Express Enrollment

Member notice

You may be able to temporarily enroll in BadgerCare Plus or Family Planning Only Services if you need service right away and meet the eligibility criteria. This process is called Express Enrollment. It allows you to get the benefits you need while your program application is being completed and processed. Your health care provider or hospital would start your Express Enrollment. Some community partners may be able to start Express Enrollment for children. You cannot apply for temporary benefits on your own. If your provider cannot help you, call Member Services at 800-362-3002. They can tell you the qualified hospitals, providers, or partners near you.

Resources for hospitals, providers, and partners

Express Enrollment is the online application used in ACCESS (ACCESS in Spanish) to make presumptive eligibility determinations to temporarily enroll individuals in BadgerCare Plus or Family Planning Only Services until a full application is completed and processed. Presumptive eligibility determinations are based on preliminary household and financial information provided by the applicant. This process allows the applicant to receive immediate health care coverage, for a short period of time, while their full application for ongoing BadgerCare Plus or Family Planning Only Services is completed and processed.

Definitions

Express Enrollment: The process of making a presumptive eligibility determination to temporarily enroll an individual in BadgerCare Plus or Family Planning Only Services.
Presumptive eligibility: The determination of whether or not an applicant is eligible to enroll in BadgerCare Plus or Family Planning Only Services temporarily.
Temporary enrollment: Short-term eligibility for BadgerCare Plus or Family Planning Only Services.

Who can make presumptive eligibility determinations?

For children?	For pregnant people?	For Family Planning Only Services?	For adults younger than 65, parents, and caretakers?
Qualified hospitals Providers Partners	Qualified hospitals Providers	Qualified hospitals Providers	Qualified hospitals

Qualified hospitals and providers

Hospitals that are Medicaid-enrolled and certified through ForwardHealth for Express Enrollment are considered qualified. Qualified hospitals will be able to make presumptive eligibility determinations for children, pregnant people, adults, and Family Planning Only Services. Providers that are Medicaid-enrolled and certified through ForwardHealth as an Express Enrollment provider can make presumptive eligibility determinations for children, pregnant people, and Family Planning Only Services.

ForwardHealth Portal Provider Enrollment Information

Qualified hospitals and providers interested in making presumptive eligibility determinations may access the online provider enrollment application via their secure ForwardHealth account.

Partners

Partners who meet the Express Enrollment criteria and are certified through ForwardHealth as an Express Enrollment partner will be able to make presumptive eligibility determinations for children.

Note: This application is only for partners and will only allow the partner to make presumptive eligibility determinations for children. Hospitals and providers should access the online provider enrollment application via their secure ForwardHealth Portal account.