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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 Makes It Easier for BadgerCare Plus Members to Get and Keep Health Care Benefits Based on Their Annual Income
As of February 25, 2023, the Wisconsin Department of Health Services (DHS) has implemented changes to assist members eligible for BadgerCare Plus through gap filling rules. These rules help members who would normally be denied health care benefits based on their monthly income but have an annual income that qualifies.
Prior to February 25, members eligible for BadgerCare Plus using their annual income had to reapply for benefits each year. A new system update makes it easier for these members to keep their coverage by allowing them to renew instead.
ACCESS will now ask applicants and members to input both their monthly and expected annual income information during the application and renewal processes to facilitate determinations for people who qualify for coverage because of their expected annual income, instead of their monthly income.
DHS has also improved correspondence for these members:
- When a member is eligible for BadgerCare Plus based on expected annual income, the letter that tells them about their benefits will include the annual income change reporting rules. If an applicant or member is denied eligibility, the letter will include both annual and monthly income details when explaining why.
- The letter accompanying the verification checklist was changed to include questions about annual income that can be used by agencies that need more information while determining eligibility.
- Starting in 2024, DHS will be sending a new letter to members getting coverage through the gap filling rules so they can submit their expected annual income information for the upcoming year.
Getting and keeping health care benefits should be an easier process for BadgerCare Plus members eligible under gap filling rules.
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