:

 

  1. Individual/family was ineligible for BadgerCare Plus.

 

  1. The group’s countable income decreased and they no longer owe a premium, if the income change was reported timely.

 

  1. A lower premium amount is due to a change in circumstances which was in effect for the entire month as long as the change was reported within ten days of the date it occurred.  The lower premium amount due is the first day of the month in which the change was reported.  A refund for the difference will be issued.

 

Example: A child without any income is added to the BadgerCare Plus group.  Based on the group's income compared to the new group size, a premium is no longer owed.  The fiscal agent will refund the premium that was paid in advance.

 

 

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