BadgerCare Plus Core Plan Update

1. BadgerCare Plus Core Plan Update Covering Kids and Families Wisconsin October 26, 2009

2. ForwardHealth Health and Nutrition Programs • dhs.wisconsin.gov/forwardhealth

4. 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

5. 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!

6. 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).

7. 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

8. 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.

9. 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**

10. 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.)

11. 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 

12. 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

13. What’s next? • BC+ for children and families • Strengthening Partner Network • FNS and CHIPRA Outreach Grants

14. Claire Smith Senior Communications Specialist Division of Health Care Access and Accountability Wisconsin Department of Health Services 608-266-1334 claire.smith@wi.gov