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BadgerCare Plus Standard Plan BadgerCare Plus Benchmark Plan

(CCS), outpatient services in the home and community for adults, and substance abuse residential treatment.

Mental health services have no dollar maximums.

Substance abuse services are limited to $7,000. Costs of mental health services, including inpatient stays, apply to this overall limit. Also, there are separate dollar limits for specific substance abuse services: - $4,500 for outpatient substance abuse services including $2,700 for outpatient services (including narcotic treatment) for substance abuse day treatment. - $6,300 for inpatient hospital stays in a general acute care hospital.

Nursing Home Services Full coverage Full coverage for stays at skilled nursing homes limited to 30 days per enrollment year.

Outpatient Hospital – Emergency Room Full coverage

Full coverage

Outpatient Hospital Services Full coverage Full coverage

Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) Full coverage Full coverage, limited to 20 visits per therapy discipline per enrollment year

Also covers up to 36 visits per enrollment year for cardiac rehabilitation provided by a physical therapist. (The cardiac rehabilitation visits do not count towards the 20 PT visits.)

Physician Services Full coverage, including laboratory and radiology Full coverage, including laboratory and radiology

Podiatry Services Full Coverage Full coverage

WISCONSIN

Effective Date:

Approval Date: 81