FoodShare WIand

Kristin Hoffschmidt

Outreach and Training

WI Dept of Health Services

Health and Nutrition Programs

The presentation will cover:

• Wisconsin FoodShare

• BadgerCare Plus

• How to Apply with ACCESS

• Enrollment Assistance Tips

---------------------------------

Remember, when in doubt – apply!

•Family Care• Family Care Plus• Family Care Partnership

ForwardHealth Elderly, Blind or

Disabled • SSI Medicaid• SSI-related Medicaid• SSI state Supplement• SSI Caretaker

Supplement• Medicaid Purchase

Plan

• Qualified Medicare Beneficiaries (QMB)• Specified Low Income Medicare Beneficiaries (SLMB)• Qualifying Individuals (QI)

Medicare Savings Programs

Wisconsin Chronic Disease

Program

• Chronic Renal Disease• Cystic Fibrosis• Hemophilia

Family Planning Waiver

•Standard Plan•Benchmark Plan•Core Plan•Core Plus

Other Long Term Care•Community Waivers • Institutions• Katie Beckett

WI Well Woman Program

WI Well Woman Medicaid

What is FoodShare?

• FoodShare Wisconsin helps low-income families and individuals to buy food

• The FoodShare benefit amount is based on household size, income, and expenses

• The average benefit is around $194/month

Wisconsin QUEST Card

•Functions like a debit card with a PIN number

•Balance information available on receipts or by calling QUEST Customer Service (1-877-415-5164)

What is the Goal of BadgerCare Plus?

To expand access to comprehensive, affordable health care to more children,families, and pregnant women in Wisconsin.

Youth Exiting

Out of HomeCare

Children

Parents of Children

0-18

Caretaker Relatives

of Children0-18

Parents with

Children in Foster Care

300%

200%

BadgerCare Plus Coverage

PregnantWomen

NO INCOME LIMITF

amil

y I

nco

me

as

a P

erc

enta

ge

of

Fed

eral

Po

vert

y L

evel

Self-EmployedAnd Farm Parents

Participants must not have health insurance access (employer pays ≥80% of premium)*; be US citizen or qualified immigrant*; and be a WI resident.*Some exceptions apply

100%

Pay deductible if above 300%

Eligible for Express Enrollment in addition to regular full-benefit BadgerCare Plus

150%

<1 1-18

250%

Who May Be Eligible?

• BC+ benefits are for individuals who do not have access to employer-sponsored health insurance in which the employer pays for 80% of the premiums, with some exceptions

• Applicants must be WI residents• Applicants must be US citizens or qualified

immigrants (except for BC+ Prenatal Program and Emergency Services)

Who May Be Eligible?• Children

• Pregnant women

• Young adults aging out of foster care

• Parents or relatives caring for a child

• Parents with children in out of home care

• Farm and other self-employed families

Eligibility Details: Children

• Children under age 19, regardless of income

• Children above 200% FPL have premiums

Eligibility Details: Pregnant Women

• Pregnant women with incomes up to 300% of FPL* ($63,599 for a family of 4)

• A pregnant woman with income

over 300% of FPL can become

eligible by meeting a deductible.

• Pregnant women do not have

to pay a premium.

Eligibility Details: Youths Exiting Foster Care

• Youth who turn 18 on or after Jan. 1, 2008 and are under age 21 are eligible.

• No income limits

• Access to health care

insurance is not

considered a barrier

to enrollment.

Eligibility Details: Parents

• Parents or relatives caring for a child with incomes up to 200% of FPL ($42,400 for a family of 4)

• Parents with children in out of home care who are working on a reunification plan for their children to return home

• Farm and other self-employed families with incomes up to 200% of FPL after depreciation is subtracted ($42,400 for a family of 4).

Access to Other Insurance

• In general, BadgerCare Plus (BC+) benefits are for families who do not have access to affordable employer-sponsored health insurance

• However, when it is determined cost effective:– Families with incomes under 150% of FPL who have

employer-sponsored insurance may be able to use BC+ to pay premiums, co-insurance, and deductibles

– Children with incomes greater than 150% of FPL who have employer-sponsored insurance may be able to qualify for BC+ by meeting a dedutible

• There are some “good cause” reasons for failure to enroll in an employer sponsored health insurance plan.

Member Expenses

• Members have small co-payments for most services, doctor visits, and prescription drugs.

• Members at higher income levels pay premiums. Examples:– Children in families with incomes above

200% of FPL– Parents and caretakers with incomes above

150% of FPL

Member Premiums• The average premium amount for those who

pay premiums is around $30 / month.– Children: Between $10 - $90.74/month– Adults: Between $10 to $286/month

• Most families with incomes at or below 300% of the FPL will not pay more than 5% of their total income for their premiums.

• For more information on premiums, see www.emhandbooks.wi.gov/bcplus; click on Tables; and then 48.1 Premiums.

