ForwardHealth: Having Someone Help You with Eligibility or Benefits

They can act on your behalf in all matters related to eligibility and benefits.

They can act on your behalf for health care and FoodShare programs you’re applying for or are currently enrolled in.

Yes. They will get letters about your eligibility and benefits instead of you.

A conservator or legal guardian must be appointed by a judge or court order. You can appoint a power of attorney.

Yes. They must send copies of the documents that prove they are your conservator, legal guardian, or power of attorney to your local county or tribal agency. They cannot act on your behalf until your local agency has the documents.

An authorized representative is a person or organization that can act on your behalf. You need to give the person or organization permission to make decisions for you.

Any person or organization can serve as an authorized representative except for the following:

• Agency employees who help determine eligibility or benefits, except in certain circumstances when special written approval is given to them.
• Homeless meal providers for a homeless food unit. A food unit is one or more people who live together and buy and make food together.
• People who are disqualified for an intentional FoodShare Program violation, except when no one else is able to serve as an authorized representative.
• Retailers who are authorized to accept FoodShare benefits.

They can do any or all of the following on your behalf:

• Apply for or renew benefits
• Report information changes
• Work with your agency on benefits-related matters
• File grievances and appeals about your eligibility for programs

If you are applying for or enrolled in a health care program, such as Medicaid or BadgerCare Plus, you can also choose to have your authorized representative:

• Receive your ForwardHealth card (the card you use for the health care programs you’re enrolled in) instead of you
• Enroll you in an HMO (health maintenance organization)
• Talk to ForwardHealth Members Services or your HMO about a bill, services, or other medical information, included protected health information.
• File grievances and appeals about your health care services, such as those related to treatment and bills.

This only applies when your authorized representative is a person, not an organization. It can also only apply if you agree to the protected health information authorization on the Appoint, Change, or Remove an Authorized Representative: Person form, F-10126A.

Once they’re appointed, an authorized representative can act on your behalf for these programs:

• BadgerCare Plus
• Caretaker Supplement (accepts paper applications only)
• Emergency Assistance Program
• Family Planning Only Services
• FoodShare
• Job Access Loans
• Medicaid
• Wisconsin Works (W-2)

An authorized representative can’t act on your behalf for the Wisconsin Shares Child Care Subsidy Program. You must apply for that program on your own.

Yes. Your authorized representative can get copies of letters about your eligibility and benefits for the programs you apply for or are enrolled in currently. If you choose this option, you will also get letters.

This applies to these programs:

• BadgerCare Plus
• Caretaker Supplement
• Family Planning Only Services
• FoodShare
• Medicaid

If you choose for your authorized representative to receive copies of your letters and you’re enrolled in Wisconsin Works (W-2) or Wisconsin Shares Child Care Subsidy in addition to one of the programs above, they can also receive letter copies from these programs.

You can only have one at a time.

Yes. Your conservator, legal guardian, or power of attorney would have to appoint your authorized representative, though.

For BadgerCare Plus, Caretaker Supplement, Family Planning Only Services, FoodShare, and Medicaid, you can appoint an authorized representative through:

• The ACCESS website
• A paper form:
  • If your authorized representative is an organization: Appoint, Change, or Remove an Authorized Representative: Organization form, F-10126B
  • If your authorized representative is a person: Appoint, Change, or Remove an Authorized Representative: Person form, F-10126A
• The health insurance marketplace

Make sure you, your authorized representative, and at least one witness fill out all the required fields. If any are left blank, your authorized representative will not be able to act on your behalf.

To appoint an authorized representative for Wisconsin Works (W-2), go to Wisconsin Department of Children and Families Forms Search. Enter “DCF-F-DWSP2375” in the search box. You can then fill out and submit the form: Wisconsin Works (W-2) and Related Programs Authorization of Participant Representative (DCF-F-DWSP2375).

You can’t have an authorized representative for the Wisconsin Shares Child Care Subsidy Program.

You, your new authorized representative, and at least one witness must fill out and submit one of these forms:

• If your authorized representative is an organization: Appoint, Change, or Remove an Authorized Representative: Organization form, F-10126B
• If your authorized representative is a person: Appoint, Change, or Remove an Authorized Representative: Person form, F-10126A

You or the organization must let your local county or tribal agency know who the new contact person is either by phone or in writing.

You must let your agency know in writing. You can send a signed statement or do one of the following:

• If your authorized representative is an organization, fill out Part A and D of Section 1 of the Appoint, Change, or Remove an Authorized Representative: Organization form, F-10126B and submit it using the instructions on the form.
• If your authorized representative is a person, fill out Part A and E of Section 1 of the Appoint, Change, or Remove an Authorized Representative: Person form, F-10126A and submit it using the instructions on the form.

They can buy food for your household.

They can only act on your behalf for FoodShare.

Your Wisconsin QUEST card is a safe and easy way to buy your food. It’s a plastic debit card with your name, card number, and the Wisconsin QUEST logo on it.

You can only have one at a time.

Yes.

Yes.

Fill out and submit the Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits form, F-16004.

Fill out and submit the Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits form, F-16004. Make sure you write in the name of your new authorized buyer and the name of the authorized buyer you want to remove.

Do one of the following:

• Call your local county or tribal agency.
• Fill out and submit the Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits form, F-16004.

They can buy food for your household.

They can only act on your behalf for FoodShare.

Yes. Your alternate payee will get a QUEST card. You will not. The card will have your alternate payee’s name on it.

You can only have one at a time.

Yes.

Yes. Your alternate payee can also be your authorized representative.

No. You can have either an alternate payee or an authorized buyer but not both.

Both you and an authorized buyer get a QUEST card. Only an alternate payee gets one. You don’t.

Fill out and submit the Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits form, F-16004.

Fill out and submit the Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits form, F-16004. Make sure you write in the name of your new alternate payee, as well as the name of the alternate payee you want to remove.

Do one of the following:

• Call your local county or tribal agency.
• Fill out and submit the Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits form, F-16004.