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BadgerCare Plus Family Planning

If you are a resident of Wisconsin and have income over the Medicaid and BadgerCare Plus limits, you may be eligible to receive family planning only services at no cost. Wisconsin Medicaid covers a variety of family planning services for individuals who are not attempting to get pregnant and want to protect themselves from sexually transmitted diseases. Available to both men and women, this program offers coverage for various methods of birth control, screenings for STDs, preventive care related to family planning, and more.

As enrollment is closed for adults without children in BadgerCare Plus, this program is helpful for those needing such services that would fit into that category. Other residents, such as young adults, may be eligible for BadgerCare Plus, which covers these services and many others with the same income limits.

The program also provides confidentiality for minors who apply for themselves or anyone who wishes to privately enroll in Family Planning Only Services. Documents can be sent to an address other than your residence, and applicants under 18 years of age will not be referred to a child support agency or asked to report their parent’s income. The local agency will also refrain from contacting parents or guardians to protect the member’s privacy.

 

Family Planning Eligibility

Individuals who are residents of Wisconsin and were either born in the United States or have legal status may apply. Income is based on household size in relation to the current Federal Poverty Level at 300 percent. Other requirements include not being a recipient of any full benefit ForwardHealth Medicaid plan, orĀ  a BadgerCare Plus Standard or Benchmark Plan.

Those who have income up to 300 percent FPL and are under age 19 qualify for full benefits through BadgerCare Plus Standard or Benchmark Plans, which also provide these services. Minors applying for Family Planning on their own are not required to count their parents’ income, however.

Adults qualify for BadgerCare Plus with income up to 200 percent of FPL, but they must be parents or caretakers. If you are an adult and do not have dependent children, or you do and your income is between 200 and 300 percent FPL, you likely are able to enroll in Family Planning. There are no asset limits for this program.

Income Guideline 300% FPL

Family of 1: $2,793 monthly, $33,516 yearly

Family of 2: $3,783 monthly, $45,396 yearly

Family of 3: $4,773 monthly, $57,276 yearly

Family of 4: $5,766 monthly, $69,192 yearly

 

Covered Benefits

This program covers a limited amount of services related to family planning, usually to be obtained at an initial or annual office visit. In order to receive the services for free, you can go to any family planning clinic that accepts ForwardHealth coverage, even if the clinic is not part of your HMO. If your medical provider cannot provide a service you need, they will give you a referral to a provider who is able to. To find out if a service is covered by certain provider in advance, you may call 888-362-3002. Family planning services available through this plan typically include:

  • Contraceptives
  • Family planning-related prescriptions
  • Natural family planning supplies
  • Screenings for STDs
  • Pap tests
  • Tubal ligation
  • Vasectomy (age 21 and older)
  • Routine preventive care related to family planning

 

Temporary Enrollment

Family Planning Only Services are immediately available to individuals who need them. If you have met all of the program criteria according to a qualified provider, you can receive services as soon as possible. Without having formally applied for the Family Planning Program, those who are approved get coverage from the day they complete the Temporary Enrollment for Family Planning Only Services form. Coverage begins on the date you were temporarily enrolled and last until the end of the second month after that date. In order to continue your benefits, you must apply for the regular Family Planning Only Services program.

 

How to Apply

To apply for coverage that lasts for a full year, contact Member Services to apply by phone at 800-362-3002, or use the online application.

ACCESS Wisconsin

 

Resources

BadgerCare Plus: Family Planning for Women

BadgerCare Plus: Family Planning for Men

Contact BadgerCare Plus

800-362-3002 or 888-701-1251 (TTY)

dhs.wi.gov/em/customerhelp

 

 

Sources:

 

1. Wisconsin Department of Health Services. “BadgerCare Plus – Family Planning Only Services.” http://www.badgercareplus.org/fpw.htm.

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