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Wisconsin Well Woman Medicaid

ForwardHealth operates a program that provides women at higher risk for common conditions such as breast and cervical cancer, and multiple sclerosis coverage for screenings and other services. The Wisconsin Well Woman Program (WWWP) gives women without health insurance, or who have a plan that does not cover such screenings, the ability to receive them at no cost. Services can be obtained from medical providers who participate in the program, though not every type of care is available through all providers. Administered by the Wisconsin Department of Health Services, Division of Public Health, this program is throughout the state’s 72 counties and 11 tribes. Without requiring premiums, deductibles, or copayments, women in Wisconsin can get essential screenings to keep them healthy.

If a woman is diagnosed with breast or cervical cancer, or a precancerous condition through WWWP, they may be eligible for Wisconsin Well Woman Medicaid (WWWMA). Women who enroll in WWWMA have access to care not only for their condition but full Medicaid benefits for any other health services. WWWMA is also available to women enrolled in Wisconsin Medicaid’s Family Planning Program and have been screened for and diagnosed with cervical or breast cancer, or a precancerous condition found through a Family Planning exam. To qualify for WWWMA, women must not be able to obtain coverage from any other public or private source for cancer treatment.

 

 

WWWP Requirements

As with every Medicaid program, the Wisconsin Well Woman Program has certain criteria to meet. Women must be residents of the state of Wisconsin, and age 45 through 64 to qualify. Some limited eligibility exceptions apply to women ages 35 through 44 year old, however. Income is also a factor, of course, and the program offers coverage to women who earn up to 250 percent of the Federal Poverty Level. Those who qualify also need to have proof of their lack of insurance coverage, or document that their current health plan does not cover these screenings.

 

Income Guidelines

Family of 1: $2,327 monthly, $27,925 yearly

Family of 2: $3,152 monthly, $37,825 yearly

Family of 3: $3,977 monthly, $47,725 yearly

Family of 4: $4,802 monthly, $57,625 yearly

Family of 5: $5,627 monthly, $67,525 yearly

Family of 6: $6,452 monthly, $77,425 yearly

Family of 7: $7,277 monthly, $87,325 yearly

Family of 8: $8,102 monthly, $97,225 yearly

Add $9,900 for each additional family member.

 

Covered Services

The Wisconsin Well Woman Program pays for screenings and diagnostic services to detect breast and cervical cancer, and Wisconsin Well Woman Medicaid covers the treatment of those conditions once diagnosed. WWWMA also provides coverage on all services offered by the traditional Medicaid program, from hospital care and emergency services to physician care unrelated to breast or cervical cancer treatment.

Services covered by WWWP include:

  • Pap tests
  • Screening mammograms
  • Clinical breast exams
  • Office visits for breast and/or cervical exams
  • Follow-up screenings
  • Diagnostic mammograms
  • Colposcopy and cervical biopsy
  • Breast ultrasound
  • Breast biopsy
  • Cervical endoscopy
  • Other diagnostic cervical procedures

Once diagnosed and approved for WWWMA, all medically necessary treatment services will be covered.

 

WWWMA Presumptive Eligibility

As treatment services are crucial to a woman’s health and survival when diagnosed with breast or cervical cancer, WWWMA offers a temporary Medicaid program for those in need of immediate care. Women who are waiting to find out if they qualify for full WWWMA benefits can apply for the Presumptive Eligibility program to receive instant coverage for breast and/or cervical cancer treatment. While coverage only lasts one month, commencing the date of diagnosis and ending the last day of the following month, you can receive free services for a short time. If you are approved for WWWMA, you will receive a member ID and all of your enrollment information in the mail, and your benefits will continue throughout the year.

 

How to Apply

Wisconsin Well Woman Program

Visit the county or tribal Well Woman coordinating agency nearest you, or a participating medical provider, fill out a form, and provide proof of age, income, and insurance status. Contact the Well Woman Program to locate a provider or agency and get more information at 608-266-8311.

Well Woman Program Agency List

Wisconsin Well Woman Medicaid

Enroll in Presumptive Eligibility to get access to benefits right away after being diagnosed through WWWP, then apply for Medicaid through the same agency or provider who diagnosed your condition. The provider will work with a Medicaid coordinator and help you complete your form and send it to the Department of Health Services. For more information call 800-362-3002.

 

Resources

Wisconsin Well Woman Program

Wisconsin Well Woman Medicaid

Contact WWWP: 608-266-8311

Contact WWWMA: 800-362-3002

 

 

Sources:

 

1. Wisconsin Department of Health Services. “Wisconsin Well Woman Program.” http://www.dhs.wisconsin.gov/womenshealth/wwwp/.

2. Wisconsin Department of Health Services. “Wisconsin Well Woman Medicaid – Wisconsin Medicaid Fact Sheet.” http://www.dhs.wisconsin.gov/medicaid/Publications/p-10065.htm.

3. Wisconsin Department of Health Services. “Appendix 5: WWWP Covered Breast & Cervical Cancer Screening Services.” pp 2-8.

 

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