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39.1.2 Emergency Services Special Rules A U.S. citizen is not eligible for BadgerCare Plus Emergency Services even when they cannot produce citizenship verification, identity verification, or both. Example 1 Jill applies for BadgerCare Plus, declares U.S. citizenship and is asked to provide documents proving her citizenship and identity. She has a driver license to prove identity but does not have anything to prove her citizenship. Since Emergency Services BadgerCare Plus does not require proof of citizenship and identity as an eligibility requirement, she then asks to be considered for this program. However, the IM worker cannot process BadgerCare Plus Emergency Services eligibility for persons declaring to be U.S. citizens. BadgerCare Plus Emergency Services is reserved for non-qualifying non-citizens. Verification of identity is not required if the applicant or member is not a U.S. citizen. Immigrants who only meet the criteria for BadgerCare Plus under the childless adults’ coverage group are ineligible for Emergency Services. An inmate who is a non-qualifying immigrant may be eligible for Emergency Services for the dates they are hospitalized as an inpatient for emergency treatment as long as they meet the rest of the eligibility criteria for Emergency Services. Pregnant non-qualifying immigrants may be eligible under the BadgerCare Plus Prenatal Program. 39.1.3 Emergency Services and Public Charge Emergency Services is not considered in public charge determinations (see SECTION 4.3.4 PUBLIC CHARGE). This page last updated in Release Number: 24-01 Release Date: 04/03/2024 Effective Date: 04/03/2024 39.2 Determining if an Emergency Exists It is not the responsibility of the IM agency to determine if the applicant’s condition is or was an emergency condition and reimbursable under BadgerCare Plus Emergency Services. The medical provider submits claims for emergency medical services to the fiscal agent. The fiscal agent then determines if a condition is an emergency medical condition covered by BadgerCare Plus Emergency Services. 39.2.1 Determining Eligibility It is the IM agency’s responsibility to manually determine if the non-qualifying immigrant meets all eligibility requirements during the dates of service and to certify if they are eligible for Emergency Services. Medicaid providers who have treated non-US citizens for emergency services can provide them the Certification of Emergency for Non-U.S. Citizens form (F-01162) to verify that the services provided were to treat an emergency medical condition. Providers are instructed to have the patient present this to the local IM agency when applying for assistance. Note The Certification of Emergency for Non-U.S. Citizens form is not required to certify Emergency Services eligibility.