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Application, (HCF
10182) (English,
Hmong, Spanish)
(PDF, 189KB) —
To apply for BadgerCare Plus.
Authorization of Representative (HCF
10126) (English,
Hmong,
Spanish)
(PDF, 600KB) — To appoint someone to
apply for BadgerCare Plus for you.
BadgerCare Plus
Brochure, PHC
10170, (English, Hmong,
Spanish) (PDF, 231KB)
BadgerCare Plus and Employer-Sponsored
Health Insurance, PHC 10177, (English),
(PDF, 40KB )
BadgerCare Plus Family Planning Services, (PHC 10068) (English)
(PDF, 155KB)
BadgerCare Plus General Fact
Sheet, (PHC
10173) (English, Hmong,
Spanish) (PDF, 122KB)
BadgerCare Plus Prenatal Services, (PHC
10026) (English, Hmong,
Spanish) (PDF,
46KB)
BadgerCare Plus Temporary Health Insurance for
Children Fact Sheet
(PHC 10168) (English,
Hmong, Spanish) (PDF, 140KB)
BadgerCare Plus Temporary Health
Insurance for
Pregnant Women Fact Sheet, (PHC
10169) (English, Hmong,
Spanish) (PDF, 102KB)
BadgerCare
Plus Change Report Card — Young Adults Exiting Out-of-Home Care,
PHC
10176, (PDF 37K)
Change Report (HCF
10183) (English,
Hmong,
Spanish)
(PDF, 33KB) — To report changes to the local agency. You can
also report changes online at access.wi.gov.
Enrollment and Benefits handbook (English,
Spanish, Hmong) (PHC 10167) (PDF,
271KB) — To learn
more about your BadgerCare Plus benefits.
Fair Hearing
Request, (DHA 28) (PDF, 100KB) — To
request a hearing if you don't agree with a decision about your
benefits.
Fair Hearing Voluntary
Withdrawal (DHA 17)
(PDF, 10KB) — If you want to withdraw
your request for a hearing.
Guide to Applying for Wisconsin's Health and Nutrition
Programs, PHC 16091, (English,
Hmong, Spanish), (PDF, 181KB)
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DHA 17 - Fair
Hearing Voluntary Withdrawal (PDF, 10KB)
— If you want to withdraw your request for a hearing.
DHA
28 -
Fair Hearing
Request, (PDF, 100KB) — To
request a hearing if you don't agree with a decision about your
benefits.
HCF
10126 - Authorization of Representative
(English,
Hmong,
Spanish) (PDF, 600KB) — To appoint someone to
apply for BadgerCare Plus for you.
HCF
10182 - Application (English,
Hmong,
Spanish) (PDF, 189KB)
—
To apply for BadgerCare Plus.
HCF
10183 - Change Report
(English,
Hmong,
Spanish) (PDF, 33KB) — To report changes to the local agency. You can
also report changes online at access.wi.gov.
(PHC
10026 - BadgerCare Plus Prenatal Services, (English,
Hmong, Spanish) (PDF, 46KB)
PHC
10068 - BadgerCare Plus Family Planning Services (English)
(PDF, 155KB)
PHC
10167 - Enrollment and Benefits handbook (English,
Spanish, Hmong)
(PDF,
271KB) — To learn
more about your BadgerCare Plus benefits.
PHC
10168 - BadgerCare Plus Temporary Health Insurance for
Children Fact Sheet (English,
Hmong,
Spanish)
(PDF, 140KB)
PHC
10169 - BadgerCare Plus Temporary Health Insurance for
Pregnant Women Fact Sheet, (English,
Hmong, Spanish) (PDF, 102KB)
PHC
10170 -BadgerCare Plus
Brochure, (English,
Hmong,
Spanish) (PDF, 231KB)
PHC
10173) BadgerCare Plus General Fact
Sheet, (English,
Hmong, Spanish) (PDF, 122KB)
PHC 10176 - BadgerCare
Plus Change Report Card — Young Adults Exiting Out-of-Home Care,
(PDF 37K)
PHC 10177 - BadgerCare Plus and
Employer-Sponsored Health Insurance, (English),
(PDF, 40KB )
PHC
16091 - Guide to Applying for Wisconsin's Health and Nutrition
Programs, (English,
Hmong, Spanish) (PDF, 181KB)
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