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Example 2 Sally received a medical service in January which was paid by the state- administered, state-funded Community Options Program in the same month. In February Sally applies for BadgerCare Plus for herself and her son, James. Sally has access to health insurance so James must meet a deductible. Since the medical bill was paid by COP within three months of Sally's BadgerCare Plus application it can be used to meet James’ BadgerCare Plus deductible. 9. Medical or remedial expenses that have been paid or will be paid by Indian Health Services that meet the conditions detailed in (SECTION 17.4.2 COUNTABLE EXPENSES) Example 3 On January 1, Michael received a medical service which will be paid by Indian Health Services. When Michael applies for BadgerCare Plus on January 10, he has to meet a deductible. The bill for the January 1 medical services may be used immediately because it will be paid by the Indian Health Services program.

Example 4 Charlie received a medical service in January which was paid by Indian Health Services in the same month. In February, Charlie’s mother applies for BadgerCare Plus. Charlie has to meet a deductible. Since the bill was paid by Indian Health Services within three months of Charlie's BadgerCare Plus application, it can be used to meet Charlie's BadgerCare Plus deductible. 17.4.3 Expenses That Cannot Be Counted Toward a Deductible Do not count the following toward the deductible: 1. Medical bills written off through bankruptcy. 2. Medical services payable or paid for by a third party who is legally liable for the bill. This includes bills that will be paid or have been paid by BadgerCare Plus, Medicare or other insurance. Note If the third party charges the applicant or member for the medical expenses, then the applicant or member remains the liable party for those medical expenses. 3. A bill cannot be used if it has been used to meet a prior deductible. If only a portion of an unpaid bill was used to meet a prior deductible any remaining balance that was not applied to the prior deductible, may be applied to a subsequent deductible period - as long as it is still owed or meets criteria in SECTION 17.4.1 WHEN EXPENSES CAN BE COUNTED TOWARD A DEDUCTIBLE. This page last updated in Release Number: 26-02 Release Date: 04/15/2026 Effective Date: 04/15/2026 17.5 Order of Bill Deduction When applying medical bills to the deductible, start with the earliest service date. If more than one bill has the same service date, use the bill with the highest amount first, then the next highest and so on down to the lowest bill with that same service date. 17.5.1 Hospital Bills Hospitals do not always itemize the cost of their services according to the day and time of day the patient received the services. It is sometimes difficult to know when the patient met the deductible. For this reason, if the patient’s hospital bill for one continuous stay in the hospital is equal to or above the deductible amount on the date of admission, the first day of admission is the date of service for the