Wisconsin Department of Health Services Will End Expanded Presumptive Eligibility for BadgerCare Plus Express Enrollment for Children

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


Wisconsin Department of Health Services Will End Expanded Presumptive Eligibility for BadgerCare Plus Express Enrollment for Children

Effective May 6, 2020, the Wisconsin Department of Health Services will end the expanded presumptive eligibility for BadgerCare Plus Express Enrollment previously announced in ForwardHealth Alert 012, titled “ForwardHealth Will Expand Presumptive Eligibility for Express Enrollment.” The expanded presumptive eligibility previously included children through age 18 in households with an income of up to 306% of the federal poverty level (FPL).

As of May 6, 2020, non-expanded income limits will resume for presumptive eligibility for Express Enrollment in BadgerCare Plus for children. Under these limits, presumptive eligibility is available for children with household incomes of up to 306% of the FPL for children up to age 1, 191% of the FPL for children ages 1–5, and 156% of the FPL for children ages 6–18.

No action is required for children who have been temporarily enrolled in BadgerCare Plus through Express Enrollment based on the previously expanded presumptive eligibility. These children will remain temporarily enrolled according to current rules. Existing income limits for presumptive eligibility for children will resume.

Providers and partners who are approved to make presumptive eligibility determinations are encouraged to help applicants obtain temporary enrollment for BadgerCare Plus through the Express Enrollment process.

Because enrollment through the Express Enrollment process is temporary, it is important for members to apply for ongoing BadgerCare Plus, Family Planning Only Services, or Medicaid coverage. Also, ongoing coverage is necessary for long-term care. Partners are encouraged to assist members with this process.