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State of Wisconsin |
Release 25-02 |
If there is a change in non-financial eligibility during the deductible period, discontinue BadgerCare Plus eligibility for those persons who have become non-financially ineligible.
Every child in a BadgerCare Plus household must have their eligibility for a deductible determined separately. If a child enters the BadgerCare Plus group after a deductible for another child in the group has been set, the new child must have their eligibility for a deductible determined separately.
If an adult caretaker relative who is EBD, or is pregnant, enters the BadgerCare Plus group, their eligibility for a deductible must be determined separately.
If a member loses non-financial eligibility and regains it during the same deductible period, the member may choose:
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, the deductible must be recalculated. 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. Beginning July 1, 2020, the deductible amount will no longer be increased when an unmet deductible assistance group has a decrease in the group size. Once a deductible period and deductible amount are established, the deductible amount will never increase during the same deductible period. Deductible amounts may be decreased due to changes in income, deductions, or group size.
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: 20-03
Release Date: 08/03/2020
Effective Date: 07/01/2020
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