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BadgerCare Plus and Medicaid SSI Benefits

We help make sure you and your family get all your Medicaid benefits. Plus, Anthem members get extra benefits at no cost!

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What you get with Anthem

Our benefits and services are designed to make a difference in your life. Most services are covered with no copays. For a full list of your benefits and services, see your member handbook.

Your Medicaid benefits include:

  • PCP visits
  • Specialist visits
  • Urgent care
  • Emergency care*
  • Physical therapy
  • Disposable medical supplies
  • Lab and X-ray services
  • Pregnancy services
  • Family planning
  • Hospital care

Some services require a referral from your PCP.

Find a doctor

Registered nurses are available anytime, day or night. They can:

  • Advise you on where to go when you need care.
  • Help you with any health questions you have.

Call the 24/7 NurseLine 24 hours a day, seven days a week at 1-855-690-7800 (TTY 711).

We’re here if you or a family member needs help. We have doctors, therapists, and counselors to help you with your behavioral health needs, like depression, anxiety, family issues, and substance use disorder. This includes:

  • Inpatient mental health care
  • Outpatient mental health care and/or care for substance use
  • Partial hospitalization
  • Intensive community-based treatment
  • Mental health rehabilitative treatment services
Find a doctor

Members in Kenosha, Milwaukee, Ozaukee, Racine, Washington and Waukesha County:

Dental benefits provided through DentaQuest

Call DentaQuest at 1-888-271-5210 (TTY 1-800-466-7566), or visit the DentaQuest website.

Members in all other Wisconsin counties:

Dental benefits provided through the state ($0.50 to $3 copay per service)

Call ForwardHealth Member Services at 1-800-362-3002, or visit the ForwardHealth website.

Your vision benefits includes the following once per year:

  • Eye exam
  • Eyeglass frames and lenses
  • Eyeglass lens replacement
  • Contact lenses (instead of frames and lenses for select members)
  • Contact lens replacement (for select members)

For more information, call MARCH Vision Care at 1-855-516-2724 (TTY 1-877-627-2456), or visit the MARCH Vision Care website.

Your benefits include generic and brand-name prescription drugs and some over-the-counter (OTC) drugs.

Copays:

  • OTC drugs: $0.50
  • Generic drugs: $1
  • Brand-name drugs: $3

Copays are limited to $12 a month per member, per provider. OTC drugs do not count toward the $12 maximum. Members are limited to five opioid prescriptions per month.

Get your drugs from any pharmacy that accepts your ForwardHealth ID card.

Find a pharmacy

Get no-cost rides to your health care appointments.

Request a ride

Health care can be overwhelming. We’re here to help you stay on top of it. Anthem members can get care management services at no cost. Get a care plan designed for you to help you meet your health care goals

Learn more

As an Anthem member, you get extra benefits — beyond what you expect. These include:

  • WW (formerly Weight Watchers): Members 18 years of age and older can lose weight and maintain a healthy lifestyle with digital tracking tools and vouchers to attend 13 wellness workshops near you. Get expert support from a skilled coach and members like you. Call 1-855-690-7800 (TTY 711) to learn more or sign up.
  • FitnessCoach®: Educational videos at no cost to you. Topics include basic exercises, stress management, weight loss and exercising with chronic conditions. Plus, over 1,000 online resources to help you live an active and fit lifestyle. Visit the FitnessCoach website to create your free account.
  • GED assistance: We’ll cover the cost of the test for members ages 18 and up. Call Member Services at 1-855-690-7800 (TTY 711) to learn more.
  • Cellphone service: A no-cost cellphone with no-cost monthly minutes, data and text messages through the federal Lifeline Assistance program.
  • New Baby, New LifeSM program: We can help you take care of yourself so you can take care of your baby. Call 1-262-523-3680 to learn more.

No-cost health videos at your fingertips with FitnessCoach®!

Enjoy at-home online access to over 1,000 resources on healthy living. Visit www.fitnesscoachresources.com/BCBSWI to create your free account.

Earn rewards for doing things that are good for your health. Enroll in the Healthy Rewards program to get debit card dollars when you complete a healthy activity. Use your debit card to buy health and wellness items from select retailers. Check the list below to see what you can earn:

Pregnant women
  • $25 for a prenatal visit in the first trimester or within 42 days of enrollment. Limit: Once per pregnancy.
  • $25 for a postpartum visit 7-84 days after delivery. Limit: Once per pregnancy.
Children ages 2 or younger
  • $25 for getting all Combo 3 vaccinations* by age 2. (Limit: Once per member).
  • $25 for completing a lead screening by age 2. (Limit: Once per member).
Children and young adults ages 3-20
  • $25 for getting an annual wellness checkup
  • Limit: Once every 12 months
Members ages 6 and older who visit the emergency room for mental health illness
  • $25 for a follow-up visit with a provider within 30 days of hospital discharge
  • Limit: Once per year
Members ages 6 and older who visit the hospital for mental health illness
  • $25 for a follow-up outpatient visit with a mental health provider within 30 days of hospital discharge
  • Limit: None
Members ages 13 and older who visit the emergency room for drug or alcohol use
  • $25 for a follow-up visit with a provider within 30 days of hospital discharge
  • Limit: Once per year
​​*Combo 3 vaccinations include Chickenpox (VZW), DTaP, HepA, HepB, HiB, IPV/Polio, MMR and PCV.

For more information, including program rules and eligibility, call 1-877-868-2004 (TTY 711).

Enroll in Healthy Rewards

Monthly premiums for some childless adults

A premium is a set amount of money you pay each month to have health care coverage from BadgerCare Plus. To keep your BadgerCare Plus benefits, you’ll need to pay your premium monthly or all at once when you renew.

You will have to pay a monthly premium if your household income before taxes is more than:

  • $531 per month for one person.
  • $718 per month for a family of two.

These amounts change every year on February 1.

You don’t have to pay monthly premiums if you:

  • Are an Alaskan native or American Indian.
  • Were homeless at any point in the last 12 months.
  • Were in a medical institution for at least 30 days.
  • Have a disability.

$8 per household

You can lower your monthly premium to as low as $4 per household by taking an optional health survey. To take the survey, call 1-800-291-2002 or log in to the ACCESS website.

Your monthly premium will be due on the 10th of every month. ForwardHealth will send you a letter before your first payment is due.

How to pay:

You must pay the premium to keep your BadgerCare Plus benefits. You can pay your premium each month, or pay all of your premiums at once when you renew your benefits each year.

If you do not pay all owed premiums at your yearly renewal time or when your BadgerCare Plus coverage ends, you will not be able to reenroll for six months. In order to reapply for benefits, you can pay all of your owed premiums or wait for six months to apply again.

Get the most from your benefits

New to Anthem?

As a new member, we know you have questions, and we want you to get the most out of your benefits. Read our tips to help you get started with your new health plan.

New member guide

Anthem member handbooks

Complete benefit information can be found in your member handbook.


Member Handbooks

Additional benefit information can be found in your handbook