BadgerCare Plus

• Choice of Doctors. Find a doctor you trust in our network.
• Prenatal Visits. Care for you before your baby is born.
• Babyscripts. The Babyscripts program rewards you for going to your prenatal and postpartum visits. Earn gift cards for signing up and pregnancy care.
• Choice of Birth Centers. Pick from a large network of hospitals across Wisconsin.
• Text4baby. Receive text messages with helpful tips and reminders.
• Wellhop for Mom & Baby. Connect with a community of moms. Get support and information as you welcome your baby.

There is no copayment for covered pregnancy care.

If you have asthma, diabetes, or another chronic condition, you can depend on us. Our plan provides the care, support and services you need. Some benefits include:

• Mental Health. Counseling and other treatments are covered.
• Substance Use Disorder. Counseling, Medication Assisted Treatment (MAT) and other treatments are covered. Also supported: care coordination with community and social supports, including Hub and Spoke (H&S) Integrated Recovery Support Services Health Homes for SUD.
• Care Manager. Get personal help managing health conditions.
• Disease Management. Focused care for those with chronic health needs like asthma and diabetes.

Behavioral health is just as important as physical health. That's why we have coverage for both.

Our plan supports your behavioral health by offering services such as:

• Mental health counseling and other treatments.
• Substance abuse (alcohol and drugs) counseling and other treatments.
• Medication Assisted Treatment (MAT).
• Coordination with community and social supports, including Hub and Spoke (H&S) Integrated Recovery Support Services Health Homes for SUD.
• Online self-care tools, such as AbleTo.
• Access to telehealth appointments for behavioral health treatment.
• 24/7 access to behavioral health crisis support.

There is no copayment for covered behavioral health services
 

We help members keep their eyesight, smile and hearing at their best.

Some benefits include:

• Vision Care. Exams and eyeglasses are covered.
• Dental Care. For individuals and families living in Kenosha, Milwaukee, Ozaukee, Racine, Washington or Waukesha Counties, dental services like cleanings, checkups and preventive dental work are covered by UnitedHealthcare. If you live in any other county, you may get dental services from any dentist who will accept your ForwardHealth ID card. Your dental services are provided by the State of Wisconsin, not UnitedHealthcare.
• Hearing Care. Tests, checkups and hearing aids, if needed.

You get the medical care and equipment needed to live safely at home.

Some benefits include:

• Equipment and Supplies. In-home medical and safety equipment are covered.
• Home Health Care. Medical and personal care in your home, if medically needed.

There is no copayment for covered home care and supplies.

Sometimes members need a little extra help using their health plan.

For those times, they can rely on:

• Language Help. Translated materials and interpreters who are ready to help.
• Member Services. Available 7am-7pm (CST)
• Member Advocate. Local advocates to get you information, services and care.
• Babyscripts. Get extra support and rewards to keep you and your baby healthy.
• Nurse Hotline℠. Speak with a registered nurse 24/7.
• Reminder Programs. We will remind you about important health actions including diabetes testing, breast cancer screening, childhood immunizations and recertification. Some programs have incentives for completing needed health actions.

UnitedHealthcare members can get rides to their appointments through the state’s non-emergency transportation (NEMT) broker.

To schedule a ride, contact 866-907-1493.

The Babyscripts program rewards you for going to your prenatal and postpartum visits. Members can earn gift cards for signing up and for receiving routine pregnancy care that leads to a healthy birth.
 

Do you have a serious health problem? If so, our care managers are in your corner. They will:

• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records.

The care manager will stay close by throughout the medical journey. He or she will:

• Think beyond your immediate health care needs.
  
• Make sure you have support at home.
• Help connect you with services and supports that help you live a healthier life, such as food, housing. and/or transportation resources.

Whether chiropractor services are your primary or alternative treatment method, you're covered.

This benefit is provided by the State of Wisconsin and you can get chiropractic treatment by any chiropractor who will accept your ForwardHealth ID card.

There may be copayments for chiropractic services provided by the State of Wisconsin

Where a pregnant person has their baby is an important choice. That's why pregnant people can pick from a large number of hospitals across Wisconsin.

We encourage parents-to-be to tour the hospital's birthing center. This way they will be familiar with it. And be more relaxed when they have their baby.

