BadgerCare+ Bulletin is published by HealthWatch Wisconsin, a project of ABC for Health, Inc. This periodic newsletter tells families, friends and advocates more about how to get, use, and keep health care benefits.Visit us online:www.healthwatchwisconsin.org.
BadgerCare Plus & Medicaid in Wisconsin
Right now, BadgerCare Plus for children and families has not changed. It is still available as a health coverage program in Wisconsin to help people pay for health care. It is an important public-private health care partnership between the federal government, the state of Wisconsin, health plans,
medical providers and the people of our state. Over 770,000 people in Wisconsin rely on the program to provide vital health care services.
BadgerCare Plus for children, families and pregnant women is the primary BadgerCare Plus program--the one most people think of when they hear "BadgerCare." This program offers free or low-cost health care coverage to certain Wisconsin families and individuals.
There are additional programs that fall under the general heading of "BadgerCare" such as the Core Plan and Basic Plan. Both of those programs are not letting in new members. Enrollment has been "frozen" for those programs. There is also a BadgerCare program called "Family Planning Only Services." This program is still available as well, for both men and women in Wisconsin.
Threats to BadgerCare & Medicaid!!
Right Now, BadgerCare Plus and Medicaid programs in Wisconsin have not changed! However, in a recent proposal, the Department of Health Services in Wisconsin is seeking to make many changes to WHO is
eligible and for WHICH services. HealthWatch Wisconsin has been following these proposals and has many concerns. We recently filmed a HealthWatch Wisconsin WatchDog, a video that looks at some of our "top ten" concerns. You can watch that video by clicking on the picture at the right.
The proposal puts new limits on the benefits and coverage available under BadgerCare Plus, while reducing the number of people who can be on the program. The proposal by the Department is long and complex. Below, we summarize a few key points. But first, consider getting involved!
SPEAK UP! You Can Help Protect BadgerCare & Medicaid
YOU CAN HELP!
There are a few things you can do to help tell our elected officials why BadgerCare and Medicaid are important to you, your family or friends, and all those in Wisconsin!
1. Call Your Elected Official: 1-800-362-9472
2. Email Your Elected Officials: Find who represents you by clicking HERE.
3. Join the Save BadgerCare Coalition. Come to the State Capitol this Thursday, November 10 to "Stand Up; Speak Out; and Fight to Save" Wisconsin's Medicaid and BadgerCare programs.
Being called a "Day of Action," you are invited to attend events at the State Capitol in Madison. Below is a look at the schedule for this Thursday, November 10:
Press Event: 9:30am - 10:00am, State Capitol Room 400 NE
Joint Finance Committee Meeting, 10:00am, State Capitol Room 412 E
Public Hearing: 10:30am - 1:30pm Public Hearing, State Capitol Room 400 NE
For general information on the BadgerCare Plus Programs please keep reading. Remember, at this time BadgerCare Plus is still available for children and families!
Proposed Changes to BadgerCare
Below, is a list and short description of just a few of the changes that are proposed by the Department of Health Services at this time. These proposals will be discussed by the Joint Finance Committee of the Legislature this Thursday. After that time, they are sent to the federal government for review and approval.
1. The "Alternative" Benchmark Plan: The proposal suggests moving all individuals that currently have BadgerCare Plus and are above 100% of the Federal Poverty Limit from the BadgerCare Plus Standard Plan into the BadgerCare Plus Benchmark Plan. Our concern is that this means more people will get fewer benefits. The Standard Plan has better health coverage at lower cost. Individuals would be asked to contribute more for premiums and co-pays under the new proposal.
2. Dropping Adults if the Proposal is Not Approved: Wisconsin's state budget says that if all these proposed changes are not approved by federal officials before the end of this year, then, in an attempt to save money, the state will instead drop parents enrolled in BadgerCare Plus and adults on the BadgerCare Plus Core Plan programs (anyone over 133% of the Federal Poverty Level) from their current coverage. Right now, that is estimated to be approximately 53,000 adults.
