WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #785
BadgerCare Plus Prenatal Program
As a result of 2005 Wisconsin Act 25, BadgerCare has expanded coverage to the following individuals:
• Pregnant non-U.S. citizens who are not qualified aliens but meet other eligibility criteria for BadgerCare.
• Pregnant individuals detained by legal process who meet other eligibility criteria for BadgerCare.
The BadgerCare Plus Prenatal Program is designed to provide better birth outcomes.
Women are eligible for all covered services from the first of the month in which their pregnancy is verified or the first of the month
in which the application for BadgerCare Plus is filed, whichever is later. Members are enrolled through the last day of the month in
which they deliver or the pregnancy ends. Postpartum care is reimbursable only if provided as part of global obstetric care. Even
though enrollment is based on pregnancy, these women are eligible for all covered services. (They are not limited to pregnancy-
related services.)
These women are not presumptively eligible. Providers should refer them to the appropriate income maintenance or tribal agency
where they can apply for this coverage.
Fee for Service
Pregnant non-U.S. citizens who are not qualified aliens and pregnant individuals detained by legal process receive care only on a
fee-for-service basis. Providers are required to follow all program requirements (for example, claim submission procedures, PA
(prior authorization) requirements) when providing services to these women.
Emergency Services for Non-U.S. Citizens
When BadgerCare Plus enrollment ends for pregnant non-U.S. citizens who are not qualified aliens, they receive coverage for
emergency services. These women receive emergency coverage for 60 days after the pregnancy ends; this coverage continues
through the end of the month in which the 60th day falls (for example, a woman who delivers on June 20, 2006, would be enrolled
through the end of August 2006).
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
bdb10985e9fa66ece496018594071554fb9ddead05b7100cc4dd1783e882508e
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