How to Get Health Insurance for Your Kids in Wisconsin

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By bossypants
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Get Health Insurance for Your Kids in Wisconsin

Did you know Wisconsin children can get free or low cost health insurance regardless of their parents' incomes? Children in Wisconsin are eligible for comprehensive medical coverage, as well as vision, dental, chiropractic, and behavioral health services, and prescription drug coverage. Even if parents have employer offered insurance, Wisconsin kids may be eligible for state paid medical assistance as a secondary insurance.

BadgerCare Plus for Families is Wisconsin's medical assistance progam for children and families. Children from birth to age nineteen may enroll in BadgerCare Plus for Families. Parents (or other relatives) may also be eligible for BadgerCare Plus if they live with and take care of a child, and are income eligible.

Difficulty: Easy

Instructions

Step 1

APPLY FOR BENEFITS. You can enroll your child by applying for health care benefits online or by completing a paper application.

To apply online, go to the Access Wisconsin website (see link under Resources) and click on "Apply for Benefits."

Paper applications are available from your County or Local Tribal agency or by calling the ForwardHealth (BadgerCare) Member Services Hotline at 800-362-3002. For a list of County or Local Tribal agency locations, see the link under Resources.
Step 2

SUBMIT THE APPLICATION. Your medical assistance application will be reviewed by your County or Local Tribal agency.

Once your online application is completed, click the "submit" button and your application be forwarded to your County or Local Tribal agency for review and approval.

You may mail in your paper application, or drop it off at the local agency office. For a list of County or Local Tribal agency addresses and locations, see the link under Resources.

By law, agencies have 30 days to review the health care insurance application and grant benefits. You will be notified by mail when the application is approved. In order to ensure timely approval of your child's health care benefits, respond promptly to any requests from the local agency for additional information and verification.
Step 3

ENROLL FASTER. You may be able to get free or low cost health insurance benefits sooner than 30 days.

If your child needs immediate assistance, inquire about Express Enrollment at your clinic. Or, contact the Forward Health Member Services Hotline (800-362-3002) for Express Enrollment locations.

Express Enrollment is a temporary 60 day health care coverage designed to help children get the immediate services they need. You will still need to complete the formal application process outlined in Steps 1 and 2. In some cases, health care insurance coverage may be backdated to help pay previously accumulated medical bills.
Step 4

USE YOUR BENEFITS. Present your child's Forward Health card whenever he/she visits the doctor or other medical professionals, and at the pharmacy, to use your health care benefits.

Within a few days of receiving your approval letter, you should get a Forward Health card in the mail. (If you don't get a card, contact the Forward Health Member Services Hotline at 800-362-3002).

If your child is enrolled in an HMO, you will likely receive a directory from the HMO listing the providers you may use.

If your child is not enrolled in an HMO, his/her enrollment is called "Straight Title 19," and you may use any health care provider in the State of Wisconsin who accepts the Forward Health Card.
Step 5

MAINTAIN YOUR BENEFITS. You're required to report to your County or Local Tribal agency and advise them of any changes in your circumstances.

You will be asked to complete a review at least once every 12 months, while your child is receiving medical assistance. If you fail to complete the review or fail to provide the requested documentation, your child's health care insurance will be terminated. Additionally, you are required to advise your County or Local Tribal agency of any changes to your income or household circumstances within 10 days of the change. Failure to inform the agency may result in the termination of health care benefits.

Depending on your income, you may be asked to pay a monthly premium for your child's health insurance benefits. If the premium payment is not received by the due date, your child's health care benefits will be terminated. (There is no grace period.) Repeated failure to pay premiums on time may result in a 6 month suspension of eligibility.

Any questions about your child's health care benefits or eligibility should be directed to your County or Local Tribal agency.