Medicaid and BadgerCare Plus Member Copays Will Be Temporarily Suspended January 1, 2020

DHS Logo

ForwardHealth Community Partners

ForwardHealth logo

Updates for local agencies, community-based organizations, and providers who provide assistance to members of Wisconsin's health and nutrition public assistance programs.


Medicaid and BadgerCare Plus Member Copays Will Be Temporarily Suspended January 1, 2020

The Wisconsin Department of Health Services (DHS) will temporarily suspend Medicaid and BadgerCare Plus member copays for dates of service on and after January 1, 2020. Per federal law, members enrolled in most forms of Medicaid may not be charged premiums and copayments that exceed five percent of their income. To ensure this requirement is met, DHS will be implementing system changes to monitor member copays.

While these changes are being implemented into the system, the Centers for Medicare & Medicaid Services has approved a temporary strategy in which DHS suspends member copays.

Beginning January 1, 2020, Medicaid-enrolled providers may not collect any copays for services provided to Medicaid and BadgerCare Plus members. DHS will provide an update in 2020 to give partners and providers notice in advance when providers may begin collecting copays again from members.

Note: The temporary suspension of copays does not apply for members enrolled in SeniorCare or the Wisconsin Chronic Disease Program (WCDP). SeniorCare and WCDP members will continue to be charged copays.