BadgerCare Plus Core Plan Update

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BadgerCare Plus Core Plan Update

• Covering Kids and Families Wisconsin
• October 26, 2009

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ForwardHealth Health and Nutrition Programs

• dhs.wisconsin.gov/forwardhealth

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Am I Eligible Tool

• Simple 10-15 minute screening
• Shows what benefits families may be eligible to
  receive
• BadgerCare Plus
• FoodShare
• Family Planning Waiver
• Heating Assistance
• Tax Credits
• WIC
• And more!
• Personalized results and next steps for applying

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BadgerCare Plus Core Plan

• Was designed for low-income adults with no
  dependent children, most of whom have been
  chronically uninsured
• Is for individuals who are not pregnant,
  disabled, or qualified for any other BadgerCare
  Plus, Medicaid, or Medicare program
• Will provide access to basic health care
  services, including primary and preventive care
• Enroll at access.wi.gov
• No paper applications!

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The Enrollment Services Center

• Enrollment Services Center will take all
  applications for adults with no dependent
  children
• BadgerCare Plus Core Plan
• FoodShare
• Family Planning Waiver
• Enrollment Services Center will determine
  eligibility and provide ongoing case management
• The ESC will be comprised of a combination of
  state and vendor staff
• The vendor is Automated Health Services (AHS).
  

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BadgerCare Plus Core Plan Program Design

• Eligibility Requirements
• Adults between ages 19 and 64 who are low-income
  adults and have no dependent children
• Individuals who are not pregnant, disabled, or
  qualified for any other BadgerCare Plus,
  Medicaid, or Medicare program
• Must be a citizen or a qualifying immigrant

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BadgerCare Plus Core Plan Program Design

• Eligibility Requirements
• Income up to 200 of the Federal Poverty Level
  (FPL)
• 20,800 annual income for single person
  (10/hour)
• 28,000 annual income for married couple
  (13.46/hour for both)
• Reporting requirements
• Move out of state, turn 65, change living
  arrangement, death, obtain health insurance, or
  become eligible for BC, Medicaid or Medicare.

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BadgerCare Plus Core Plan Covered Services

• The BadgerCare Plus Core Plan will cover these
  services
• Doctor visits Hospital services
• Emergency room visits Emergency ambulance
  rides
• Emergency dental services Physical therapy
• Occupational therapy Durable medical equipment
• Speech therapy Cardiac
  rehabilitation
• Dialysis/kidney-related services
• Some disposable medical supplies
• Chiropractic Services (effective July 1, 2009)
• Generic and some brand name prescription drugs
• For More Information See Covered Services
  Handout

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BadgerCare Plus Core Plan Non-Covered Services

• The BadgerCare Plus Core Plan does not cover
  these services
• Non-emergency dental services
• Hearing services
• Routine vision exams
• Home health care
• Hospice
• Nursing home care
• Podiatry
• Non-emergency transportation
• Inpatient mental health/substance abuse treatment
  
• Reproductive health services (These services are
  covered by the Family Planning Waiver.)

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Core Plan Waitlist

• Core Plan Suspended Friday, Oct. 9
• Number of applications received was greater than
  the number of spots available
• Governor Doyle also directed DHS to design a
  proposal to offer some basic level of self-funded
  coverage for those on the Core Plan waiting
  list. 
• More information available in late November 

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Applying for the Core Plan

• Apply online at access.wi.gov
• The BC Core Plan has a four step enrollment
  process
• Application
• Health Survey (Health Needs Assessment)
• HMO Selection (Available January 2010)
• Payment
• If you are assisting with a Core Plan application
  and the individual has a question that you cannot
  answer, they can call 800-291-2002

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Whats next?

• BC for children and families
• Strengthening Partner Network
• FNS and CHIPRA Outreach Grants

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• Claire Smith
• Senior Communications Specialist
• Division of Health Care Access and Accountability
• Wisconsin Department of Health Services
• 608-266-1334
• claire.smith_at_wi.gov