The BadgerCare program is a health insurance program that provides health coverage to low-income, uninsured families with children under the age of 19 who are not eligible for Medicaid and who are uninsured.
- A child whose family has a household income at or below 185% of the federal poverty level (FPL) is eligible for BadgerCare. For a family of three, this works out to an annual income of up to $30,710, or a monthly income of $2,559. If your income increases while enrolled, you may be able to remain eligible until your income exceeds 200% of the FPL.
- BadgerCare does not impose a pre-existing condition exclusion period. If a family meets the eligibility guidelines, an applicant’s pre-existing medical condition does not exclude him from coverage.
- BadgerCare provides comprehensive benefits identical to those available under the Medicaid program including doctor visits, hospital care, prescriptions, mental health services and dental care.
- If your family income is below 150% of the federal poverty level, you will not pay a premium or co-pay. If it is at or above 150%, you will pay a monthly premium equal to 5% of your family income.
- Most BadgerCare families are enrolled in the Wisconsin Medicaid Managed Care Health Insurance Organization program. However, BadgerCare can pay premiums to enroll families into their employer-sponsored health insurance. To qualify for the Health Insurance Premium Purchase (HIPP) program, the employer must pay at least 40%, but less than 80%, of a family premium. Also, the employer-sponsored plan must be cost-effective compared to BadgerCare HMO coverage for the family.
- For more information, contact the BadgerCare program at (800) 362-3002 or visit them at http://www.dhfs.state.wi.us/badgercare/.