Benefits

BadgerCare Plus has two benefit plans—the Standard Plan and the Benchmark Plan. The plan you are in depends on your income. For example, most families with incomes below 200% of the Federal Poverty Level (which is $35,199.96 annual income for a family of three) will be in the Standard Plan. Families with incomes above 200% of the Federal Poverty Level will be in the Benchmark Plan. 

If you are currently enrolled in family Medicaid, BadgerCare, or Healthy Start, you will be enrolled automatically. If you are in an HMO now, you will not have to change your HMO.

• The Standard Plan has the same benefits you currently have.
• Co-payments for health care services will range from $.50 to $3.00. (See the exceptions to these co-payments.)
• There are no co-payments for well child checkups (HealthCheck) or other preventive services.

The new Benchmark Plan is for families with higher incomes and self-employed families, including farm families.

• Co-payments for health care services range from $2.00 per day for Hospice service and $100.00 for a hospital stay.(See the exceptions to these co-payments.)

• There are no co-payments for well child checkups (HealthCheck) or other preventive services.

Those in the Benchmark Plan will have some premiums. To see example premium rates, click here.

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