Wis. ForwardHealth Online Handbook, Hospice, Topic #18777

ForwardHealth may complete real-time eligibility determinations for BadgerCare Plus and/or Family Planning Only Services

applicants who meet pre-screening criteria and whose reported information can be verified in real time while applying in ACCESS

Apply for Benefits. Once an applicant is determined eligible through the real-time eligibility process, they are considered eligible

for BadgerCare Plus and/or Family Planning Only Services and will be enrolled for 12 months, unless changes affecting eligibility

occur before the 12-month period ends.

A member determined eligible through the real-time eligibility process will receive a temporary ID (identification) card for

BadgerCare Plus and/or Family Planning Only Services. Each member will get their own card, and each card will include the

member's ForwardHealth ID number. The temporary ID card will be valid for the dates listed on the card and will allow the

member to get immediate health care or pharmacy services.

Eligibility Verification

When a member is determined eligible for BadgerCare Plus and/or Family Planning Only Services through the real-time eligibility

process, providers are able to see the member's eligibility information in Wisconsin's EVS (Enrollment Verification System) in real

time. Providers should always verify eligibility through EVS prior to providing services.

On rare occasions, it may take up to 48 hours for eligibility information to be available through interChange. In such instances, if a

member presents a valid temporary ID card, the provider is still required to provide services, even if eligibility cannot be

verified through EVS.