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State of Wisconsin |
Release 26-02 |
A member’s suspension is lifted and full-benefit BadgerCare Plus coverage will start on the first of the month in which the member is released from incarceration if the member continues to meet all other eligibility criteria for BadgerCare Plus. A new application is not needed to lift the suspension and start full-benefit BadgerCare Plus.
The suspension period will have an end date at the end of a benefit month, but the restriction on covered services will end when the person is no longer incarcerated. This means that the restriction on covered services may end on a date after the suspension end date displayed in the system. See Section 45.2 Covered Services.
Members can report their expected release date to their IM agency prior to their release. If the expected release date is known, the IM agency will redetermine BadgerCare Plus eligibility prior to the release to lift the suspension and start full-benefit BadgerCare Plus, if eligible, on the first of the month in which the member is released.
| Example 1 | Dolores is incarcerated and enrolled in suspended BadgerCare Plus. On August 25, she reports to her IM agency that her expected release date is September 20. The IM agency redetermines her eligibility. Her suspension will be lifted effective September 1. The restriction on covered services will be lifted on September 20 (the date Dolores is released). |
The suspension may be lifted effective for the first of the month when the person was released from prison or jail, even if the release was reported untimely. However, this retroactive lifting may only go as far back as the beginning of the current certification period.
| Example 2 | Risha is incarcerated and enrolled in suspended BadgerCare Plus. Her current certification period started January 1. She was released on April 3, but she doesn't inform the IM agency that she has been released. She continues to be enrolled in suspended BadgerCare Plus. On July 5, she reports to the IM agency that she was released from jail on April 3. The suspension is lifted April 1. The restriction on covered services will be lifted on April 3 (the date Risha was released). |
The member’s health care certification renewal date will not change.
| Example 3 | Cameron is incarcerated and enrolled in suspended BadgerCare Plus. His renewal date is June 30 of the following year. Cameron is released on December 15. The suspension is lifted effective December 1. The restriction on covered services will be lifted on December 15 (the date Cameron is released). His renewal date remains June 30 of the following year. |
This page last updated in Release Number: 25-03
Release Date: 08/13/2025
Effective Date: 08/13/2025
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