3. Getting Rid of "Backdating:" Right now, in many situations, individuals and children are able to apply for BadgerCare Plus and have their coverage actually start at a date prior to when they applied. This is called "backdating" an application. This is helpful for individuals seeking BadgerCare once they are already at a hospital, to make sure that bill is covered. The proposal is to get rid of these "extra dates of coverage" and only allow BadgerCare coverage to begin after the full application is submitted.
4. Increased Premiums & Paying Late: More people will be responsible for higher premiums under the new proposal. The penalties for not paying those premiums on time are severe: you will lose your BadgerCare Plus coverage for one full year.
5. Counting Income of Everyone in Your House: The new proposal says that everyone in your household, including unrelated roommates, will have their income included in your application for BadgerCare Plus. Right now, if a person is applying for BadgerCare Plus, the State will look at the incomes of those people "legally responsible" for the children in the home. The new rule would broaden that definition. This is a dramatic change that could potentially make thousands of people "not eligible" or responsible for a high premium.
6. No BadgerCare for 19-26 Year Olds: The proposed rule says that individuals aged 19-26 are not eligible for BadgerCare Plus, that they should instead be added to their parents private insurance. The rule is not very specific, and therefore causes concern for many individuals who may be living very far away from their parents, may be "out of network" or may have special health care needs not addressed by their parent's insurance.
Reminder: Who Can Get BadgerCare Plus Right Now?
Who Can Get BadgerCare Plus?
You will first be asked if you live in Wisconsin, are a citizen (or can prove your immigration status), and whether you fall under a certain income limit.
You then will have to answer additional questions about your family--do you have children under the age of 19 in the home? Are you pregnant? Are you a relative taking care of a child?
If you answered "yes" to any of these questions, chances are you are on your way to getting BadgerCare Plus.
Remember, the state will need to know your income to determine if you fit the right category of health care coverage. Using your income and family size, the state will calculate where you fall on the "Federal Poverty Level" (FPL). Click here to learn more about FPL or visit our "FPL Calculator" online!
How To Apply
To see if you can get BadgerCare Plus, you will need to fill out an application form. It's just like filling out a survey that asks about you and your family:
How much money you make if you are working,
The names of the people living in your house and how you are related to them,
Birthdays of everyone in your house,
Social security numbers (or registration numbers for immigrant families)
Whether you have private health insurance right now
BadgerCare Plus offers two different health plans, each which offers a different level of benefits: the Standard Plan and the Benchmark Plan.
Standard Plan
The Standard Plan provides the most complete package of benefits and services, also known as "full Medicaid benefits." This plan is available for certain groups of people with incomes at or below 200% of the FPL.
Benchmark Plan
The Benchmark Plan covers limited services for certain groups of people with incomes higher than 200% of the FPL. Unlike the Standard Plan, the Benchmark Plan requires members to pay premiums. It also requires higher co-payments than the Standard Plan.
Covered Services
BadgerCare Plus covers a variety of services, including doctor visits, hospital and emergency care, check-ups, immunizations, eyeglasses, hearing aids, prescriptions, mental health services, prenatal care, and family planning.
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People Speak Up About Wisconsin's Health Care Programs
This year, Wisconsin's Medicaid and other public health care programs have come under attack. It is important that the people who need and use these programs speak out and share their stories, so that the rest of Wisconsin - especially the legislators - know what's at stake when they make cuts and changes.
In early March 2011, HealthWatch Wisconsin hosted public hearings to focus attention on the impact of BadgerCare and Medicaid cuts on the 1.2 million Wisconsin residents who benefit from these programs. The event drew hundreds of people to listen, learn, and for some, to share their stories and the stories of loved ones.
If you want to share your own story, please contact ABC for Health. Call 1-800-585-4222 ext. 208 or email info@safetyweb.org.
Federal Poverty Level
Federal Poverty Level (FPL): A minimum income level below which a person is officially considered to be living in poverty. A simple version of the federal povertythresholds used to decide financial eligibility for certain federal and state programs. It is issued each year by the U.S. Department of Health and Human Services. The FPL is set using weighted averages of final federal poverty thresholds. It is made available in the Federal Register.
