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3. Qualify for coverage under a BadgerCare Plus category other than that for childless adults (see SECTION 39.1.2 EMERGENCY SERVICES SPECIAL RULES) A person can be eligible for Emergency Services for an emergency that occurred within the three months prior to the application month as long as the person met the eligibility requirements for Emergency Services during the month(s) in which the emergency occurred. An emergency means a medical condition (including labor and delivery) that shows acute symptoms of sufficient severity (including severe pain) such that the lack of immediate medical treatment could result in one or more of the following: 1. Serious jeopardy to the patient's health 2. Serious impairment to bodily functions 3. Serious dysfunction of a bodily organ or part BadgerCare Plus Emergency Services covers: 1. Only those medical services needed for the treatment of an emergency medical condition 2. All labor and delivery services for eligible non-qualifying immigrants For information on manually processing applications, see Process Help, Section 12.9 Health Care (BC+ and MA) Emergency Services Manual Application Processing. For information on manually processing renewals for members who have an ongoing emergency condition, see Process Help, Section 12.10 Manual Renewal Report. 39.1.1 Emergency Services Income Limits Group Income Pregnant Women Up to 306% FPL Newborns to age 1 Up to 306% FPL Children ages 1 - 5 Up to 191% FPL Children ages 6 - 18 Up to 156% FPL Former Foster Care Youth Any FPL Level Parents and Caretakers Up to 100% FPL

Note These income limits must be applied because not everyone who meets the rules for BadgerCare Plus qualifies for BadgerCare Plus Emergency Services. Emergency Services is funded through the Medicaid Program (T- 19), and is only available for people whose coverage is provided under a Medicaid state plan. As a result, children above the income limits for Medicaid (T-19) and childless adults whose coverage is provided under a federal waiver do not qualify for Emergency Services.