39.1 Emergency Services

BadgerCare Plus Emergency Services is a limited BC+ benefit for documented immigrants who have not been in the U.S. for 5 years or more and for undocumented immigrants.

A citizen is not eligible for BadgerCare Plus Emergency Services even when s/he cannot produce citizenship and/or identity verification.

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.

Because Emergency Services is funded through Title XIX only those who would receive their BC+ benefits under Title XIX are eligible for BC+ Emergency Services. Therefore, not everyone who meets the income limits for BC+ qualifies for BC+ Emergency Services.

An immigrant who only meets the eligibility criteria for the BadgerCare Plus Core Plan is not eligible for Emergency Services.

An immigrant who is ineligible for BC+ because of his/her immigration status The legal status conferred on a non-citizen by immigration law is eligible for BC+ Emergency Services coverage if:

S/he meets the income limits listed in the chart below and
Meets all other eligibility requirements, except having or applying for an SSN Social Security Number.

BC+ Emergency Services Income Limit

Group	Income
Pregnant Women	Up to 250% FPL
Newborns to age 1	Up to 250% FPL
Children ages 1 - 5	Up to 185% FPL
Children ages 6 - 18	Up to 150% FPL
Youths Existing Out of Home Care	Any FPL Level
Parents and Caretakers	Up to 130% FPL

Note: Pregnant non-qualifying immigrants Non-qualifying immigrants are individuals that are not eligible for BC+ due to immigration status. may be eligible under the BC+ Prenatal Program.

An emergency means a medical condition (including labor and delivery) that shows acute symptoms of sufficient severity (including severe pain) such that the lack of immediate medical treatment could result in one or more of the following:

Serious jeopardy to the patient's health.
Serious impairment to bodily functions.
Serious dysfunction of a bodily organ or part.

BC+ Emergency Services covers :

Only those medical services needed for the treatment of an emergency medical condition.
All labor and delivery services for eligible non-qualifying immigrants.

See Process Help Chapter 11.1, for BC+ Emergency Services manual application processing.

This page last updated in Release Number: 09/05

Release Date: 08/10/09

Effective Date The begin date of a specific action such as an approval, denial, closure or other change in eligibility or coverage.: 06/01/09