MedicaidCoverageMedium impact
Introducing the Medicaid Purchase Plan, Family Care to begin in Portage and La Crosse counties, Long term care services covered under Family Care, What's new on the Medicaid Web site, Special advisory bulletin describes exclusion from federal health care programs
Wisconsin Medicaid (ForwardHealth)·WI · Geriatrics, Physical Therapy, Occupational Therapy +2 more·Medical Policy
Effective date
Mar 15, 2000
We identified it
Jun 20, 2026
Summary
Wisconsin introduces the Medicaid Purchase Plan allowing disabled adults with income below 250% FPL to purchase Medicaid coverage while working, and expands Family Care managed long-term care programs to Portage and La Crosse counties. Family Care covers only long-term care services with primary/acute care remaining fee-for-service.
Action Required
Immediately: Billing team must verify eligibility using EVS system codes 58 or 59 to identify Family Care-CMO enrolled members before providing services. Long-term care providers must join Family Care-CMO networks or obtain prior approval for reimbursement. Update eligibility verification procedures to check member enrollment status monthly as members can enroll/disenroll at any time.