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80% of the premium. His children are not eligible for BadgerCare Plus because they are currently covered. Children under 19 years of age who are ineligible for BadgerCare Plus due to current coverage can become eligible by meeting a deductible (see CHAPTER 17 DEDUCTIBLES). 7.4.2 Current Coverage Test for BadgerCare Plus Prenatal Program Pregnant people who are otherwise eligible only for the BadgerCare Plus Prenatal Program are not eligible for the BadgerCare Plus Prenatal Program if they are currently covered by any health insurance plan which qualifies as minimum essential coverage as defined at 26 USC § 5000A(f)(1). The plan does not have to be employer-sponsored, but the insurance must cover services provided in a service area that is within a reasonable driving distance from the person’s residence. This page last updated in Release Number: 25-02 Release Date: 04/09/2025 Effective Date: 04/09/2025 7.5 Reserved

This page last updated in Release Number: 25-02 Release Date: 04/09/2025 Effective Date: 02/22/2025 7.6 Reserved This page last updated in Release Number: 17-01 Release Date: 04/11/2017 Effective Date: 04/11/2017 7.7 Health Insurance Premium Payment 7.7.1 Introduction Wisconsin’s HIPP program helps BadgerCare Plus families pay the employee contribution of their employer sponsored insurance. The HIPP program pays the family’s share of the monthly premium, co- insurance, and deductibles associated with the family health plan along with any BadgerCare covered services not included in the family health plan through fee-for-service (wrap around). HIPP will be considered for the following BadgerCare Plus members when it is cost effective to do so: • Children • Pregnant Women • Parents and Caretakers HIPP is not available for childless adults. In addition to families with employer sponsored health insurance plans, the following BadgerCare Plus families may also be considered for HIPP: • Farm and other self-employed families • Members with self-funded insurance plans