Each member can choose a primary care physician (PCP). Use the "Doctor Lookup" tool to see if your doctor is in our network.

The PCP is your main doctor for:

• Preventive care.
• Treatment if you are sick or injured.
• Referrals to specialists for certain conditions.

For members who don't have a doctor or whose doctor is not in our network, we can help find a new one close by.

Exams and cleanings are covered to help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that's covered as well.

If you live in Kenosha, Milwaukee, Ozaukee, Racine, Washington or Waukesha Counties, your dental benefits are provided by UnitedHealthcare Community Plan. There is no copayment for covered dental services provided by UnitedHealthcare in these counties.

If you live outside of Kenosha, Milwaukee, Ozaukee, Racine, Washington or Waukesha Counties, you may get dental services from any dentist who will accept your ForwardHealth ID card. Your dental services are provided by the State, not UnitedHealthcare. There may be copayments for dental services provided by the State.

If you have chronic or high-risk illnesses, our disease management services are designed to support you.

We have special programs for:

• Chronic obstructive pulmonary disease (COPD)
• Coronary artery disease (CAD)
• Congestive heart failure (CHF)
• Diabetes
• High Risk Pregnancy and NICU
• Sickle Cell Disease

Some members may need extra support to live safely at home.

Our plan covers medical equipment ordered by your doctor or case manager.

This can include supplies like:

• Hospital beds.
• Oxygen tanks.
• Wheelchairs or walkers.

There is no copayment for covered medical equipment and supplies.

Your UnitedHealthcare Community Plan is proud to offer you access to Federally Qualified Health Centers (FQHCs) across the state.

Federally Qualified Health Centers (FQHCs) “are community-based and patient-directed organizations that deliver comprehensive, culturally competent, high-quality primary health care services to the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and veterans.” *

In addition to primary care, FQHCs provide access to important services such as pharmacy, mental health, substance use disorder treatments and oral health services (dental). This means that you may be able to get all of these important services at one place.

To find a FQHC in your community, the state of Wisconsin maintains a list of FQHCS in the state. You can also contact member services and they can help find a primary care provider within a FQHC to be your provider.

* https://bphc.hrsa.gov/about-health-centers/what-health-center

We provide the exams needed to help keep feet in great shape. And for those with diabetes, good foot care can help prevent much more serious problems.

Our podiatry coverage includes:

• Routine foot exams.
• Tips about foot care and choosing the right shoes.
• Information about nerve damage warning signs.

There is no copayment for covered foot care visits.

Build a healthy future for you and your baby with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy.

We will help you:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Get supplies, including breast pumps for nursing pregnant members.
• Connect with community resources such as Women, Infants and Children (WIC) services or Prenatal Care Coordination through a local, community-based agency.

Trouble hearing can affect a person's life in many ways. Our plan includes services and support to help protect your hearing.

We cover:

• Exams, therapy and tests.
• Hearing aids and batteries.

There is no copayment for covered hearing care and equipment.

After surgery or a serious illness, you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing.

With approval from your doctor, our plan covers:

• In-home medical visits.
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies
• Help with personal care

There is no copayment for covered home health care visits

UnitedHealthcare Community Plan pays for expenses related to a hospital stay.

We cover:

• Nursing care.
• Room and board.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams.

And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.

There is no copayment for covered hospitalizations.

UnitedHealthcare offers services to help you talk with your doctor or other health care workers. You can get this service if you do not speak English or have hearing and speech barriers. You do not need a referral from your doctor to get these services.

Interpreter services are offered free of charge.

To ask for help with interpreter services, please call 1-800-504-9660, TTY 711. Representatives are available Monday through Friday from 7:00 a.m. -7:00 p.m. Central Time.

Knowing what's wrong and finding it early can make all the difference.

Our plan covers:

• Labs and testing.
• X-rays, scans and other imaging.

We'll help you get the information needed to improve your health or be at your best.

There is no copayment for covered lab and x-ray services.

You can receive information in your preferred language. Just ask. We also have people at our member service centers who speak more than one language. Chances are, we have someone who speaks your language.

Prescriptions and certain over-the-counter items are provided by the State of Wisconsin.

