WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #4903
Copay Information
No Copay
If a member is enrolled in BadgerCare Plus or Wisconsin Medicaid and is exempt from paying copays for services, providers will
receive the following response to an enrollment query from all methods of enrollment verification:
• The name of the benefit plan
• The member's enrollment dates
• The message, No Copay
If a member is enrolled in BadgerCare Plus, Wisconsin Medicaid, or SeniorCare and is required to pay a copay, the provider will
be given the name of the benefit plan in which the member is enrolled and the member's enrollment dates for the benefit plan only.
Copay
If a member is enrolled in BadgerCare Plus, Wisconsin Medicaid, or SeniorCare and is required to pay a copay, providers will
receive the following response to an enrollment query from all methods of enrollment verification:
• The name of the benefit plan
• The member's enrollment dates
Non-Emergent Copay
If a member is enrolled in BadgerCare Plus and is eligible for the $8 non-emergent copay, providers will receive the following
response to an enrollment query from all methods of enrollment verification:
• The name of the benefit plan
• The member's enrollment dates
• The message, Member Eligible for Non-Emergent Copay or Eligible for Non-Emergent Copay
The messages Member Eligible for Non-Emergent Copay and Eligible for Non-Emergent Copay indicate that a member is a
BadgerCare Plus childless adult, and they are eligible for the copay if they do not meet the prudent layperson standard and seek
and receive additional post-stabilization care in the emergency department after being informed of the $8 copay and availability of
alternative providers with lesser or no cost share.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
4b549bd665ac26ef2f1e84d17021bf6b6793d94d9786d9140714bc8648d8071f
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