SB518,7,6

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149.471 (4) (a) 4. a. The individual is a parent or caretaker relative of a child who
2is living in the home with the parent or caretaker relative or who is temporarily
3absent from the home for not more than 6 months or, if the child has been removed
4from the home for more than 6 months, the parent or caretaker relative is working
5toward unifying the family by complying with a permanency plan under s. 48.38 or
6938.38.

SB518,7,108 49.471 (4) (a) 7. Individuals who qualify for a medical assistance eligibility
9extension under s. 49.46 (1) (c), (cg), or (co) when their income increases above the
10poverty line.

SB518,7,1813 49.471 (4) (b) 4. a. The individual is a parent or caretaker relative of a child who
14is living in the home with the parent or caretaker relative or who is temporarily
15absent from the home for not more than 6 months or, if the child has been removed
16from the home for more than 6 months, the parent or caretaker relative is working
17toward unifying the family by complying with a permanency plan under s. 48.38 or
18938.38.

SB518,7,2521 49.471 (5) (b) 1. Except as provided in sub. (6) (a) 1., a pregnant woman is
22eligible for the benefits specified in par. (c) during the period beginning on the day
23on which a qualified provider determines, on the basis of preliminary information,
24that the woman's family income does not exceed 300 percent of the poverty line and
25ending on the applicable day specified in subd. 3.

SB518,8,73 49.471 (5) (b) 2. Except as provided in sub. (6) (a) 2., a child who is not an unborn
4child is eligible for the benefits described in s. 49.46 (2) (a) and (b) during the period
5beginning on the day on which a qualified entity determines, on the basis of
6preliminary information, that the child's family income does not exceed 150 percent
7of the poverty line and ending on the applicable day specified in subd. 3.

SB518,8,1310 49.471 (5) (c) 2. On behalf of a woman under par. (b) 1. whose family income
11exceeds 200 percent of the poverty line, the department shall audit and pay allowable
12charges to a provider certified under s. 49.45 (2) (a) 11. only for ambulatory prenatal
13care services under the benefits under sub. (11).

SB518,8,1815 49.471 (5) (c) 1. On behalf of a woman under par. (b) 1. whose family income
16does not exceed 200 percent of the poverty line, the department shall audit and pay
17allowable charges to a provider certified under s. 49.45 (2) (a) 11. only for ambulatory
18prenatal care services under the benefits described in s. 49.46 (2) (a) and (b).

SB518,9,221 49.471 (6) (a) 2. Any pregnant woman, including a pregnant woman under sub
22(5) (b) 1., child who is not an unborn child, including a child under sub. (5) (b) 2.,
23parent, or caretaker relative whose family income is less than 150 percent of the
24poverty line is eligible for medical assistance under this section for any of the 3
25months prior to the month of application if the individual met the eligibility criteria

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1under this section and had a family income of less than 150 percent of the poverty
2line in that month.

SB518,9,74 49.471 (6) (a) 1. Any pregnant woman, including a pregnant woman under sub.
5(5) (b) 1., is eligible for medical assistance under this section for any of the 3 months
6prior to the month of application if she met the eligibility criteria under this section
7in that month.

SB518,9,2312 49.471 (7) (b) 1. A pregnant woman, or an unborn child, whose family income
13exceeds 300 percent of the poverty line may become eligible for coverage under this
14section if the difference between the pregnant woman's or unborn child's family
15income and the applicable income limit under sub. (4) (b) is obligated or expended
16for any member of the pregnant woman's or unborn child's family for medical care
17or any other type of remedial care recognized under state law or for personal health
18insurance premiums or for both. Eligibility obtained under this subdivision
19continues without regard to any change in family income for the balance of the
20pregnancy and, for a pregnant woman but not for an unborn child, to the last day of
21the month in which the 60th day after the last day of the woman's pregnancy falls.
22Eligibility obtained by a pregnant woman under this subdivision extends to all
23pregnant women in the pregnant woman's family.

SB518,10,9

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149.471 (7) (b) 2. A child who is not an unborn child and, whose family income
2exceeds 150 percent of the poverty line, and who is ineligible under this section solely
3because of sub. (8) (b) may obtain eligibility under this section if the difference
4between the child's family income and 150 percent of the poverty line is obligated or
5expended on behalf of the child or any member of the child's family for medical care
6or any other type of remedial care recognized under state law or for personal health
7insurance premiums or for both. Eligibility obtained under this subdivision during
8any 6-month period, as determined by the department, continues for the remainder
9of the 6-month period and extends to all children in the family.

SB518,10,2012 49.471 (7) (b) 3. For a pregnant woman or an unborn child to obtain eligibility
13under subd. 1., the amount that must be obligated or expended in any 6-month
14period is equal to the sum of the differences in each of those 6 months between the
15pregnant woman's or unborn child's monthly family income and the monthly family
16income that is 300 percent of the poverty line. For a child to obtain eligibility under
17subd. 2., the amount that must be obligated or expended in any 6-month period is
18equal to the sum of the differences in each of those 6 months between the child's
19monthly family income and the monthly family income that is 150 percent of the
20poverty line.

SB518,10,2523 49.471 (7) (c) 1. Deduct from family the individual's income, up to the amount
24of the individual's income, any payments made by amount the individual is obligated
25to pay for court-ordered child or family support or maintenance.

SB518,11,22 49.471 (8) (d) 1. f. An individual described in sub. (4) (a) 7.

SB518,11,125 49.471 (8) (d) 2. c. One or more members of the individual's family were eligible
6for other health insurance coverage or Medical Assistance under s. 49.46 or 49.47 at
7the time the employee failed to enroll in the health insurance coverage under par. (b)
81. and no member of the family was eligible for coverage under this section at that
9time or, if one or more members of the individual's family were eligible for coverage
10under this section at that time, family income did not exceed 150 percent of the
11poverty line or the individual qualified for a medical assistance eligibility extension
12as provided in sub. (4) (a) 7.

SB518,11,1815 49.471 (10) (a) Copayments. Except as provided in s. 49.45 (18) (am) 2. and (b)
162., all cost-sharing provisions under s. 49.45 (18) apply to a recipient with coverage
17of the benefits described in s. 49.46 (2) (a) and (b) to the same extent as they apply
18to a person eligible for medical assistance under s. 49.46, 49.468, or 49.47.

SB518,11,2020 49.471 (10) (b) 4. g. An individual described in sub. (4) (a) 7.

SB518,12,423 49.471 (10) (b) 5. If a recipient who is required to pay a premium under this
24paragraph or under sub. (2m) or (4) (c) either does not pay a premium when due or
25requests that his or her coverage under this section be terminated, the recipient's

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1coverage terminates and the recipient is not eligible for BadgerCare Plus for 6
2consecutive calendar months following the date on which the recipient's coverage
3terminated, except for any month during that 6-month period when the recipient's
4family income does not exceed 150 percent of the poverty line.

SB518,12,117 49.471 (12) (b) If the amendments to the state plan submitted under sub. (2)
8are approved and a waiver that is substantially consistent with all of the provisions
9of this section is granted and in effect, the department shall publish a notice in the
10Wisconsin Administrative Register that states the date on which BadgerCare Plus
11is implemented.