New Suspension of Health Care Benefits Policy for Inmates Going into Effect on October 24, 2020

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ForwardHealth Community Partners

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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.

New Suspension of Health Care Benefits Policy for Inmates Going into Effect on October 24, 2020

Starting on October 24, 2020, the Wisconsin Department of Health Services (DHS) and the Wisconsin Department of Corrections will be implementing a new suspension of health care benefits process for individuals participating in Medicaid or BadgerCare Plus who become incarcerated. The new suspension of benefits process will help ensure that inmates who qualify for BadgerCare Plus or Medicaid are able to access health care services immediately upon release from jail or prison.

Currently, members have their health care benefits terminated when they enter jail or prison and must submit a new application to receive health care benefits after they are released. Many other states have seen improved outcomes upon changing such policies.

Incarcerated individuals are more likely to have chronic physical and mental health conditions, serious mental illnesses, or substance use disorders. Delaying access to medical services for these individuals when they leave jail or prison can have negative effects not just for them, but for their communities as well.

Under the new process, BadgerCare Plus and Medicaid members who become incarcerated will have their benefits placed on hold. While their benefits are on hold, BadgerCare Plus and Medicaid will only cover health care services for those members when they are admitted to a hospital as an inpatient for 24 hours or more.

As long as a member who is in jail or prison continues to meet the rules for health care benefits, reports required changes, and completes their annual renewal when it is due, they will remain enrolled in BadgerCare Plus or Medicaid with their benefits on hold.

If a member's release date is reported to their income maintenance or tribal agency and they remain eligible, upon their release the hold on their benefits will be removed and they will have access to full benefits. Members will also need to contact their agency to let them know where they will be living upon their release, so they can receive communications.

DHS has created new letters and updated current letters to help individuals who become incarcerated after October 24 understand this new process. Upon entering jail or prison, members will receive a new letter informing them that their benefits were placed on hold. After their release date is reported to their agency, upon their release they will get a second letter explaining that that the hold on their benefits will be removed, and describing how they will be able to access health services.

DHS is working on additional information for members and training materials for partners who work with members who are leaving prison or jail. We will share these resources as they become available.