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 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? |
|---|---|---|---|
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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.
- Enrollment Criteria for Partners and Providers to Provide Express Enrollment of Children in BadgerCare Plus, F-11318 (PDF)
- ForwardHealth Portal Express Enrollment Partner Application
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.
Express enrollment training
The presentation meets the Express Enrollment training requirement for partners, providers, and qualified hospitals that are approved by ForwardHealth to complete Express Enrollment applications.
Express Enrollment Training for Partners, Providers, and Qualified Hospitals
Resources
- Chapter 12 of the ACCESS Handbook
- Example of the letter to members about temporary enrollment has ended (PDF)
- Example of the letter to members about temporary enrollment has been extended (PDF)
Contact Information
For questions about Express Enrollment, please email us at dhsforwardhealthpartners@dhs.wisconsin.gov.