FAQs

BadgerCare Plus Programs & HIRSP

Q: If I lost eligibility for Medicaid or BadgerCare Plus am I eligible for HIRSP?

Answer: If you are no longer eligible for Medicaid or BadgerCare Plus and can’t find new coverage in the commercial market, you may be eligible for HIRSP. Answer a few more questions to learn more about your eligibility.

Q: If I drop my BadgerCare Plus Basic or Core Plan coverage, am I eligible for HIRSP?

Answer:If you drop your Badger Care Plus Basic or Core Plan coverage for any reason and can’t find new coverage in the commercial market, you may be eligible for HIRSP. Answer a few more questions to learn more about your eligibility.

Q: If I need medical services or prescription drugs that are not covered by BadgerCare Plus can I also take HIRSP coverage?

Answer:If you are covered under BadgerCare Basic, Core Plan or Benchmark Plan, and can’t get coverage in the commercial market, you may also be eligible for HIRSP. If you are eligible for comprehensive Medicaid or BadgerCare Plus Standard Plan, you are not eligible for HIRSP coverage. Answer a few more questions to learn more about your eligibility.

Q: If I lose or drop my Medicaid or BadgerCare coverage and enroll in HIRSP, will I have a waiting period for coverage of my pre-existing conditions?

Answer: If you apply to HIRSP within 45 days of losing/dropping your Medicaid/BadgerCare Plus coverage and are found to be eligible for HIRSP, you will not be subject to the HIRSP six month pre-existing condition waiting period on medical services.  You can begin receiving medical and drug services as of your HIRSP effective date, subject to the deductible you choose and any required coinsurance.

Q: Is there any help available if I can’t afford the HIRSP premium?

Answer: HIRSP offers premium and deductible reductions if your household income is below $34,000 per year.  The subsidy program offers premium and deductible discounts and reduced cost sharing for prescription drugs. To learn more about the HIRSP Low-Income Subsidy Program click here.

Check Eligibility To quickly check your initial eligibility for both HIRSP and HIRSP Federal please click on the blue “Check Your Eligibility” button.

Or call HIRSP Customer Service at 1.800.828.4777.