Wis. ForwardHealth Online Handbook, Hospice, Topic #23277

Children

Most children enrolled in BadgerCare Plus or Medicaid programs will keep their health insurance coverage for 12 months. Even if

their family has a change in income or other circumstances, children under age 19 will have coverage at least until their next

renewal. This policy is required by the federal Consolidated Appropriations Act, 2023.

Children enrolled in Foster Care Medicaid or SSI Medicaid will have 12-months of continuous coverage even if their out-of-home placement, subsidized guardianship, court-ordered kinship care, adoption assistance agreement, or SSI payment ends.

Qualifying Programs

Members under age 19 in the following programs qualify for continuous coverage:

• BadgerCare Plus

• Emergency Services Medicaid

• Family Planning Only Services

• Foster Care Medicaid

• HCBW (Home and Community-Based Waiver) Medicaid

• Institutional Medicaid

• Katie Beckett Medicaid

• MAPP (Medicaid Purchase Plan)

• Medicare Savings Programs

• Special Status Medicaid

• SSI (Supplemental Security Income)-Related Medicaid

• SSI Medicaid

• Tuberculosis-Related Medicaid

• Wisconsin Well Woman Medicaid

Exceptions to Continuous Coverage

Continuous coverage does not apply to children:

• Enrolled under presumptive eligibility, also known as Express Enrollment.

• Enrolled by meeting a deductible. These are members who become eligible for up to a six-month period based on their

medical expenses.

Children remain eligible for the 12 months until their next renewal unless:

• They turn 19.

• They move out of Wisconsin.

• Their citizenship or immigration status is not verified.

• Their eligibility was based on inaccurate information or agency error.

• The family asks to end their coverage.

Assisting Members Through Enrollment Renewals

Helping families through the health care renewal process remains vital to keeping children covered. Providers are asked to remind

BadgerCare Plus and other Wisconsin Medicaid program members to renew their coverage, even if they think their situation will

change in the future. Members should also be reminded to tell their agency about any changes to their address, phone number, or

email to ensure they continue to receive important information about their health care coverage from Wisconsin DHS (Department

of Health Services).

Member Resources

Free Health Insurance Application and Renewal Assistance

Members who need help with applying for or renewing health care coverage can access the following resources:

• Covering Wisconsin (free expert help with health insurance), available at the WisCovered website

• 211 Wisconsin at 211 or 877-947-2211

Continuous Coverage and Health Care Renewal Information

Additional member resources regarding health care renewals and continuous coverage for children are available:

• Medicaid: Programs for Children web page

• Health Care Renewals web page

• "Keeping Kids Covered" 12-Month Continuous Coverage for Children fact sheet

• BadgerCare Plus: Frequently Asked Questions

Additional policy information on continuous coverage for children is available in the BadgerCare Plus Handbook.