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BadgerCare Plus Core Plan presentation


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BadgerCare Plus Core Plan presentation

  1. 1. BadgerCare Plus Core Plan Update Covering Kids and Families Wisconsin October 26, 2009
  2. 2. ForwardHealth Health and Nutrition Programs <ul><li> </li></ul>
  3. 4. Am I Eligible Tool <ul><li>Simple 10-15 minute screening </li></ul><ul><li>Shows what benefits families may be eligible to receive: </li></ul><ul><ul><li>BadgerCare Plus </li></ul></ul><ul><ul><li>FoodShare </li></ul></ul><ul><ul><li>Family Planning Waiver </li></ul></ul><ul><ul><li>Heating Assistance </li></ul></ul><ul><ul><li>Tax Credits </li></ul></ul><ul><ul><li>WIC </li></ul></ul><ul><ul><li>And more! </li></ul></ul><ul><li>Personalized results and next steps for applying </li></ul>
  4. 5. BadgerCare Plus Core Plan <ul><li>Was designed for low-income adults with no dependent children, most of whom have been chronically uninsured </li></ul><ul><li>Is for individuals who are not pregnant, disabled, or qualified for any other BadgerCare Plus, Medicaid, or Medicare program </li></ul><ul><li>Will provide access to basic health care services, including primary and preventive care </li></ul><ul><li>Enroll at </li></ul><ul><ul><li>No paper applications! </li></ul></ul>
  5. 6. The Enrollment Services Center <ul><li>Enrollment Services Center will take all applications for adults with no dependent children: </li></ul><ul><ul><li>BadgerCare Plus Core Plan </li></ul></ul><ul><ul><li>FoodShare </li></ul></ul><ul><ul><li>Family Planning Waiver </li></ul></ul><ul><li>Enrollment Services Center will determine eligibility and provide ongoing case management </li></ul><ul><li>The ESC will be comprised of a combination of state and vendor staff </li></ul><ul><li>The vendor is Automated Health Services (AHS). </li></ul>
  6. 7. <ul><li>Eligibility Requirements </li></ul><ul><li>Adults between ages 19 and 64 who are low-income adults and have no dependent children </li></ul><ul><li>Individuals who are not pregnant, disabled, or qualified for any other BadgerCare Plus, Medicaid, or Medicare program </li></ul><ul><li>Must be a citizen or a qualifying immigrant </li></ul>BadgerCare Plus Core Plan Program Design
  7. 8. BadgerCare Plus Core Plan Program Design <ul><li>Eligibility Requirements </li></ul><ul><li>Income up to 200% of the Federal Poverty Level (FPL) </li></ul><ul><ul><li>$20,800 annual income for single person (~$10/hour) </li></ul></ul><ul><ul><li>$28,000 annual income for married couple (~13.46/hour for both) </li></ul></ul><ul><li>Reporting requirements </li></ul><ul><ul><li>Move out of state, turn 65, change living arrangement, death, obtain health insurance, or become eligible for BC+, Medicaid or Medicare. </li></ul></ul>
  8. 9. BadgerCare Plus Core Plan Covered Services <ul><li>The BadgerCare Plus Core Plan will cover these services: </li></ul><ul><ul><li>Doctor visits Hospital services </li></ul></ul><ul><ul><li>Emergency room visits Emergency ambulance rides </li></ul></ul><ul><ul><li>Emergency dental services Physical therapy </li></ul></ul><ul><ul><li>Occupational therapy Durable medical equipment </li></ul></ul><ul><ul><li>Speech therapy Cardiac rehabilitation </li></ul></ul><ul><ul><li>Dialysis/kidney-related services </li></ul></ul><ul><ul><li>Some disposable medical supplies </li></ul></ul><ul><ul><li>Chiropractic Services (effective July 1, 2009) </li></ul></ul><ul><ul><li>Generic and some brand name prescription drugs </li></ul></ul><ul><ul><li>**For More Information See Covered Services Handout** </li></ul></ul>
  9. 10. <ul><li>The BadgerCare Plus Core Plan does not cover these services: </li></ul><ul><ul><li>Non-emergency dental services </li></ul></ul><ul><ul><li>Hearing services </li></ul></ul><ul><ul><li>Routine vision exams </li></ul></ul><ul><ul><li>Home health care </li></ul></ul><ul><ul><li>Hospice </li></ul></ul><ul><ul><li>Nursing home care </li></ul></ul><ul><ul><li>Podiatry </li></ul></ul><ul><ul><li>Non-emergency transportation </li></ul></ul><ul><ul><li>Inpatient mental health/substance abuse treatment </li></ul></ul><ul><ul><li>Reproductive health services (These services are covered by the Family Planning Waiver.) </li></ul></ul>BadgerCare Plus Core Plan Non-Covered Services
  10. 11. Core Plan Waitlist <ul><li>Core Plan Suspended Friday, Oct. 9 </li></ul><ul><ul><li>Number of applications received was greater than the number of spots available </li></ul></ul><ul><li>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.  </li></ul><ul><ul><li>More information available in late November  </li></ul></ul>
  11. 12. Applying for the Core Plan <ul><li>Apply online at </li></ul><ul><li>The BC+ Core Plan has a four step enrollment process: </li></ul><ul><ul><ul><li>Application </li></ul></ul></ul><ul><ul><ul><li>Health Survey (Health Needs Assessment) </li></ul></ul></ul><ul><ul><ul><li>HMO Selection (Available January 2010) </li></ul></ul></ul><ul><ul><ul><li>Payment </li></ul></ul></ul><ul><li>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 </li></ul>
  12. 13. What’s next? <ul><li>BC+ for children and families </li></ul><ul><li>Strengthening Partner Network </li></ul><ul><li>FNS and CHIPRA Outreach Grants </li></ul>
  13. 14. <ul><li>Claire Smith </li></ul><ul><li>Senior Communications Specialist </li></ul><ul><li>Division of Health Care Access and Accountability </li></ul><ul><li>Wisconsin Department of Health Services </li></ul><ul><li>608-266-1334 </li></ul><ul><li>[email_address] </li></ul>