Resource Binder
Health Insurance
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**Please include necessary documents**
Health Insurance Options: Information for Navigators
Patients can enroll in the following health insurance options:
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Employer covered Health Insurance: Does the patient have the option to get health insurance from their employer? Is this an affordable option?
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They will have to talk to their employer about signing up for the insurances. Mostly likely there is an enrollment time around the start of employment and during enrollment period.
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Medicare: To qualify for Medicare you must be 65 or over, receiving Social Security Disability (SSDI), OR have end-stage kidney disease.
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Can apply online at medicare.gov or calling 1-800-242-1060
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BadgerCare Plus (Wisconsin’s Medicaid): This program is for low-income adults, parents, and children to get health coverage.
Apply at https://access.wisconsin.gov/
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The Marketplace: The marketplace is a place were people can find private insurance and potentially receive financial help. Financial help is based on income.
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Open Enrollment is from November 1st to December 15th.
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If is outside the deadline, patients can still sign up if they experience a life change.
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Loss of coverage – loss of employer coverage from a job, turning 26 and losing parent’s insurance or other.
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Release from incarceration
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Changes in Household size - Birth or adoption, Marriage, divorce, legal separation, death
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Immigration – Gain of citizenship or lawful presence in the U.S.
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Moving – A permanent move out of county that results in access to new plans.
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Tribal Membership – Member of a federally recognized tribe may enroll at any time.
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To begin enrollment – healthcare.gov or 1-800-318-2596
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Dual Eligible Specials Needs Plan: Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans for people who qualify for both Medicare and Medicaid. D-SNPs offer more specialized care and coordination of benefits. More information can be found at medicare.gov or by calling 1-800-242-1060.
Access Wisconsin
updated 3.8.2025
About this resource: ACCESS Wisconsin helps individuals apply for and manage Wisconsin benefits and programs in one place, at any time.
Included ACCESS programs:
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BadgerCare Plus
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Emergency Assistance Program
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Family Planning Only Services
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FoodShare
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Job Access Loans
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Medicaid
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Wisconsin Shares Child Care Subsidy Program
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Wisconsin Works
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You can also submit a pre-application for the Women, Infants, and Children (WIC) Program.
Who can use this resource? US Citizens and legal residents are eligible for all the programs if they meet program requirements (eg. income, age...etc.). Undocumented clients are eligible for WIC and pre-natal care.
Next Steps: Apply online here OR call the Dane county office 888-794-555 for assistance.
Covering Wisconsin
updated 3.8.2025
Phone: (608) 261 1455
Website: coveringwi.org
About this resource: Covering Wisconsin helps connect Wisconsin residents with appropriate insurance coverage and other programs that support health. Covering Wisconsin provides help enrolling in Health Insurance Marketplace and BagerCare Plus. Covering Wisconsin provides free, expert help to anyone in Wisconsin to understand, access, use, and keep health insurance.
Who can use this resource? Any Wisconsin resident. They provide up to date information for all residents irregardless of immigration status.
See this page for community resources for Immigrants seeking healthcare. Materials are printable.
Next Steps:
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Call (608) 261-1455 to speak to a Covering Wisconsin navigator in the Madison office.
Capital Consortium
Phone: 1-888-794-5556
About this resource: Capital Consortium determines enrollment for certain benefits, like Medicaid, and provides case management. Capital Consortium also provides Medicaid coverage for pregnant women as well as emergency services for immigrants. No one is ever reported to Immigration and Naturalization Service.
Who can use this resource? Anyone
Next Steps:
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Call 1-888-794-5556 to speak with a Capital Consortium Representative.
**They are able to take calls in English, Spanish, and Hmong at this time.
Health Insurance Assistance- Not Updated
Contact:
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Cari Torales (bilingual-Spanish)
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Economic Support Specialist
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Dane County Department of Human Services
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(608) 288-2504
About:
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For uninsured and underinsured UW Health patients only
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If patient is looking to enroll in Medicaid/Badgercare or Medicare, they can get direct assistance from a Dane County worker with filling out applications. She also has the capability to check the status of applications.
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Send patient ID to dmaglaque@uwhealth.org if one of your patients can benefit from this direct assistance.