BadgerCare Plus definition

BadgerCare Plus. The program that merges Family Medicaid, BadgerCare, and Healthy Start to form a comprehensive health insurance program for low income children and families. Coverage will include: All children (birth to age 19) with incomes above 185 percent of the Federal poverty level (FPL). Pregnant women with incomes between 185 and 300 percent of the FPL. Parents and caretaker relatives with incomes between 185 and 200 percent of the FPL. Caretaker relatives with incomes between 44 and 200 percent of the FPL. Parents with children in xxxxxx care with incomes up to 200 percent of the FPL. Youth (ages 18 through 20) aging out of xxxxxx care. Farmers and other self-employed parents with incomes up to 200 percent of the FPL, contingent on depreciation calculations.
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BadgerCare Plus means the Medical Assistance program described in this section.
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BadgerCare Plus to read: BadgerCare Plus: Effective January 1, 2014, the following populations will be eligible for BadgerCare Plus: • Parents and caretakers with incomes at or below 100 percent of the Federal Poverty Level (FPL). • Pregnant women with incomes at or below 306 percent of FPL. • Children (ages 18 and younger) with household incomes at or below 306 percent of the FPL. • Childless adults with incomes at or below 100 percent of the FPL. • Transitional medical assistance individuals, also known as members on extensions, with incomes over 100 percent of the FPL.
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Examples of BadgerCare Plus in a sentence

  • This is necessary because commercial health insurance is always primary to BadgerCare Plus.

  • BadgerCare Plus and Wisconsin Medicaid will not reimburse the provider if the commercial health insurance plan denied or would deny payment because a service otherwise covered under the commercial health insurance plan was performed by a provider outside the plan.

  • Except for emergency services and covered services that are not covered under the commercial health insurance plan, members enrolled in both a commercial health insurance plan and BadgerCare Plus or Wisconsin Medicaid (i.e., state-contracted MCO (managed care organization), fee-for-service) are required to receive services from providers affiliated with the commercial health insurance plan.

  • Topic #844 Claims for Services Denied by Commercial Health InsuranceIf commercial health insurance denies or recoups payment for services that are covered by BadgerCare Plus and Wisconsin Medicaid, the provider may submit a claim for those services.

  • Topic #601 Definition of Commercial Health InsuranceCommercial health insurance is defined as any type of health benefit not obtained from Medicare or Wisconsin Medicaid and BadgerCare Plus.

  • Providers are reminded that, except for a few instances, Wisconsin Medicaid, BadgerCare Plus, SeniorCare, and WCDP are payers of last resort for any covered service.

  • Wisconsin Medicaid and BadgerCare Plus are not payers of last resort for members who receive coverage from certain governmental programs.

  • The Explanation of Medical Benefits form requirement applies to paper claims and paper adjustments submitted to Wisconsin Medicaid, BadgerCare Plus, SeniorCare, and the WCDP (Wisconsin Chronic Disease Program).

  • If a member becomes retroactively enrolled in Wisconsin Medicaid or BadgerCare Plus after the provider has already been reimbursed by one of these government programs, the provider may be required to submit the claims to ForwardHealth and refund the payment from the government program.

  • Topic #16677 BadgerCare Plus Benefit Plan ChangesEffective April 1, 2014, all members eligible for BadgerCare Plus were enrolled in the BadgerCare Plus Standard Plan.

Related to BadgerCare Plus

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Nursing Care Plan means a plan of care developed by a nurse that describes the medical, nursing, psychosocial, and other needs of a child and how those needs shall be met. The Nursing Care Plan includes which tasks shall be taught, assigned, or delegated to the qualified provider or family.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Primary care physician or “PCP” means a Plan Provider who has an independent contractor agreement with HPN to assume responsibility for arranging and coordinating the delivery of Covered Services to Members. A Primary Care Physician’s agreement with HPN may terminate. In the event that a Member’s Primary Care Physician’s agreement terminates, the Member will be required to select another Primary Care Physician.

  • Care Plan means a licensee's written description of a resident's needs, preferences, and capabilities, including by whom, when, and how often care and services are to be provided.

  • Family child care provider means a person who: (a) Provides

  • Day Care Centre means any institution established for day care treatment of illness and/or injuries or a medical setup with a hospital and which has been registered with the local authorities, wherever applicable, and is under supervision of a registered and qualified medical practitioner and must comply with all minimum criterion as under -

  • Health care practitioner means an individual licensed

  • Pharmacy means prescribed drugs and medicines dispensed by a pharmacist and/or travel and allergy vaccines dispensed by a pharmacist or doctor.

  • child care centre means a building used for the daily accommodation and care of 6 or more children under 18 years of age in the absence of their parents or guardians;

  • Health care provider or "provider" means:

  • Child abuse means any of the following acts committed in an educational setting by an employee or volunteer against a child:

  • Child day care center and "center" means any place in which child day care is provided for thirteen or more children at one time or any place that is not the permanent residence of the licensee or administrator in which child day care is provided for seven to twelve children at one time. In counting children for the purposes of this definition, any children under six years of age who are related to a licensee, administrator or employee and who are on the premises of the center shall be counted.

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Child Care Program means a person or business that offers child care.

  • TRICARE means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, and all laws applicable to such programs.

  • Adult day care center means any facility that is either operated for profit or that desires licensure

  • Medical physicist means a person trained in evaluating the performance of mammography equipment and facility quality assurance programs and who meets the qualifications for a medical physicist set forth in 41.6(3)“c.”

  • Long-term inpatient care means inpatient services for

  • Nursing home-type patients means a patient who has been in hospital more than 35 days, no longer requires acute hospital care, cannot live independently at home or be looked after at home, and either cannot be placed in a nursing home or a nursing home place is not available.

  • Marihuana means that term as defined in section 7106 of the public health code, 1978 PA 368, MCL 333.7106.

  • small and medium-sized enterprises or ‘SMEs’ means micro, small and medium-sized enterprises as defined in Article 2 of the Annex to Commission Recommendation 2003/361/EC;

  • Homecare Worker means a provider, as described in OAR 411-031- 0040, that is directly employed by a consumer to provide either hourly or live-in services to the eligible consumer.

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Adult foster care means room and board, supervision, and special services to an adult who has a

  • Healthcare shall have the meaning set forth in the introductory paragraph hereof.