48.1.1 Premiums for Children

Official source

Non-exempt children with an assistance group income above 201% of the Federal Poverty Level ( FPL ) will be charged premiums. Each child’s premium will be based on their own assistance group’s (AG) size and income. The 5% cap for the cost of total household premiums for children will continue to apply. The cap will be 5% of the income of the premium assistance group with the highest countable income amount. The total household’s premiums will be determined based on the combined amount of all children’s premiums or the 5% cap, whichever amount is less. See Section 19.2 Premium Calculations and Section 19.3 Premium Limits for more information on premium caps.

The below table outlines the premium amounts for children.

FPL Income Range Above 201% to 210.99% 211% to 220.99% 221% to 230.99% 231% to 240.99% 241% to 250.99% 251% to 260.99% 261% to 270.99% 271% to 280.99% 281% to 290.99% 291% to 300.99% 301% to 306.00% Premium Amounts $10 $10 $10 $15 $23 $34 $44 $55 $68 $82 $97.53

Note Children in extensions are not charged premiums (see Section 19.1 BadgerCare Plus Premiums ).

A child cannot be charged a new or increased premium during their 12-month continuous coverage period, but their premium may be reduced, if applicable. If the premium is lowered, that new amount becomes their premium cap for the rest of the 12-month period. If the AG’s size and income changes during the 12-month period, the child’s premium amount may not align with the FPL percentage of the AG’s income, as shown in the table above.

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48.1.1 Premiums for Children

Official source

Non-exempt children with an assistance group income above 201% of the Federal Poverty Level ( FPL ) will be charged premiums. Each child’s premium will be based on their own assistance group’s (AG) size and income. The 5% cap for the cost of total household premiums for children will continue to apply. The cap will be 5% of the income of the premium assistance group with the highest countable income amount. The total household’s premiums will be determined based on the combined amount of all children’s premiums or the 5% cap, whichever amount is less. See Section 19.2 Premium Calculations and Section 19.3 Premium Limits for more information on premium caps.

The below table outlines the premium amounts for children.

FPL Income Range Above 201% to 210.99% 211% to 220.99% 221% to 230.99% 231% to 240.99% 241% to 250.99% 251% to 260.99% 261% to 270.99% 271% to 280.99% 281% to 290.99% 291% to 300.99% 301% to 306.00% Premium Amounts $10 $10 $10 $15 $23 $34 $44 $55 $68 $82 $97.53

Note Children in extensions are not charged premiums (see Section 19.1 BadgerCare Plus Premiums ).

A child cannot be charged a new or increased premium during their 12-month continuous coverage period, but their premium may be reduced, if applicable. If the premium is lowered, that new amount becomes their premium cap for the rest of the 12-month period. If the AG’s size and income changes during the 12-month period, the child’s premium amount may not align with the FPL percentage of the AG’s income, as shown in the table above.