Wisconsin Badgercare Health Insurance

Badgercare health insurance is only available to individuals and/or families that meet certain requirements in the state of Wisconsin. Originally Badgercare was a health care reimbursement program created by our Governor Tommy Thompson on July 1st of 1999 to provide medical insurance to residents who made to much money to be covered under Medicaid and who's existing employer didn't provide a health insurance plan. Enrolling children and parents in the Wisconsin Badgercare program can be a painstaking event which is why it's important to discuss your options and the requirements with a licensed health insurance agent.

Although you may not be required to pay any health insurance premiums if you qualify for the Badgercare program, WIHIN recommends that you complete our Plan Finder to discuss Badgercare and other health insurance options to fully understand your situation and the choices you may have. The program itself was altered in 2008 to Badgercare+, a more complex program that greatly expands the original scope of coverage originally implemented by Governor Tommy Thompson. It is designed so that a great many, if not all, of the children have access to healthcare in Wisconsin. It has also been approved to expand to cover childless adults and by completing your request for information, a licensed health insurance agent will review your request and assistance may be offered/recommended to better assist you in the enrollment process.

A few highlights of the Badgercare program as of 10/2011:

  • 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.

To determine eligibility click here