Healthy Mom, Healthy Baby Insurance Information
What is the difference?
Medicaid, BadgerCare Plus, ForwardHealth, HMO, Chorus Community Health Plans... what do these all mean?
Medicaid is a form of health insurance, funded by both the federal and state governments, that helps cover medical costs for those who meet specific eligibility requirements. All states have Medicaid programs, but they may be set up a little differently in each state. For residents of Wisconsin, there are several different Medicaid programs. One of Wisconsin's Medicaid programs, for children and adults who meet income requirements, is called BadgerCare Plus.
BadgerCare Plus, along with other Medicaid health care programs and nutritional benefit programs (like WIC and FoodShare), are coordinated under an umbrella called ForwardHealth. ForwardHealth helps coordinate health insurance benefits, process claims and access coverage information. You apply for Medicaid (BadgerCare Plus) coverage through ForwardHealth. You would also receive your benefits card and information from ForwardHealth. You may access your benefits for any of the programs that ForwardHealth coordinates through their website (ACCESS) or their app (MyACCESS) MyAccess.
ForwardHealth works with a number of HMOs (Health Maintenance Organizations) to deliver health care benefits for programs like BadgerCare Plus. HMOs help administer the state's Medicaid plans, process health-related medical claims and offer a variety of additional services (like case management or social support programs) for their members. Chorus Community Health Plans is a BadgerCare Plus Medicaid HMO.
Individuals with BadgerCare Plus may select their HMO when enrolling for benefits. It's important to select your HMO. If you don't select one (or don't select one in the timeframe required), a HMO will be assigned to you. You can verify your HMO on ForwardHealth's website or app, or you can call the phone number on the back of the health insurance card that you received from ForwardHealth.
Click here for more information on BadgerPlus, to apply for benefits or learn more about ForwardHealth.
There are also county and tribal offices across the state that can provide enrollment support for eligibility questions, help with applying for BadgerCare Plus or FoodShare programs, and help to change or renew your benefits.
Finding Care
You can look for a provider on our website or on the ForwardHealth website. You can search for a specific provider or a clinic that your plan covers. You can also choose how far away the provider's office is from your home.
When searching for a provider, it's important to know what kind of provider you need. If you are pregnant, you might want to see an obstetrician, a family medicine doctor who helps with pregnancy, or a midwife. Not sure what kind of doctor you need? Learn about some common types of providers you might see while you are pregnant.
Need more help finding a provider?
Call our Member Advocate team at 1-877-900-2247 or the Healthy Mom, Healthy Baby team at (414) 337-2229.
Dental Care
Did you know that taking care of your teeth is very important when you're pregnant? If you have dental problems and don't treat them, it can lead to early births and other complications!
Need a dentist and live in Southeastern Wisconsin (Milwaukee, Racine, Kenosha, Waukesha, Washington, and Ozaukee Counties), start here.
Southeastern Wisconsin dentist
Need a dentist and live outside of Southeastern Wisconsin?
Pregnancy-Related Durable Medical Equipment (DME)
Your provider might suggest medical equipment while you are pregnant. This is known as Durable Medical Equipment (DME). Examples of DME during pregnancy could include a breast pump or a machine to check your blood pressure or blood sugar if you have certain health concerns. Usually, your provider will need to write a prescription for the DME you need.
To find all the covered DME companies, you can search under our Find a Provider page. DME companies are listed as a Facility Type in the Facility search. Make sure to search for the Facility Type "Durable Medical Equipment."
Breast Pumps
If you want to feed your baby with human milk, you can get a breast pump in your third trimester or after your baby is born. Both manual and electric pumps are usually covered. Here’s how to get a breast pump:
- You’ll need an order from your doctor. Our CCHP nurse practitioner can help you with this.
- You will get your pump from a DME company. Your doctor will send the order to the DME company, which will check your insurance coverage and tell you which type of pump is available. They will help you choose the best pump for you.
- The DME company will arrange to deliver the pump to you. This may mean shipping it to your home or bringing it to you directly.
We often work with these DME companies for breast pumps:
Note: You can now get a breast pump in your third trimester, which is a new change. If you have trouble getting a breast pump during this time or need more help, we are here for you! We can also provide assistance with breastfeeding.
Questions?