You may receive a prescription from a UnitedHealthcare doctor, specialist or dentist. You can fill your prescription at any pharmacy that is a provider for BadgerCare Plus. Just show your ForwardHealth ID card to the pharmacy when you get your prescriptions filled. For questions about pharmacy, please contact the State of Wisconsin at 1-800-362-3002.

You may have copayments or have limits on covered medications that are administered by the State of Wisconsin.

We're looking out for you. Our local member advocates can help solve problems, provide training and education, and work on issues that concern members. Local member advocates are available at 1-888-246-8140 Monday through Friday, 8:00 a.m.-4:30 p.m. Central Standard Time.

Our Member Advocates can:

• Answer your questions about your benefits.
• Help with doctor issues or complaints.
• Help you recertify your health care benefits.

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24 hours a day, 7 days a week.

You can connect with one of our member call center advocates Monday through Friday from 7am to 7pm by calling 1-800-504-9660, TTY 711. We'll answer your questions simply and completely.

We can answer your questions about UnitedHealthcare benefits and coverage, and help you find:

• A primary care provider for you and your family.
• Home care providers.
• Dentists and vision providers.
• Adult day health centers.

In addition, when you have questions about your health, you can call a nurse 24 hours a day, 7 days a week, at no cost to you via our Nurse Hotline 1-866-827-0806.

Medical questions and situations sometimes happen at bad times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week, at no cost to you

Our nurses will:

• Listen and learn about your symptoms.
• Help with self-care.
• Advise you about getting care at a doctor visit or an urgent care center.
• Help you know when to go to the emergency room.

Sometimes the basics are hard to do yourself in your home after an illness or injury.

If needed, we provide someone to help with:

• Dressing.
• Bathing.
• Feeding.
• Other eligible activities of daily living

There is no copayment for covered personal care services.

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

At these visits, the clinic will:

• Make sure both you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

There are no copayments for covered prenatal visits and care

Most people know the bad health effects of smoking. And they know they need to quit. We support our members to help them quit. The only thing they won't get from us is a lecture.

When you are ready to make the change and are looking for more information, the Wisconsin Tobacco Quit Line can help you. Call 1-800-QUIT-NOW, text READY to “200-400” or log onto www.quitline.wisc.edu to learn more about supports and services that can help you quit.

After a serious illness, surgery or injury, you may need extra nursing and therapy. In these situations, our plan covers short stays in a rehabilitation center where you can heal.

Included are:

• Skilled Nursing Home Care.
• 24-hour nursing care.
• Help with activities of daily living.

There are no copayments for covered skilled nursing home care
 

Did you know that 80% of our health comes from where we work and play and not the doctor’s office? Food, housing, employment and education all play an important role in our health and the health of our families.

To help you and your family achieve their best health, we offer screenings to identify barriers to key social drivers of health such as food insecurity and poor housing. Based on your individual responses, we can help identify local community resources to help you address these barriers and access supports that will help you reach your health goals.

Physical, occupational and speech therapy can help members recover from a serious injury or illness, or simply reach their full potential.

Our plan covers visits for:

• Occupational therapy.
• Physical therapy.
• Speech therapy.
• In-home therapy.

There is no copayment for covered therapy visits.

BadgerCare Plus provides non-emergency medical transportation to and from health care appointments through a transportation broker.

This benefit includes trips to:

• Doctor and therapy visits.
• Urgent care centers.
• Diagnostic testing.

To schedule a ride, contact 866-907-1493.

You’ll get the care, eyeglasses and treatment that let you see life more clearly.

Coverage includes:

• Regular exams.
• Up to two pairs of eyeglass frames each year.
• Prescription lenses for your eyeglasses.

There is no copayment for covered vision services.

Well visits with your doctor can help keep you healthy. These visits can catch health problems early, so they can be treated.

Preventive services include:

• Checkups for adults and children.
• Well-baby care.
• Care for pregnant people expecting a baby.
• Routine shots and tests.
• Mammograms.

There are no copayments for preventive care.

Connect with other expectant parents. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.

Here’s how it works:

• Join video conversations every other week with pregnant people who have similar due dates and a group leader.
• Chat and share experiences with participants from your group on the Wellhop app or website.
• Visit the Wellhop library. You’ll find articles, videos and more.