MedicaidCoverageMedium impact
BadgerCare Expansion for Certain Pregnant Women
Wisconsin Medicaid (ForwardHealth)·WI · OB-GYN, Family Medicine·Medical Policy
Effective date
Jan 1, 2006
We identified it
Jun 20, 2026
Summary
BadgerCare expanded coverage to pregnant non-U.S. citizens who are not qualified aliens and pregnant individuals detained by legal process, effective January 1, 2006. These women are eligible for all Medicaid-covered services during pregnancy through delivery, but postpartum care is only reimbursable as part of global obstetric care.
Action Required
Immediately: Billing team must verify eligibility through EVS for pregnant women in these new categories before providing services. Update procedures to bill only fee-for-service (no managed care) for this population. For global OB care claims, ensure minimum of 6 antepartum visits are documented or postpartum care will not be reimbursed. Refer patients to county/tribal social services for coverage applications and newborn coverage separately.