MedicaidCoverageHigh impact
Changes to BadgerCare Plus Due to the Affordable Care Act and 2013-15 Wisconsin Act 20
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Apr 1, 2014
We identified it
Jun 20, 2026
Summary
BadgerCare Plus (Wisconsin Medicaid) is eliminating multiple benefit plans and consolidating all eligible members into the Standard Plan effective April 1, 2014. Income eligibility thresholds are changing, with many populations transitioning to federal Health Insurance Marketplace coverage.
Action Required
By April 1, 2014: Billing team must verify member enrollment before rendering services as many BadgerCare Plus members will transition to private insurance through Health Insurance Marketplace. Update systems to reflect discontinuation of Benchmark, Core, and Basic Plans - all remaining members will be on Standard Plan only. Submit all claims for discontinued plans within 365 days of service date. For continuing services, existing prior authorizations will transfer automatically, but new PA requests must be submitted for any new services requiring authorization under Standard Plan.