Page 232

When a county 51.42 board, 51.437 board, human services department, or social services department places a person in a care facility that is located in another county, the placing county remains responsible for the applicant. This does not include situations where a guardian or the member elects to voluntarily move the member to another county. For interstate placements, see Medicaid Eligibility Handbook 6.8 Interstate Placements. This page last updated in Release Number: 26-02 Release Date: 04/15/2026 Effective Date: 04/15/2026 32.1 Introduction Presumptive eligibility is a streamlined eligibility determination for temporary enrollment in BadgerCare Plus or Family Planning Only Services. It is based on preliminary household and financial information provided by the applicant. It allows eligible applicants immediate health care coverage for a short period until an application for ongoing coverage is completed and processed. Note See the Medicaid Eligibility Handbook, Section 36.2.2.1 Temporary Enrollment/Presumptive Eligibility Available Only To Women Enrolling Through WWWP for information on temporary enrollment under the Wisconsin Well Women Medicaid program for women under age 65 with breast or cervical cancer. 32.1.1 Definitions • Express Enrollment: The process of making a presumptive eligibility determination to temporarily enroll an individual in BadgerCare Plus or Family Planning Only Services. Qualified entities (see SECTION 32.1.2 QUALIFIED ENTITIES) make these determinations using ACCESS for Partners and Providers (see ACCESS Handbook, Chapter 12 ACCESS for Partners and Providers). • Presumptive eligibility: The determination of whether or not an applicant is eligible to temporarily enroll in BadgerCare Plus or Family Planning Only Services. • Temporary enrollment: Short-term eligibility for BadgerCare Plus or Family Planning Only Services. 32.1.2 Qualified Entities Qualified entities that can make presumptive eligibility determinations include hospitals, providers, and partners that are approved by ForwardHealth and have received Express Enrollment training. The table below explains which qualified entities can make presumptive eligibility determinations for a population and program: Qualified Entities: Can make presumptive eligibility determinations for: Children Pregnant Women Family Planning Only Services Adults, Parents, and Caretakers Qualified Hospitals X X X X Providers X X X