ABC 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 info@safetyweb.org for answers.

  • What will ABC do for my family and me?
    • ABC 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.
  • I'm uninsured, what options do I have?
    • Your 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.
  • How do I fill out the one page application for Family Medicaid and BadgerCare?
    • Many 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.
  • What happens after I apply for Medicaid, either in person or by mail?
    • After 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 county—there might be something wrong with your application. Make sure to keep copies of your application. If there is a problem, contact ABC for Health.
  • What can I do if my Medicaid application is denied?
    • If 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.
  • What do I do once I get my Medicaid?
    • Make 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?
    • No, 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.
  • I’m looking for information about BadgerCare, where can I find it?
  • I have medical bills I can’t pay, what can I do?
    • Contact 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.
  • It looks like I make too much money to qualify for Medicaid or BadgerCare. What I can do?
    • If you have a dependent child in your household, you may have options. Both BadgerCare and Medicaid have a variety of income deductions.
    • Through 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.
  • My claim for payment of services was denied, what should I do?
    • It 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.
  • My child has Medicaid and needs dental services / mental health services--where can we go?
    • Unfortunately 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.
  • I'm an undocumented immigrant who needs health care, what can I do?
    • Medicaid 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
      • Children under age 19;
      • Pregnant Women;
      • Disabled adults
      • Parents of children under age 19.
    • Undocumented 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.
  • I'm 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?
    • An unmarried pregnant woman who is eligible for Healthy Start is not required to give the father’s contact information. You cannot be denied prenatal care if you choose not to cooperate with your local child support agency.
    • However, 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 programs.
    • If you have any questions, contact ABC for Health.
  • I'm pregnant and uninsured, what are my options?
    • Pregnant 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 state’s Healthy Start program. Healthy Start covers:
      • All doctor visits and hospital costs.
      • Prescription drugs.
      • Delivery of your baby.
      • Health care (including medical, dental, vision, counseling) for pregnant women up to 60 days following delivery.
      • Health 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 100% FPL).
    • Once your child is born, you may be eligible for BadgerCare. Contact ABC for Health or your local County Human Services Office for details.
  
   
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