CHIP in Wisconsin

LOOKING FOR ADDITIONAL INFORMATION?

The Wisconsin Children’s Health Insurance Program (CHIP) allows thousands of low-income families to afford quality health care for their children every year. Residents who know how to apply for CHIP in Wisconsin can receive essential health care services for children. These services include check-ups, tests, prescriptions, emergency services and more. Many often ask, “Is CHIP considered Medicaid?” due to the close relationship between the two programs and with many states providing CHIP coverage through an expansion in Medicaid as a separate program or as a combination of the two. Like most states, Wisconsin’s CHIP program is a combination of the two strategies, with some residents covered through a Medicaid-funded CHIP program and others covered through a separate program altogether. The following paragraphs provide information about the Children’s Health Insurance Program in Wisconsin, explaining its connection to Medicaid and providing information about the application steps and requirements for eligibility.

Overview of CHIP in Wisconsin

Most of the Wisconsin CHIP and Medicaid enrollment is managed through a service known as the BadgerCare Plus, a program that offers health care coverage to all Wisconsin residents who meet certain income eligibility requirements. Wisconsin incorporates CHIP into BadgerCare Plus, unlike other states that offer a separate service specifically for the Children’s Health Insurance Program. Besides covering children enrolling in CHIP and Medicaid, BadgerCare Plus also provides health care coverage for pregnant women and adults younger than 65 years of age. As a result, those applying for Medicaid or CHIP in Wisconsin may do so by completing just one convenient application. The Wisconsin Department of Health Services (DHS) will then determine an applicant’s eligibility based partly on his or her income.

“What is covered by CHIP Medicaid in Wisconsin?” is a question prospective applicants often ask when they consider enrolling in CHIP and Medicaid. Under BadgerCare Plus, Wisconsin residents are eligible to receive coverage for check-ups, hospital care, emergency services, drug prescriptions, rehabilitation services, lab visits, X-rays and much more. The WI Children’s Health Insurance Program also covers dental and mental health services. Those interested may apply for CHIP or Medicaid coverage under BadgerCare Plus at any time without needing to wait for specific enrollment periods. Coverage under Medicaid and the Children’s Health Insurance Program (CHIP) begins once the Wisconsin DHS receives a petitioner’s completed application. Applicants eligible for Medicaid or CHIP who have unpaid medical bills in any of the three months prior to their application date may receive “backdated coverage” for those bills provided their income during those months qualifies them for coverage.

Find comprehensive information about the requirements of Medicaid and how to apply to the program successfully in our in-depth guide.

What is CHIP Medicaid in Wisconsin?

Understanding the difference between Children’s Health Insurance Program and Medicaid for children in Wisconsin can be challenging due to the close relationship between the two programs in the state. Both CHIP and Medicaid are under the name “BadgerCare Plus,” which makes it difficult for residents to distinguish. Fortunately, this also means most applicants will not have to worry about determining whether their children qualify for one program or the other, as the Wisconsin DHS has one application for both programs. Even if parents from households do not meet the requirements for Medicaid eligibility children from the same household can enroll in CHIP benefits. 

Whether receiving Medicaid coverage or benefits from CHIP, children enrolled in BadgerCare Plus receive help paying for all covered services, including dental, mental and medical services. However, depending on income limits, households making more money may be subject to monthly premiums and small copayments for drug prescriptions and certain services covered by CHIP Medicaid in WI.

CHIP Eligibility in Wisconsin

To be eligible for the Children’s Health Insurance Program (CHIP) in Wisconsin, a child must be a resident of the state, be younger than 19 years of age, have U.S. citizenship or be a qualified non-citizen. Medicaid for Wisconsin children shares these same basic requirements. CHIP and Medicaid enrollment eligibility differ when it comes to income thresholds. To be eligible for WI CHIP coverage, children must live in families with monthly incomes at or below roughly 300 percent of the federal poverty level (FPL). However, households with incomes on the higher end of the limit may have to pay for premiums and copayments. To meet Medicaid eligibility children must live in households with even lower gross income.

How to Apply for CHIP in Wisconsin

For those wondering how to apply for the Children’s Health Insurance Program (CHIP) in Wisconsin, the state’s Department of Health Services offers multiple options. Parents and guardians of CHIP and Medicaid eligible children may apply for BadgerCare Plus online, in person, by phone, mail or fax. To enroll in Wisconsin Medicaid or CHIP, applicants will need their names, Social Security Numbers or proof of immigration status, income information and the policy numbers of any existing health insurance plans.

Those interested in applying for CHIP are able to do so online on the Wisconsin’s official website. Services like children’s Medicaid and Wisconsin FoodShare can also be accessed through the online application. Those interested in applying in person or by phone should contact their nearest DHS locations. Finally, to apply by mail or fax, petitioners in Milwaukee County should send their completed applications to:

MDPU
PO Box 05676
Milwaukee WI 53205

Fax: 1-888-409-1979

Those living in other counties should send their completed applications to:

CDPU
PO Box 5234
Janesville, WI 53547-5234

Fax: 1-855-293-1822

Download our free guide for more information about Medicaid coverage and benefits for approved applicants.