Tip 195- Coverage For Kids

Here’s a question that comes up frequently.

Shopping for health insurance during the OEP, Sarah and Jim have settled on a ‘silver’ plan with a $3,000 deductible, plus office visit and Rx co-pays, and a per person out of pocket (OOP) limit of $6,350. Their premium would be $748; to add their daughter would be an additional $195, for a total of $943/month.

The question: would Badgercare+ be a better option for their daughter?
For an answer, we turned to The City of Milwaukee Health Department’s Community

Healthcare Access Program (CHAP). Here’s what we learned.

In general, there are no premiums for Badgercare+ if household income is under 200% of FPL. Between 200 – 300% of FPL, premiums grade up toward $200/month. Regardless of premium, coverage under Badgercare+ is comprehensive; i.e., in most cases, no deductibles or other OOP costs.

Note however that eligibility for Badgercare is means tested and the rules are tricky. So don’t rely on this 30 Second summary. Milwaukee County residents can prescreen their eligibility for Badgercare with a call to CHAP at 414-286-8620.