Medicaid Coverage

Foster Care Medicaid refers to all Medicaid provided by the Department of Children and Families (DCF). It is sometimes called Title XIX Medicaid or “straight MA.”

Children and youth who receive Foster Care Medicaid include those placed in out-of-home care through a court order (such as with relatives or in a licensed foster home). It also includes those with an active Adoption Assistance or Subsidized Guardianship Agreement.

Foster Care Medicaid is a full benefit, fee-for-service plan. There are no co-pays, premiums, or deductibles. Household income does not impact eligibility for Foster Care Medicaid.

Coverage under Foster Care Medicaid is the same as coverage under BadgerCare Plus. 

  • To browse a general list of services covered by Foster Care Medicaid, visit the Wisconsin Department of Health Services list of covered services.
  • To find medical, mental health, and dental providers in your area who accept Foster Care Medicaid, visit the ForwardHealth Provider Directory. Please note that providers on this list may not all be accepting new patients; call the provider to find out.
  • To ask whether a specific, specialized service can be covered by Foster Care Medicaid, call ForwardHealth Member Services at (800) 362-3002. 

Children and youth who are covered by Foster Care Medicaid should receive a ForwardHealth Medicaid ID card. If you need a replacement Medicaid ID card, ask a child welfare professional or call ForwardHealth Member Services at (800) 362-3002.

Who do I contact if...?

  • There's an issue with my insurance billing.
  • My child is also covered by private insurance, and there is an issue with billing.
  • I want to know if Foster Care Medicaid covers a specific service.
  • I need to report that my child is also covered by private insurance.
  • I want help finding a provider in my area.

ForwardHealth Member Services
(800) 362-3002

  • I need to report that my address has changed.
  • I want to disenroll my child from Foster Care Medicaid.
  • I need to update or correct a name, date of birth, or social security number.
  • I need to add or remove a parent from my child's ForwardHealth record.
  • The wrong name for my child is listed on the ForwardHealth record.
  • My child's medical providers won't speak to me because I am not listed on the ForwardHealth record.
  • My child's medical providers are saying that my child does not have active coverage.
  • I have another question not covered here.

Department of Children and Families 
Medicaid Program
(833) 543-5246

  • I want to request transportation to non-emergency medical services.
  • I want to request mileage reimbursement for travel to medical services.

Medical Transportation Management (MTM)
(866) 907-1493
https://mtm.mtmlink.net/#/

When does Foster Care Medicaid end?

After children and youth leave out-of-home care, and after Adoption Assistance and Subsidized Guardianship Agreements end, Foster Care Medicaid doesn’t end right away. Foster Care Medicaid lasts an additional 3 to 12 months to give families time to find other health care coverage for their children. This is often referred to as the “grace period.” Learn more about using Foster Care Medicaid during the grace period (DCF-P-5723).

To find out when a child’s Foster Care Medicaid will end, call (833) 543-5265 or contact a child welfare professional you have worked with, such as:

  • An ongoing case manager from your county or Tribe
  • The individual completing your Subsidized Guardianship annual reviews
  • Any Adoption Assistance Program staff

ForwardHealth should mail a notice before a child’s Foster Care Medicaid ends. Make sure to inform DCF if your address changes so that this notice is sent to the right place. Call (833) 543-5265 to report an address change during the grace period.

Click on the boxes below to learn more about Medicaid coverage for different populations.

Children in Out-of-Home Care

Children placed in out-of-home care are eligible for Foster Care Medicaid in Wisconsin regardless of the type of placement or financial assistance their caregiver may be receiving (e.g., kinship care). Foster Care Medicaid is renewed annually during the out-of-home care placement episode. 

While in out-of-home care, children should receive medical care based on the HealthCheck schedule. See the HealthCheck Benefits Brochure for more information. 

Children in some counties may be eligible for additional health care benefits through the Care4Kids program.

If a child is placed in another state through the Interstate Compact on the Placement of Children (ICPC), the child may or may not be automatically eligible for Medicaid in that state, depending on the child’s Title IV-E eligibility status and the other state’s policies. Wisconsin ICPC professionals will help determine whether children are eligible in the new state and will facilitate the transfer of Medicaid if possible.

For more information on Foster Care Medicaid for children in out-of-home care, ask a child welfare professional or contact the DCF Medicaid Program at 833-543-5265. 

Children with Active Adoption Assistance Agreements

Children with an Adoption Assistance Agreement are eligible for Foster Care Medicaid while the agreement remains active, plus a grace period.

If the child is also covered by private insurance, the private insurance will always be billed as the primary insurance for any service it covers. Foster Care Medicaid will be billed as secondary insurance for anything not covered by the private insurance but covered by Foster Care Medicaid.

Moving out of Wisconsin? In nearly all cases, Foster Care Medicaid can be transferred to the new state for Adoption Assistance recipients through the Interstate Compact on Adoption and Medical Assistance (ICAMA). 

