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BadgerCare Plus Express Enrollment

BadgerCare Plus Express Enrollment - Patient Resources, Social Work Services Quick Guide, Social Work Manual, Financial, Medicaid a.k.a. Medical Assistance a.k.a. Title 19, Wisconsin, BadgerCare Plus


From the April, 2009 Healthwatch Newsletter

Changes to BC+ Express Enrollment for Children and Pregnant Women

The following three points explain important changes to Express Enrollment for children and pregnant women. These changes appeared in the March 2009 ForwardHealth Update (2009-11), titled "Changes to Express Enrollment in BadgerCare Plus for Children and Pregnant Women." They were brought to our attention by Sarah J. Fraley, Southeast Wisconsin Medicaid Policy Analyst in the Division of Health Care Access and Accountability Department of Health Services.

1. More Children Are Now Eligible for Express Enrollment

The state is broadening the requirements for Express Enrollment (EE) for children to allow more children to enroll. Effective April 1, 2009, children who meet the following criteria can temporarily enroll in BadgerCare Plus via EE and receive health care coverage under BadgerCare Plus while a full application is being processed by their local county or tribal agency:

Children younger than age 1 whose family income is at or below 250 % of the FPL.

Children ages 1 through 5 whose family income is at or below 185 % of the FPL.

Children ages 6 through 18 whose family income is at or below 150 % of the FPL.

2. One Period of Temporary Enrollment Per Child Per Year

Effective April 1, 2009, a child is allowed to have only one period of temporary enrollment in a 12-month period. Therefore, it is important for children to apply for full BadgerCare Plus coverage as soon as possible to avoid gaps in health care coverage. The period of temporary enrollment remains the same. Temporary enrollment will still run from the date of application to the end of the following month. However, if an application is submitted to a local county or tribal agency and enrollment in full BadgerCare Plus is denied, the temporary enrollment period ends on the same date BadgerCare Plus enrollment is denied. If an application submitted to the local county or tribal agency is not processed before the end of the second month, the local agency will extend the EE enrollment period by one month.

3. Temporary Express Enrollment Cards

The eligibility period for Express Enrollment remains unchanged; people are still eligible until the last day of the month following the month in which they applied. Children and pregnant women who are temporarily enrolled in BadgerCare Plus via EE will receive a temporary card that is valid for 14 days. When the 14 days has expired, members will need to use the ForwardHealth identification card they receive in the mail for the duration of their express enrollment period. This identification card replaces the temporary card, usually within three business days after the EE application is submitted and approved. To ensure children and pregnant women receive needed services in a timely manner, providers should continue to accept the printed paper EE cards for children and either the printed paper EE card or the beige identification cards for pregnant women for the dates printed on the card. Providers may use Wisconsin's Enrollment Verification System to verify enrollment for dates after those printed on the card. Providers are encouraged to keep a photocopy of the card.