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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

Get your free flu shot today! Give your health the best shot this flu season.

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.

Limitations and restrictions apply. Benefits may change.

You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on the Benefit Reward Hub or call Member Services at 855-690-7800 (TTY 711) Monday to Friday from 8 a.m. to 5 p.m. local time.

Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages you to get the care you need to create a healthy lifestyle. You can redeem these rewards through the Benefit Reward Hub.

  • $25 for lead screening
  • $60 for well-baby visits
  • $20 for ADHD medication management
  • $25 for breast cancer screenings
  • $25 for a well-child visit
  • $25 for getting your child’s childhood immunizations (shots) on time
  • $25 for getting your child’s adolescent immunizations (shots) on time
  • $25 for a diabetic A1c screening
  • $25 for pregnant members who go to a prenatal visit in their first trimester or within 42 days of enrollment
  • $25 for new moms who go to their postpartum visit 7-84 days after delivery
  • $5 for a vaccination importance quiz
  • $5 for a diabetes management quiz
  • $25 for a follow-up visit with a provider after an emergency department visit for alcohol and substance abuse.
  • $25 for a follow-up visit with a provider after an emergency department visit for mental health
  • $25 for a 30-day follow-up after a behavioral health discharge.

Requesting benefits

Log in to the Benefit Reward Hub to redeem your healthy rewards. You can also call the Healthy Rewards Customer Service Line at 888-990-8681 (TTY 711), Monday to Friday from 9 a.m. to 8 p.m. Eastern time.

Benefit Reward Hub

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