Prior to moving or as soon as possible after moving, notify the Adoption Assistance Program at (866) 666-5532 of the date of the move and your address in the new state. A referral will be sent to the new state to have your child enrolled in Medicaid there. 

Some states take several weeks to enroll a child who has moved from another state. It is important that you notify the Wisconsin Adoption Assistance Program as soon as possible to avoid gaps in coverage for your child. We also recommend stocking up on at least one month’s worth of any necessary prescriptions prior to leaving Wisconsin.

For more information on Foster Care Medicaid for children receiving Adoption Assistance, see Adoption and Medical Assistance: Frequently Asked Questions (FAQs) or contact the DCF Medicaid Program at (833) 543-5265.

Children with Active Subsidized Guardianship Agreements

Children with a Subsidized Guardianship Agreement are eligible for Foster Care Medicaid while the agreement remains active, plus a grace period.

If the child is also covered by private insurance, the private insurance will always be billed as the primary insurance for any service it covers. Foster Care Medicaid will be billed as secondary insurance for anything not covered by the private insurance but covered by Foster Care Medicaid.

Moving out of Wisconsin? In some cases, Foster Care Medicaid can be transferred to the new state for Subsidized Guardianship recipients through the Interstate Compact on Adoption and Medical Assistance (ICAMA). 

Prior to moving or as soon as possible after moving, notify your Subsidized Guardianship professional and the DCF Medicaid program (833-543-5265) of the date of the move and your address in the new state. The DCF Medicaid program will help determine whether Medicaid can be transferred to the new state. If eligible, a referral will be sent to the new state to have your child enrolled in Medicaid there. More information is available on the County/State Subsidized Guardianship and Out-of-State Medicaid: Guidance for Child Welfare Professionals (DCF-P-5676) info sheet.

Some states take several weeks to enroll a child who has moved from another state. It is important that you notify the DCF Medicaid program as soon as possible to avoid gaps in coverage for your child. We also recommend stocking up on at least one month’s worth of any necessary prescriptions prior to leaving Wisconsin.

For more information on Foster Care Medicaid for children under a Subsidized Guardianship, ask your Subsidized Guardianship worker or contact the DCF Medicaid Program at 833-543-5265. 

Children in Private Pre-Adoptive Placements

Children placed in pre-adoptive homes by private agencies are eligible for up to 12 months of Foster Care Medicaid in Wisconsin. This coverage is not mandatory. It may be the child’s sole coverage or may be in addition to private insurance, if available.

The private agency will contact the Department of Children and Families (DCF) to enroll the child in 12 months of Foster Care Medicaid. For infants, coverage starts from the date of birth. For older children, the date of placement is the start date for Foster Care Medicaid.

For more information on Foster Care Medicaid for children in private pre-adoptive placements, see Medical Assistance for Private Pre-Adoptive Placements: Frequently Asked Questions (FAQs) or contact the DCF Medicaid Program at 833-543-5265. 

Former Foster Care Youth

Youth who were placed in out-of-home care, regardless of the placement setting or financial assistance their caregiver was receiving (e.g., kinship care), or under an active Subsidized Guardianship Agreement on their 18th birthday may be eligible for BadgerCare Plus until their 26th birthday. 

These youth must meet some eligibility requirements, but no income test is required. BadgerCare Plus for former foster care youth has no premiums, but there may be a small co-pay for some services.

Youth approaching their 18th birthday should work a child welfare professional (e.g., ongoing case manager or adoption professional) to begin the process of applying for BadgerCare Plus for Former Foster Care Youth. The BadgerCare Plus - Former Foster Care Youth (FFCY) form (F-10184) can be completed by a child welfare professional to provide documentation that the youth was or will be in an eligible placement on their 18th birthday. Youth can then complete the ACCESS online application or apply via phone, mail, or in-person at their county or Tribal Income Maintenance (IM) Agency.

All states offer Medicaid to former foster care youth under the age of 26. Youth who move out of Wisconsin can contact their new state’s Medicaid program for more information.

More information is available in the 2022 memo on BadgerCare Plus Enrollment for Foster Foster Care Youth.

Parents, Caregivers, and Other Children and Adults

Parents, caregivers, and others who do not fall in any of the above categories are not eligible for Foster Care Medicaid. This includes children who are residing with relatives informally (without a court order) or under a court-ordered guardianship that is not subsidized.

It is important that everyone has high quality health insurance that meets their needs. Covering Wisconsin is a statewide program that can help anyone find health care coverage and other programs to support health.

Individuals may be eligible for BadgerCare Plus or another Medicaid program based on income, disability, and other life circumstances. To learn more about different types of Medicaid in Wisconsin, visit the Wisconsin Department of Health Services Medicaid information page. You can also contact your county or Tribal Income Maintenance (IM) Agency in person or via phone for more information or to apply.