WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #278
Persons Detained by Legal Process
Most individuals detained by legal process who are eligible for BadgerCare Plus or Wisconsin Medicaid benefits will have their
eligibility suspended during their detention period. During the suspension, ForwardHealth will only cover inpatient services
received while the member is outside of jail or prison for 24 hours or more.
Note: Detained by legal process means a person who is incarcerated because of law violation or alleged law violation, which
includes misdemeanors, felonies, delinquent acts, and day-release prisoners. Inmates who are released from jail under the Huber
Program to return home to care for their minor children may be eligible for full benefit BadgerCare Plus or Wisconsin Medicaid
without suspension.
Pregnant women detained by legal process who qualify for the BadgerCare Plus Prenatal Program and state prison inmates who
qualify for Wisconsin Medicaid or BadgerCare Plus during inpatient hospital stays may receive certain benefits and are not subject
to eligibility suspension. Additionally, inmates of county jails admitted to a hospital for inpatient services who are expected to
remain in the hospital for 24 hours or more will be eligible for PE (presumptive eligibility) determinations for BadgerCare Plus by
qualified hospitals. Refer to the Presumptive Eligibility chapter of either the Inpatient or Outpatient Hospital service area for more
information on the PE determination process.
The DOC (Department of Corrections) or county jail oversee health care-related needs for individuals detained by legal process
who do not qualify for the BadgerCare Plus Prenatal Program or for state prison inmates who do not qualify for Wisconsin
Medicaid or BadgerCare Plus during an inpatient hospital stay.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
d783d5adf73b8de909b12ee6ef79e6e90c669e0f359ddfe1ea96a65fccbefb6a
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