Youth Exiting

Out of HomeCare

Children 0- 18

Parents of Children

0-18

Caretaker Relatives

of Children0-18

Parents with

Children in Foster Care

300%

200%

Benchmark Plan Standard Plan

BadgerCare PlusBenefits Plans

PregnantWomen

Self-Employed Parents

Fam

ily

In

com

e a

s a

Per

cen

tag

e o

f F

eder

al P

ove

rty

Lev

el

Participants must not have health insurance access (employer pays ≥80% of premium)*; be US citizen or qualified immigrant*; and be a WI resident.*Some exceptions apply

100%

150%

Pay deductible if above 300%

Pay premium if between 150 and 200%

NO INCOME LIMIT

Some may have the Benchmark Plan

Benefits Include:• Doctor and clinic visits • Prescription drugs• Prenatal and maternity care• Inpatient and outpatient hospital services• Emergency room visits• Nursing home stays• Laboratory and x-ray services• Medical supplies and equipment• Dental and vision services• Mental health and substance abuse• Day treatment services• Nursing services

Member Card

The new card says “Forward Health”.

People who were BadgerCare members may still be able to use their old card.

How Do I Enroll?

• On-line using access.wi.gov

• Call Member Services at 1-800-362-3002

• In person at a local county or tribal agency

• Some medical providers and community- based organizations can provide Express Enrollment

ACCESS: Your Key to Health and

Nutrition Programs

access.wi.gov

• Am I Eligible?– 15 minute self-assessment tool (launched 8/04)

• Apply For Benefits – application for FoodShare, Medicaid and the Family Planning Waiver program (launched 6/06). Upgraded to include Elderly, Blind or Disabled Medicaid application information in 6/07.

• Check My Benefits – personalized, up-to-date benefit information (launched 9/05)

• Report My Changes – online change reporting (launched 9/06)

Overview of https://access.wi.gov

Simple 15-minute screening for:– FoodShare– All subprograms of Medicaid– SeniorCare and Medicare Part D– Women, Infants and Children (WIC)– The Emergency Food Assistance Program– School meals and summer food – Tax credits (EITC, Homestead and Child Credit)– Home Energy Assistance

Personalized results and “next steps” for applying 96% of those who completed the self-assessment were

potentially eligible for at least 1 program

Am I Eligible?

• Online application for FoodShare, Medicaid, and/or the Family Planning Waiver Program.– Questions for Elderly, Blind or Disabled (EBD)

applicants were added on 6/22/07, and EBD applicants in need of long-term care now must use ACCESS to apply for benefits.

• A full application takes 30 to 60 minutes to complete, depending on household size, reading speed, and computer skills. Customers may save their application and finish it later.

Apply For Benefits (AFB)

• The customer signs the application electronically and it is immediately sent to the local agency for processing

• Applications are processed within 30 days.

• FoodShare applicants must meet with a worker or speak to them by phone to complete the application process.

Apply For Benefits (AFB)

• Access to up-to-date information about benefits without having to call local agency

• User creates a secure account with a user ID and password – Enter Social Security Number, date of birth, and either

their case number, FoodShare card number, or Medicaid/Forward Health card number

– Customers without a Social Security Number can use their PIN – ask the worker for more information

• Benefit information sent directly from the CARES system

Check My Benefits (CMB)

• Report changes in employment, address, income, housing and utility bills, and household composition (someone moved in or out of the home, got married / divorced, had a baby, etc.)

• To report changes, users must create a secure account through Check My Benefits

• Like AFB, customers receive a tracking number and a printable copy of their change report

• They may also track the status of the change through Check My Benefits

Report My Changes (RMC)

• If you’d like to try out the online application without applying for benefits, please use:

–trn.access.wisconsin.gov

–This version of ACCESS is only for testing and training

ACCESS Resources

Enrollment Assistance Tips

To ensure the best health care service for your clients, remember the steps to successfully applying and staying enrolled:

1 - Completing the Application

2 - Required Documentation

3- Staying Enrolled

Completing the Application

Best practice suggestions:

• Give the applicant a copy of the printed application after submitting it on ACCESS.

• Provide a folder so they can keep all of their paperwork together (such as the Guide to Applying, Enrollment and Benefits Handbook, letters, notices, etc.).

Required Documentation

Best practice suggestions:• Show the applicant the documentation

list in the Guide to Applying

• Make a follow-up appointment for the applicant to bring in their documentation

• Write the application tracking number on all of the documentation sent to the county or tribal agency.

Staying EnrolledBest practice suggestions:• Applicant can set up an account to use “Check

My Benefits” and “Report My Changes” online• Remind the applicant of the importance of

following enrollment guidelines:– Keep appointments and show the

ForwardHealth Card at appointments– Read all letters and notices carefully and

respond to them quickly– Report changes within 10 days– Complete the annual review on time

BadgerCare Plus Core Plan• Health coverage for adults without

minor children in April 2009• Some proposed eligibility requirements:

–Age 19 to 64–At or below 200% of FPL

• Updates at badgercareplus.org

Where to Get Information

QUEST Customer Service877-415-5164

WI Medicaid Member Services 800-362-3002

WI FoodShare Websitedhs.wi.gov/foodshare

BadgerCare Plus Websitebadgercareplus.org