Access Public Benefits

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Wisconsin Medicaid: a joint state and federal program that provides health care coverage for the state’s citizens who have a very low income and people with qualifying disabilities. Medicaid also covers pregnant women and children. Visit this website to learn more about Medicaid Programs in Wisconsin: https://www.dhs.wisconsin.gov/medicaid/index.htm 

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• BadgerCare Plus: This is the main term that you will hear to describe Wisconsin's Medicaid. It is sometimes informally referred to as just BadgerCare. BadgerCare Plus targets low income Wisconsin residents.  

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Patients can visit https://access.wisconsin.gov/access/ to determine eligibility and apply for either of these programs.

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Navigators can visit https://www.dhs.wisconsin.gov/medicaid/index.htm for more information on Medicaid. 

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Wisconsin Medicare: a federal program that provides health care coverage to people over the age of 65. A person can also qualify if they have been diagnosed with end-stage renal disease or ALS (Lou Gehrig’s disease) or if a person has certain disabilities.

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• Original Medicare (same regardless of what state you live in)

  • Part A: hospital coverage includes hospital services, some home health care, nursing home care, and hospice

  • Part B: medical coverage includes preventative doctor visits, outpatient care, ambulance service, screenings and tests, and some medical equipment

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After you enroll in original Medicare, you can also enroll in Medicare Advantage (Part C), Medicare Supplement (Medigap plan) or Prescription Drug Coverage (Part D).

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• Medicare Advantage (sold through private insurance companies)

  • Part C: offers prescription drug coverage, vision, dental and hearing coverage, over-the-counter pharmacy allowances, non-emergency transportation, group fitness classes, and more!

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• Prescription Drug Benefit (sold through private insurance companies)

  • Part D: offers prescription drug coverage. You will have a deductible to meet before coverage kicks in. For 2020, the maximum deductible is $435. There also is a spending limit ($4,020 in 2020). If you go over the spending limit, you will have to pay a copay on every prescription that you purchase.

 

Patients can apply for Wisconsin Medicare through Social Security:

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Apply online at https://www.ssa.gov/benefits/medicare/

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OR

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Call 1-800-772-1213 Monday through Friday from 7:00 AM-7:00 PM

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OR

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Apply in person at your local Social Security office.

 

Navigators can visit https://www.medicareplanfinder.com/medicare-by-state/the-ultimate-guide-to-wisconsin-medicare/ for more information on Medicare.

 

**Individuals can be enrolled in Medicaid and Medicare at the same time.

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Health Insurance Marketplace: this is a platform which offers private health insurance plans to individuals, families, or small businesses. People will usually pay a monthly premium to their insurance company (regardless of whether they receive any medical services) and usually must meet their deductible before coverage kicks in. ** Does not include dental **