Family Planning Waiver  Services for Males

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General Information

Effective May 1, 2010, the Family Planning Waiver Plan provides certain family planning services to men ages 15 through 44. 

The primary purpose of this plan is to prevent unplanned pregnancies.  So, the covered services are limited to family planning and related services like the testing and treatment of sexually transmitted diseases/infections (STDs/STIs).

Covered Services

Covered services for males include:

• Family planning-related office visits,
• Condoms (you will need a prescription from a doctor or nurse practitioner), 
• Testing and treatment of sexually transmitted diseases/infections (STDs/STIs), and
• Voluntary sterilizations for men 21 years of age or older.

Federal law allows members to choose their provider, including physicians and family planning clinics, for family planning services and supplies.  Therefore, if you are in an HMO you can also go to any family planning clinic that will accept your ForwardHealth ID card, even if the clinic is not part of your HMO.

If you need health care services your family planning provider is unable to provide, s/he will refer you to a provider who can.  You may also be referred to your local community health center if you need any follow up care.  If you have questions about getting a referral, ask your family planning provider.  

Note:  Only certain services are covered under this plan.  For example, inpatient hospital services and vaccinations are not covered.  You should tell your health care provider you have this coverage before you get services.  Your provider should tell you if a services is not covered.  If your provider tells you that a service is not covered and you still choose to get the service, you will have to pay for it. 

You will be able to enroll in the Family Planning Waiver Plan if you:

• Are a U.S. Citizen, or have qualifying immigration status,
• Are age 15 through 44,
• Are not enrolled in Medicaid or BadgerCare Plus Standard or Benchmark Plans, and
• Have a family gross income of no more than 200% of the federal poverty level. (If you are under 19, your parents’ income is not counted).

Temporary Enrollment 

If you are age 15 through 44, you can get family planning services right away, even before you have applied for Family Planning Waiver Plan with the Enrollment Services Center.

A “qualified provider” is BadgerCare Plus approved and s/he can decide if you can get temporary family planning services.  Your own doctor may be a qualified provider but if not, it is easy to find one.  Member Services at 1-800-362-3002 can give you a list of BadgerCare Plus Family Planning Waiver Plan providers in your area.

Note: If you are not a U.S. citizen, you must apply for BadgerCare

Plus Family Planning Waiver Plan with the Enrollment Services Center and provide proof of your immigration status.

Temporary Enrollment Period

Temporary enrollment for this plan begins on the day you fill out the Temporary Enrollment for BadgerCare Plus Family Planning Waiver Plan application and a “qualified provider” finds you are able to enroll.  The qualified provider can help you fill out the application.

You will stay enrolled until the end of the second month following the month you are temporarily enrolled.

Example:  John goes to the clinic and his provider enrolls him for temporary Family Planning Waiver Plan on March 10.  If John does not file a BadgerCare Plus application and get enrolled for ongoing coverage, his temporary enrollment will end on May 31st.

How to Enroll 

To enroll for ongoing coverage through the Family Planning Waiver Plan:

:   Go online to: access.wi.gov and click on “Apply for Benefits”

(  Call 1-800-291-2002 to apply over the phone

-  Download an application at dhs.wi.gov/em/customerhelp or call Member Services at 1-800-362-3002 to have an application mailed to you.  Send your completed application to:

            Enrollment Services Center

            P.O. Box 7190

            Madison, WI. 53707-7190

Note: If you have dependent children who are living with you, you may be able to enroll in the BadgerCare Plus Standard or Benchmark Plan which pays for more services.

Confidentiality

If you apply for BadgerCare Plus Family Planning Waiver Plan, you will have the following protections:

• Written information can be sent to an address other than your home address.

• If you are under age 19: 

  • You will not be referred to the child support agency.

  • The agency will not contact your parents or other caretakers about your family planning enrollment or services.

  • Your parents’ income will not be counted to see if you can enroll in the plan.

For More Information Contact:

Information provided is general.  For more detailed information:

• Go to dhs.wi.gov/em/customerhelp or

•  Call 1-800-291-2002.

P-00176 (04/10)

Last Revised: July 12, 2010