Medicaid in Wisconsin after an SSI decision

The Department of Health Services calls this SSI Medicaid, Medical Assistance, or Title 19. Social Security decides the SSI payment. Receipt of SSI is what makes the person eligible. The state does not ask for a second SSI Medicaid application.

If your loved one has SSI and Medicare, the state also pays Medicare out-of-pocket costs, such as premiums, deductibles, and copayments, without a separate request.

BadgerCare Plus is a different program. Other Medicaid that is not SSI Medicaid is requested through ACCESS, by mail, by phone, or in person at the local agency.

Check the case in ACCESS or in the MyACCESS app. MyACCESS can show benefits, digital cards, and document requests. An address or phone update can be made there. An email address change is done in ACCESS.

Open ACCESS

If the coverage is still missing, call the local income maintenance agency or tribal agency. The phone number depends on the county or tribe. The Department of Health Services keeps the directory.

Find the income maintenance agency

You can also call ForwardHealth Member Service at 1-800-362-3002, Monday through Friday, 8:00 a.m. to 6:00 p.m. Central, except state holidays. That line is for members asking about enrollment and benefits.

SSI Medicaid continues while the SSI payment continues. If the SSI payment ends, SSI Medicaid can end too. Some people who lose SSI for a special reason, including childhood disability benefits, have extra rules in the state handbook. Simply losing SSI does not, by itself, create that protection. The handbook is the place to read which group applies.

A request for a hearing on a Medicaid action is generally due 45 days from the effective date of the adverse action. A FoodShare action uses 90 days from the date of the action. If the notice prints a different limit, that limit controls. The filing date is the day the agency receives the request, or the postmark, whichever is earlier.

Mail a written request to the Division of Hearings and Appeals, P.O. Box 7875, Madison, WI 53707. Benefits can continue only when the request meets the Medicaid time limits in the federal rules. Use the date and the instructions on your own notice.