Badgercare: Marketplace Insurance In Wisconsin?

BadgerCare Plus is a health insurance program that provides coverage for low-income children, pregnant people, and adults in Wisconsin. It is the state's largest Medicaid program, with approximately 1 million members. BadgerCare Plus is funded by Medicaid and the Children's Health Insurance Program (CHIP). While it is often referred to simply as BadgerCare, the official name of the program is BadgerCare Plus. It is one of the many health care programs available to Wisconsin residents, who all have access to health insurance through different sources depending on their financial situation.

BadgerCare Plus is Wisconsin's largest Medicaid program

BadgerCare Plus is a health insurance program that helps low-income children, pregnant people, and adults in Wisconsin. It is the state's largest Medicaid program, with roughly 1 million members.

BadgerCare Plus is funded by Medicaid and the Children's Health Insurance Program (CHIP). It covers preventive care, urgent and emergency visits, vaccinations, prescriptions, and more.

To be eligible for BadgerCare Plus, you must be a Wisconsin resident and a U.S. citizen or qualifying immigrant. You also need to be in one of the following groups:

• A child aged 18 or younger with income at or below 300% of the federal poverty level (FPL).
• A parent or caretaker of a child aged 18 or younger with income at or below 100% of the FPL.
• An adult aged 19-64 who is not receiving Medicare, does not have dependent children, and has income at or below 100% of the FPL.
• A pregnant person with income at or below 300% of the FPL.
• An adult under 26 at any income level who was in a foster home, court-ordered kinship care, or subsidized guardianship when they turned 19.

BadgerCare Plus is not considered Marketplace insurance. Wisconsin uses the federally run health enrollment platform, HealthCare.gov, for residents to purchase ACA Marketplace plans.

It provides health insurance for low-income children, pregnant people, and adults

BadgerCare Plus is a health insurance program that provides coverage for low-income children, pregnant people, and adults in Wisconsin. The program is funded by Medicaid and the Children's Health Insurance Program (CHIP).

BadgerCare Plus covers a range of health services, including routine check-ups, doctor and clinic visits, urgent care and emergency room visits, hospital care, prescriptions, immunizations, dental and vision care, laboratory and X-ray services, and medical supplies and equipment. It is the state's largest Medicaid program, with approximately one million members.

To be eligible for BadgerCare Plus, individuals must be residents of Wisconsin and meet certain income requirements. For example, children aged 18 or younger must have an income at or below 300% of the federal poverty level (FPL), while pregnant people must have an income at or below 300% of the FPL. Adults aged 19 to 64 without dependent children and not receiving Medicare must have an income at or below 100% of the FPL to qualify.

The program offers comprehensive health coverage for those who may not qualify for Medicaid or who need different types of services. It is an important resource for low-income families, pregnant people, and adults in Wisconsin, helping to ensure that they have access to the health care they need.

It is funded by Medicaid and the Children's Health Insurance Program

BadgerCare Plus is a health insurance program that helps low-income children, pregnant people, and adults in Wisconsin. It is funded by Medicaid and the Children's Health Insurance Program (CHIP).

BadgerCare was originally created in 1999 as a way to provide a healthcare safety net for low-income families transitioning from welfare to work. The program aimed to provide coverage to families with uninsured children who were entering the workforce. The goal was to ensure that all Wisconsin residents have access to health insurance, regardless of their income level.

In 2008, BadgerCare Plus was created to expand Medicaid coverage to all uninsured children (up to age 18), pregnant women with incomes below 300% of the Federal Poverty Level (FPL), and parents and caretakers with incomes below 200% FPL. The program has since undergone several revisions and expansions to include more individuals, such as childless adults and young adults exiting foster care.

BadgerCare Plus provides comprehensive health coverage, including routine check-ups, doctor and clinic visits, urgent and emergency care, hospital care, prescriptions, immunizations, dental and vision care, laboratory and X-ray services, and medical supplies and equipment. The program also covers preventive care and helps individuals manage chronic conditions, receive treatment for substance use disorders, and access mental health services.

By expanding Medicaid through BadgerCare, Wisconsin can improve health outcomes, reduce disparities, and enhance financial security for its low-income residents. It is a powerful tool to ensure that all residents have access to quality, affordable healthcare, regardless of their income or family situation.

It covers routine check-ups, prescriptions, immunizations, and more

BadgerCare Plus is a health insurance program that helps low-income children, pregnant people, and adults in Wisconsin. It is the state's largest Medicaid program, with roughly 1 million members.

BadgerCare Plus covers routine check-ups, prescriptions, immunizations, and more. Here is a detailed list of what is covered:

• Routine check-ups
• Doctor and clinic visits
• Urgent care and emergency room visits
• Hospital care and outpatient care
• Prescriptions
• Immunizations
• Dental and vision care
• Laboratory and X-ray services
• Medical supplies and equipment
• Basic medical needs
• Care with a nurse or nurse practitioner
• HealthCheck, which provides health care to kids and young adults (age 20 or below)
• Lab work and X-rays
• Medical supplies and equipment
• Prescription drugs and over-the-counter drugs
• Care in certain settings, such as at a hospital, an intermediate care facility, or a rural health clinic
• Eye care, including eyeglasses
• Foot care (podiatry)
• Physical, occupational, respiratory, speech, hearing, and language therapy
• Tuberculosis (TB) care
• Pregnancy and family planning, including prenatal care coordination for those at high health risk
• Treatment for patients in institutions for mental disease, including hospitals and skilled nursing and intermediate care facilities
• Mental health and medical day treatment
• Mental health and psychosocial rehab services, including case management from staff at certified community support programs
• Some home and community-based services, such as home health, nursing services, and personal care
• Skilled nursing home care
• Case management, such as meeting with a social worker
• Help to quit smoking (smoking cessation treatment)
• Help with transportation to health care appointments
• Substance abuse (alcohol and other drug abuse) care

Some members get all services at no cost, while others may have a copay for certain services. A copay is a small amount of money you pay each time you get a health service. The cost of copays ranges from $0.50 to $3.00 per service, depending on the service provided. The monthly copay limit is set at 5% of the member's total gross income.

Eligibility is based on income and citizenship or immigration status

BadgerCare Plus is a health insurance program that provides coverage to low-income children, pregnant people, and adults in Wisconsin. It is the state's largest Medicaid program, with about 1 million members.

Eligibility for BadgerCare Plus is based on income and citizenship or immigration status. To be eligible, one must be a resident of Wisconsin and either a U.S. citizen or a qualifying immigrant.

For children aged 18 or younger, the income must be at or below 300% of the federal poverty level (FPL). For parents or caretakers of children aged 18 or younger, the income limit is set at 100% of the FPL. Pregnant people with an income below 300% of the FPL also qualify for BadgerCare Plus. Adults aged 19-64 who are not receiving Medicare, do not have dependent children, and have an income at or below 100% of the FPL are also eligible.

In addition, adults under 26 of any income level who were in a foster home, court-ordered kinship care, or subsidized guardianship when they turned 19 may qualify.

The monthly income levels used to determine enrollment are subject to change annually based on federal guidelines.

If one is not a U.S. citizen or qualifying immigrant, they may still be able to receive assistance through Emergency Services or the BadgerCare Plus Prenatal Plan if they are pregnant. The DHS will not share immigration status with the U.S. Citizenship and Immigration Services (USCIS).

Frequently asked questions