for Health Frequently Asked Questions
Here is a
short list of some of the most frequently asked questions we hear at ABC
for Health. Please check back often, as we are always adding to this list.
If you have any questions that are not answered with the below list, please
contact us at firstname.lastname@example.org
will ABC do for my family and me?
for Health will treat you with respect when you call and try to
help you connect to health care coverage. Drawing on our extensive
experience, we will help you sort through the broad range of health
care financing resources that may be available to you.
uninsured, what options do I have?
options for health care coverage depend on who you are. There are
54 different Medicaid programs in the state of Wisconsin, most of
which cover the aged, the disabled, children, or families with dependent
children. There are no Medicaid programs available for healthy adults
who are not pregnant or parents of dependent children. However,
many hospitals have charity care programs for people who are ineligible
for public health care assistance, and other financing sources may
be available. If you have questions about your health care coverage
options, contact ABC for Health.
do I fill out the one page application for Family Medicaid and BadgerCare?
people have problems filling out the application, and it is important
that you fill out the application completely and correctly or else
your eligibility may be denied or delayed. If you are concerned
about filling out the application correctly, contact ABC
for Health. We strongly suggest getting help from a knowledgeable
advocate. Please use our line-by-line application guide
to help you through this complex process.
happens after I apply for Medicaid, either in person or by mail?
receiving a completed application, the county has 30 days to make
a decision about your eligibility. You must wait for a notice from
the county informing you of your Medicaid eligibility. If you receive
a positive determination, you will get your Forward Card in the
mail. If you do not receive the report or the Forward card within
the 30 days, call the countythere might be something wrong
with your application. Make sure to keep copies of your application.
If there is a problem, contact ABC for Health.
can I do if my Medicaid application is denied?
you are denied coverage, contact your Economic Support worker to
make sure there was not an error. If you are unable to resolve the
problem and cannot get coverage, you are allowed a fair hearing.
You must request a fair hearing within 45 days of the date on the
denial notice. Keep copies of all notices and other letters from
the county, and contact ABC for Health
if you have questions about the fair hearing process.
do I do once I get my Medicaid?
sure to show your Forward card to your medical providers each visit.
Call the billing offices of all the doctors, hospitals, and clinics
that you owe money to. Tell them that you have Medicaid and give
them your number on your Forward card. Call them again in a month
to make sure that your Medicaid paid what it was supposed to. If
there is a problem, contact ABC for Health.
- I was
told I was ineligible over the phone, can they do that?
but sometimes this happens. The county cannot make a definitive
determination of your eligibility unless you have filled out an
application. While there are income guidelines for Medicaid programs,
there are also various deductions and disregards and even if you
appear to have an income that is over the limit, you may still be
eligible. Do not let anyone tell you that you are not eligible over
the phone. If you are told you are ineligible over the phone, contact
ABC for Health.
looking for information about BadgerCare, where can I find it?
- I have
medical bills I cant pay, what can I do?
ABC for Health right away, you may have
options that you are not aware of. Medicaid programs may pay old
medical bills, and sometimes hospitals will write off unpaid care.
looks like I make too much money to qualify for Medicaid or BadgerCare.
What I can do?
you have a dependent child in your household, you may have options.
Both BadgerCare and Medicaid have a variety of income deductions.
features such as the Medicaid Deductible and the
Family Fiscal Unit test, individuals and families
can obtain Medicaid eligibility, even if they exceed the income
limits of the program.
claim for payment of services was denied, what should I do?
is not at all uncommon for either Medicaid or private insurance
companies to deny payment for goods or services. In both cases,
you have appeal rights. For Medicaid, you have 45 days from your
notice of denial to file for a fair hearing. Private insurance appeals
vary from insurer to insurer. The appeal process is often complicated
and involves complex legal issues. If you have questions about your
rights and responsibilities, or need representation at your hearing
contact ABC for Health.
child has Medicaid and needs dental services / mental health services--where
can we go?
dental and mental health services are not easily accessible to Medicaid
recipients. There are some alternative sources of care for these
services. If you are having difficulty accessing the services, contact
ABC for Health.
an undocumented immigrant who needs health care, what can I do?
for Emergency Services provides payment of health care costs
for an eligible non-citizen who had experienced a medical emergency.
Medicaid for Emergency Services is available to
under age 19;
of children under age 19.
immigrants are eligible for Medicaid for Emergency Services if they
meet all other eligibility requirements for Medicaid. (For example
a pregnant woman or child under six must meet the eligibility requirements
for Healthy Start.)
Note: if someone only meets the eligibility requirements for
BadgerCare, they are not eligible for Medicaid.
worried about telling Medicaid who my baby's father is because I don't
want child support to go after him, what can I do?
unmarried pregnant woman who is eligible for Healthy
Start is not required to give the fathers contact information.
You cannot be denied prenatal care if you choose not to cooperate
with your local child support agency.
if you choose not to cooperate with the child support agency, your
Healthy Start benefits will expire 60 days after the child is born.
From this point you will not be eligible for any other Medicaid
you have any questions, contact ABC
pregnant and uninsured, what are my options?
women who earn less than 185% of the federal poverty level (FPL)
($1,790/month for a single pregnant woman. $2721/month for a family
of four) are eligible for the states Healthy
Start program. Healthy Start covers:
doctor visits and hospital costs.
of your baby.
care (including medical, dental, vision, counseling) for pregnant
women up to 60 days following delivery.
care (including medical, dental, vision, counseling) for children
up to age 6. (After age 6, children can still be eligible for
Healthy Start until age 19, but the income threshold drops to
your child is born, you may be eligible for BadgerCare.
Contact ABC for Health or
your local County Human Services
Office for details.